Virtual clinics versus face-to-face review: Is the benefit the same for new orthopaedic patients?

Background: COVID-19 shocked global healthcare systems, particularly the surgical services, resulting in a significant backlog of patients with waiting times not expected to return to pre-pandemic levels until 2025. The Royal College of Surgeons has recommended a wider use of virtual clinics to meet the increased demand. The efficacy of virtual follow up is well documented in the literature; however, there is very little evidence of the role of virtual clinics in the assessment of new elective patients.

Methods: Observational study comparing clinical outcomes of new patients electively referred to orthopaedic virtual clinics between January and February 2021 with face-to-face clinics in January and February 2020.

Results: Over the equivalent time frame, more patients were reviewed in virtual clinics compared to traditional face-to-face (821 vs 499). However, virtual clinics lead to significantly more patients being brought back for follow up (78.3% vs 37.3%) and fewer patients received outcomes that progressed their journey towards a definitive intervention or discharge.

Conclusion: The overall benefit of virtual clinic appointments in the context of reviewing new patients remains to be proven. Despite increasing use of virtual clinics in the National Health Service, we have shown a potential delay to patients' clinical progression, ultimately delaying healthcare delivery. Potential methods to improve the benefit of virtual clinics are proposed.