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272 Background: MSK is deploying teleoncology solutions that improve the patient experience, quality of care, and enhance patient access. MSK’s teleoncology mission is to utilize digital technology as a mainstream channel for connected care across the cancer continuum. Methods: Teleoncology programs were established between Manhattan and four regional sites in support of Psychiatry, Genetic Counseling, and Supportive Care. MSK’s “Virtual Programs” delivered tele-education and tele-support to patients and caregivers in their home or place of work to prepare them for each stage of their care. Patient acceptability ratings were evaluated for quality of care, ease of use, interaction quality, and satisfaction and future use. Results: The four programs generated 7563 teleoncology visits. Virtual Programs served 3865 patients over 766 sessions. Fifty-eight percent (N = 2269) of patients participated in group education sessions (8.3±1.2 patients per session), while 41.3% (N = 1596) participated in support groups (3.2±0.3 patients per session). Overall, 60% of Virtual Program sessions were delivered to patients at home, and 20% to patients at work. Tele-genetics counseling was provided to 3516 patients. The majority of tele-genetics sessions occurred at regional sites (61.4%). Thirty-eight patients completed 159 telepsychiatry visits (4.2±5.8 visits/patient). In Supportive Care, 23 patients completed 38 visits (1.6±1.4 visits/patient). Patients saved 95 minutes of travel time per teleoncology visit. Acceptability ratings for teleoncology were collected from 1185 patients (15.7%). Ninety-one percent of patients were satisfied or extremely satisfied with their teleoncology experience, 95.6% with the information they received, 94.4% with the skill of the provider, and 86.3% with the ease of use of the teleoncology platform. Conclusions: Teleoncology offers an innovative means of providing cancer care to patients by decreasing the stress of travel, missed work, and caregiver requirements. Patients reported that teleoncology made care more accessible and allowed them to remain in their community with family support. For clinicians, teleoncology expanded patient outreach, and improved patient adherence.

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BackgroundThe NHS is facing unprecedented pressure to provide care with an ever decreasing budget. Inspired by the Choosing wisely initiative and a recent document by the Academy of Medical Royal Colleges, which have documented positive changes in improving patient care by highlighting areas of overdiagnosis and overtreatment.MethodsA workgroup of junior and middle grade doctors and an operational manager identified common presentations to the paediatric ED. Seven presentations were chosen and the most common diagnostic tests ordered listed, which were compared to national guidelines. The cost of all of the tests were sought and the difference calculated.ResultsThe chosen presentations to the paediatric ED with proposed changes are: pneumonia, bronchiolitis, gastroenteritis, cellulitis, asthma, febrile convulsions and ankle/knee injuries. Spot check initial results showed significant potential cost savings without compromising best patient centred care. There would also have been a significant reduction in potential pain and discomfort to the patient and a reduction in unnecessary radiation exposure.ConclusionsBetter patient care can be achieved by following national guidelines more strictly, with the added benefits of less waste and cost savings. We have calculated as a conservative estimate, that if our department reduced only 30% of the identified unnecessary tests, a saving of £20,000 per annum could be achieved.