AB099. SOH25_AB_222. Digitally-enabled patient-initiated review

Background: Routine follow-up of chronic disease patients constitutes a significant proportion of a typical outpatient review clinic, with many patients routinely being recalled at set intervals. Patient-initiated review (PIR) is an emerging system that allows patients to schedule their outpatient review when necessary and timely. There is a risk that some patients might be lost to follow-up in this system, and so digital enablement may act as a safety net to catch at-risk patients.

Methods: A narrative review of the literature was performed using Medline, EMBASE, CINAHL and the Cochrane databases looking at the efficacy and safety of PIR. Search terms included patient-initiated review/follow-up and digital health technologies. HSE and National Health Service (NHS) guidelines were reviewed.

Results: PIR empowers patients to manage follow-up based on their perceived need and symptoms rather than with routine appointments. Current pathways are primarily telephone-based, with few centres utilising smartphone-based applications. In rheumatoid arthritis and inflammatory bowel disease, PIR has been shown to have no adverse effect on outcomes and reduced outpatient attendance by 30%. Digitalisation of PIR and enabling communication between the platform and hospital-based electronic patient records (EPRs) can allow for active and passive triggers to for clinical review, reducing anxiety related to the reduced direct oversight.

Conclusions: PIR offers a promising approach to outpatient care by shifting routine management to the community while ensuring timely clinical review when needed. Digitally-enabled PIR enhances efficiency through streamlined communication, integration with electronic records, and automated triggers for clinician review, potentially ensuring better safety and efficiency of the system.

Keywords: Chronic disease management; digital transformation; electronic patient record (EPR); outpatient follow-up; patient-initiated review