Abstract
Background: The global rise in chronic diseases has created immense pressure on healthcare systems, necessitating innovative solutions to meet the growing demand for care. Healthcare systems are also grappling with environmental challenges, and there is an urgent need to reduce their carbon footprint. Leveraging technology to create alternative care pathways offers an opportunity to address these issues, especially in the context of climate change. Integrated care, which emphasizes coordination across health services, is key to building resilient healthcare systems. This paper explores the early implementation of two virtual care pathways for General Practitioners (GPs) to access specialist consultant advice, aiming to improve chronic disease management and support sustainable healthcare practices aligned with global climate action goals.
Approach: This review focuses on two virtual care pathways: (A) GP-to-Consultant Heart Virtual Clinics (HVC) and (B) GP-to-Consultant e-advisory services. These pathways were developed to reduce the need for in-person consultations, minimize patient travel, and alleviate pressure on outpatient departments (OPD). The initial rollout at an early adopter site provided valuable insights, which were used to create implementation guides for broader use. In early 2024, these guides were shared with integrated chronic disease teams across regions, and data on e-referrals, referral activity, and patient outcomes were collected from new sites to assess the impact of these pathways on chronic disease management.
Results: Between January and August 2024, seven healthcare sites implemented Heart Virtual Clinics, resulting in 287 new case referrals and 251 virtual consultations. Two additional sites adopted the GP-to-consultant e-advisory pathway, generating 138 new referrals and 133 case contacts. These results suggest that GPs are increasingly using these virtual pathways to seek specialist advice. Notably, when given the option between traditional OPD referrals and virtual pathways, over 25% of GPs chose the virtual route, indicating a preference for more sustainable care models. This suggests that these virtual pathways have the potential to reduce unnecessary in-person visits, easing the strain on healthcare systems and contributing to sustainability goals.
Implications: The early data underscore key implications for healthcare sustainability and climate action. Virtual pathways can reduce in-person OPD visits, alleviating system congestion and lowering carbon emissions from patient travel—an important contribution to SDG 13 on climate action. These pathways also align with SDG 11, which promotes inclusive, resilient, and sustainable cities. Additionally, virtual care supports integrated care by fostering collaboration between GPs, specialists, and patients, leading to more efficient and patient-centered care. However, scaling these pathways presents challenges, including gaps in technological infrastructure, clinician training, and regulatory barriers. Addressing these obstacles is essential to fully realize the potential of virtual care models for sustainable healthcare delivery.
Conclusion: In conclusion, technology-driven virtual care pathways offer a promising solution for improving chronic disease management while promoting sustainable healthcare systems.