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AB1062 Telephone Contact between Patients and Rheumatology Department in A Private Healthcare System

Background Direct telephone communication is one way through which patients can reach their doctor; this is particularly useful for people with reduced mobility and with chronic diseases needing frequent advice. However, the volume of calls may mean that either the patient does not get the best out of this contact, or that staff do not have time to deal with calls adequately.1–3 In Cyprus there is a dual healthcare system, with traditional state hospitals on one hand, but a significant proportion of the country's healthcare is delivered privately. Unavoidably, there is more direct contact between patient and private practitioner and appointments are more often 'on demand'. To our knowledge, there has been no previous study analysing such telephone contact in Cyprus, something that would be especially interesting when patients have direct access to mobile telephone numbers and where they also use text messaging. Objectives To analyze landline, mobile phone contacts and text messaging between patients and a rheumatology department in order to help focus on areas of communication that need improvement or suggest a change in practice so as to use time and resources more efficiently. Methods The rheumatology department at Aretaeion Hospital Nicosia is a single-handed department with no specialist nurse. For eight consecutive days the following were recorded: frequency of calls to the receptionist, calls and texts to the rheumatologist, timing and duration of each call and the reason. The physician also noted whether the calls were urgent or routine. Results During the 8 days of data collection, 261 phone calls and 32 texts were received. Only 19 calls were urgent. The doctor received on average 18 phone calls per day on his personal mobile phone with a mean of 3 minutes and 19 seconds duration for each call. This implied roughly an hour per day of telephone consultations. Texts from patients ranged from updates regarding progress through to purely non-urgent ones. All texts had to be replied to by the doctor. 89% of the communication was via telephone calls and 11% via text. The doctor received 45% of the total number of telephone calls on his mobile phone while the receptionist received only 44% on the department landline. Adding the texts to the analysis shows that the doctor received 56% of the total communication, while the receptionist received only 44%. (Fig. 1) Conclusions The doctor received more calls than the receptionist spending a significant amount of time speaking on the phone. This time could have been better invested in face-to-face patient care and consultations. Reasons for the large proportion of phonecalls directly to the doctor should be studied. The huge usefulness of specialist nurses is emphasized here; a suitably trained nurse would be able to deal with a significant proportion of the calls, allowing for wiser resource allocation. References Bunn F, Byrne G, Kendall S. The effects of telephone consultation and triage on healthcare use and patient satisfaction: a systematic review. Br J Gen Pract 2005 Dec;55(521):956-961. Foster J, Jessopp L, Dale J. Concerns and confidence of general practitioners in providing telephone consultations. Br J Gen Pract 1999 Feb;49(439):111-113. Toon PD. Using telephones in primary care. BMJ 2002 May 25;324(7348):1230-1231. Disclosure of Interest None declared DOI 10.1136/annrheumdis-2014-eular.3515