Virtual outreach consultations across video conference links save time and money for patients but incur greater costs for the NHS than standard outpatient appointments, according to an economic evaluation published in the BMJ .
In their discussion of the evaluation and conclusions, however, the researchers speculate that changes in the costs of technology and the more widespread routine availability of equipment and services purchased specially for the trial may improve the relative economic position of virtual consultation in the future.
They also point out that the main results from the trial, published last year in the Lancet, showed that some specialties appear to be more appropriate for virtual outreach consultation than others. In the economic evaluation, orthopaedics stood out as a markedly more expensive specialty for virtual outreach, while urology was actually less expensive.
The trial’s model for virtual consultation included having the patient’s GP present during the consultation – something that does not happen in a conventional outpatient appointment.
The researchers comment: “Virtual consultations might also be delivered more cost effectively along more conventional lines, without the presence of a general practitioner. However, further research would be needed to investigate this, as it is not possible to extrapolate the outcomes of this study to such a mode of consultation.”
The evaluation was carried out after a major randomised controlled trial of virtual consultations in London and Shrewsbury involving 3170 patients. It found that virtual consultations cost £724 per patient while conventional outpatient appointments were £625 per patient – a difference of £108. Patients saved on average £19 in costs and loss of productive time. The researchers conclude that adoption of virtual outreach cannot be justified on economic grounds