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Since the COVID-19 pandemic started, there have been changes in clinical practice to limit transmission, such as switching from face-to-face to remote consultations. We aimed to study the influence of technical factors on remote consultations in our experience during the pandemic. 12 clinicians completed data collection forms after consultations, recording the technology used (video vs phone); technical problems encountered; discharge or subsequent appointment status; and technical aspects of the consultation process using 0–10 numerical rating scales (NRS) (Time Adequate; Relevant History; Physical Exam; Management Plan; and Communication Quality). Data were collated on an MS Access 2016 database and transferred to SPSS version 25 for statistics. Of 285 forms valid for analysis, 48 (16.8%) had video consultations. Of 259 forms with technical problems data recorded, 48 (18.5%) had a technical problem. Video patients were significantly younger (mean 49.3 vs 61.3 years, p < 0.001), had higher scores on Physical Exam scale (mean 4.0 vs 2.6, p < 0.001), but had no significant difference on Management Plan scale (7.3 vs 7.2). Those with technical problems were more common among video consultations (33.3% vs 15.4%, p = 0.005), had lower scores on Time Adequate scale (7.7 vs 8.7, p < 0.001) and Communication Quality scale (7.1 vs 8.4, p < 0.001), but had no significant difference on Management Plan scale (7.3 vs 7.2). The strongest correlation of Management Plan scale was with Communication Quality scale (Rho = 0.64). Of the NRS, a 1-point reduction in scores on Management Plan scale was the strongest predictor of subsequent face-to-face appointment (Odds Ratio 1.88, 95% CI 1.58–2.24), and this remained an independent predictor in multivariate analysis (adjusted OR 1.90, 1.57–2.31). Having a technical problem was inversely associated with the outcome of a subsequent face-to-face appointment (OR 0.17, 0.04–0.74), and this remained significant after adjustment for Management Plan in multivariate analysis (adjusted OR 0.09, 0.12–0.54). Video patients were younger suggesting a preference for video amongst younger patients. Although technical problems were more common with video, having a video consultation or a technical problem had no significant impact on management plan. Scoring lower on the Management Plan scale was the strongest predictor of, and independently associated with, requesting a subsequent face-to-face appointment. The inverse relationship of technical problems with subsequent face-to-face appointment request will need validation in further studies.

Background/Aims Since the COVID-19 pandemic started, there have been changes in clinical practice to limit transmission, such as switching from face-to-face to remote consultations. Although there was some evidence of efficacy for remote consultations before the pandemic, the implications of a more widespread provision are unclear. We aimed to study the influence of technical factors on remote consultations in our experience during the pandemic. Methods Clinicians were asked to complete a data collection form after each remote consultation for information on technology used (video vs phone); technical problems encountered; discharge and subsequent appointment status; and technical aspects of the consultation itself using 11-point numerical rating scales (NRS) including Time Adequate, Relevant History, Physical Exam, Management Plan, and Communication Quality scales. Data were collated in a Microsoft Access 2010 database, and analysed in SPSS version 25. For dichotomous variables, Mann-Whitney U tests were used to compare means, and Chi-square tests to compare proportions. Spearman correlations were used to describe strength of association amongst NRS. Odds ratios were used to describe strengths of association of variables to subsequent appointment status. Results Of 285 forms valid for analysis, 48 (16.8%) had video consultations. 259 forms had technical problems data recorded, with 48 (18.5%) experiencing a technical problem. Video patients were significantly younger (mean 49.3 vs 61.3 years, P &lt; 0.001), had higher scores on Physical Exam scale (mean 4.0 vs 2.6, P &lt; 0.001), but had no significant difference on Management Plan scale (7.3 vs 7.2). Those with technical problems were more common among video than phone consultations (33.3% vs 15.4%, P = 0.005), had lower scores on Time Adequate scale (7.7 vs 8.7, P &lt; 0.001) and Communication Quality scale (7.1 vs 8.4, P &lt; 0.001), but had no significant difference on Management Plan scale (7.3 vs 7.2). The strongest correlations of Management Plan scale were with Communication Quality scale (R = 0.64, P &lt; 0.001), and Relevant History scale (R = 0.63, P &lt; 0.001). Of the NRS, a 1-point reduction in scores on Management Plan scale was the strongest predictor of subsequent face-to-face appointment request (Odds Ratio 1.88, 95% CI 1.58-2.24), and this remained an independent predictor in multivariate analysis (adjusted OR 1.90, 1.57-2.31). Conclusion Video patients were younger suggesting a preference for video over phone amongst younger patients. Although technical problems were more common with video than with phone consultations, having a video consultation or a technical problem had no significant impact on the management plan. However, scoring lower on the Management Plan scale was the strongest predictor of, and independently associated with requesting a subsequent face-to-face appointment. Further studies might help refine the selection of clinical contexts and technologies deployed to improve outcomes with remote consultations. Disclosure S. Vasireddy: None. S. Wig: None. M. Hannides: None.

Background/Aims The COVID19 pandemic significantly altered healthcare provision. Our department switched immediately to remote consultations without suspending service, including telephone and video consultations. In this analysis we aimed to explore the role of patient-related factors in influencing the process and outcome of remote consultations with a view to improving the quality of service provision. Methods A data collection form was developed and offered to all clinicians to complete after each remote consultation. Information on age, gender, new or follow up status and interpreter use were collected. Clinicians were asked to rate the effectiveness of specific components of the consultation process (time adequate, relevant history, physical examination, management plan and communication quality) as compared to the usual face to face appointments on Numerical Rating Scales (NRS, 0–0). Data were collated in a Microsoft Access database. Statistical analysis was performed using SPSS version 25. Results In total, 285 valid forms were evaluated. 193 (67.7%) were women. Patients registered for new appointments (n = 51, 18%) were significantly younger (mean±SD 52.9 ± 19.7 vs 60.6 ± 17.2 years, P = 0.012). There were no significant correlations with age or any significant differences with gender in mean scores of NRS. New patients scored lower on NRS for relevant history (8.0 ± 1.1 vs 8.9 ± 1.2, P&lt;0.001), management plan (4.8 ± 2.5 vs 7.8 ± 2.0, P&lt;0.001) and communication quality (6.6 ± 2.0 vs 8.4 ± 1.6, P&lt;0.001). Interpreter usage (n = 9, 3.4%) had lower scores for relevant history (7.1 ± 2.4 vs 8.8 ± 1.1, P = 0.012) and communication quality (5.4 ± 2.6 vs 8.1 ± 1.8, P = 0.002). There was no significant association of age or gender with subsequent follow up appointment requested as face-to-face or remote. New patients were significantly more likely than follow-up patients to be offered a face-to-face follow up appointment (univariate regression, odds ratio (OR) 5.49, 95% CI 2.7-11.1, P &lt; 0.001). However, once adjusted for management plan in multivariate regression, new patients were no longer significantly associated with subsequent follow up face-to-face appointment (adjusted OR 1.19, 0.48-2.92, P = 0.71). Conclusion Our study is one of the first in the UK to explore patient-specific factors influencing remote consultations in rheumatology. In our cohort, patient age or gender was not a limiting factor in utilising remote consultation. New consultations and interpreter use pose challenges for remote consultations, and further studies are needed to address these to see if any measures such as appropriate selection at triaging new appointments may be possible, to improve outcomes. Disclosure M. Hannides: None. S. Wig: None. S. Vasireddy: None.