PWE-181 Quantitative Assessment Of Global Small Bowel Motility In Chronic Intestinal Pseudo-obstruction And Controls: A Preliminary Study

Abstract

IntroductionOutpatient visits to secondary care are costly to Primary Care (PC), time consuming for patients and not always appropriate. Our Trust having been a pioneer in nephrology e-Consultation (eC), we started a hepatology eC service in March 2012. This allows patients' records to be shared between PC and secondary care (SC) without the need for a detailed referral letter. Our aims were to analyse our initial experience and perform a cost analysis of hepatology eC. MethodsRetrospective analysis of eC between Mar 12- Oct 13 using SystmOne. Tariffs used for cost analysis: new patient (NP) referral {pound}181, follow up (FU) {pound}103, eC {pound}24. ResultsIn 18 months there were 81 eC (31M/50F mean age 52/56 y), each taking 10-15 min to complete. The median response time was 2 days (43% within 1 day). Referral reasons: isolated raised bilirubin/ALT/ALP/GGT: 44/81 (54%), mixed raised LFT's: 16/81 (20%), abnormal radiology 10%, hyperferritinaemia 9%, HBV/HCV 4%, general advice 2%. There was one inappropriate referral. In 18 cases, SC referral was recommended (22%), with 10/18 being referred and seen. The mean number of FU appointments was 3. Total cost to PC was {pound}8,114: eC {pound}1,944 and {pound}6,170 for subsequent referrals. A minimum cost saving of {pound}14,890 was made (81 NP ({pound}14,661) and assuming one FU for each ({pound}8,343)). ConclusioneC is a rapid, cost-effective method of providing hepatology advice. Hidden costs including consultant time, clinic costs etc are difficult to quantify. We would, however, recommend eC as the way forward with a more appropriate tariff. Disclosure of InterestNone Declared.