Endocrine Abstracts

Background: Telemedicine use has increased rapidly during the COVID-19 pandemic, replacing many face-to-face (FTF) consultations. FTF consultations are associated with increased CO2 emissions (CO2em) from travel to clinics. This study evaluates the triple bottom line of children and young people’s (CYP) and parent or guardian experience of a new telemedicine service, estimated CO2em saving from reduced travel and cost saving to families.

Methods: Data were collected via telephone interview from CYP and their families, looked after by a single paediatric diabetes service and who had recently had a telemedicine consultation. Parents and young people were contacted by telephone after their telemedicine consultation and data regarding their experience collected via semi-structured interviews. An estimate of CO2em was calculated based on published average vehicle CO2em and distance travelled. Families were also asked to estimate how much a FTF appointment would have cost them in travel expenses including petrol and parking charges.

Results: 42 telephone interviews with CYP, age 6-18 years, and their families were conducted. 64% of interviewees described the video call quality as being just as good as FTF, with 36% describing it as satisfactory but not as good as FTF. Overall, 45% interviewed described preferring remote consultation, 26% expressing no preference and 29% preferring FTF consultation. 93% of interviewees reported that they would be happy to use remote consulting again. Average CO2em was calculated at 1.65 kg per clinic visit per patient for travel to F2F appointments. With an expected 4 clinic visits per patient per year this equates to 6.62 kg CO2 emitted via travel per patient year. Median reported cost saving from not coming to a F2F clinic was 9.40GBP.

Conclusions: A large reduction in CO2em is achieved in reducing travel to appointments. Remote consultation allows for lower CO2em per clinic review with good levels of patient satisfaction reported. Some aspects of FTF diabetes consultation such as HbA1c measurement are more challenging via telemedicine consultation, however wearable glucose monitoring devices may offer alternative measurements.