Video consultations in reproductive medicine: Safety, feasibility and patient satisfaction.

OBJECTIVE: To study the safety and feasibility of virtual consultations in reproductive medicine. DESIGN: This was a descriptive cross-sectional study involving subfertile patients attending a video consultation between September 2021 and August 2022. Clinicians conducting virtual consultations during the same period responded to a parallel survey for healthcare professionals. SETTING: University Hospital in Manchester, UK. PARTICIPANTS: Subfertile patients attending a virtual consultation. Healthcare professionals conducting virtual consultations. INTERVENTION: The survey link was offered in 4,932 consultations. A total of 577 (11.69%) patients responded and 510 completed the questionnaire (88.3%). MAIN OUTCOME MEASURES: Patient satisfaction measured as the percentage of patients preferring virtual to in person consultations. RESULTS: The majority of the patients (475, 91.70%) had a positive experience with the video consultation and just under half of the patients (152, 48.65%) preferred a video consultation to an in person consultation due to cost and time savings. Most patients (375, 72.68%) felt safer and less exposed to COVID-19. When the risk of COVID-19 subsides, 242 patients (47%) would still prefer to attend video consultations, while 169 (32.82%) had no preference. Analysis of the responses from patients reporting a negative experience identified technical problems as a possible cause. The virtual consultations appeared to be suitable for patients with disabilities. The clinicians' survey identified potential legal and ethical concerns. CONCLUSION: Virtual consultations are a safe and feasible alternative to in person consultations for subfertile patients. This large cross-sectional study revealed a high rate of patient satisfaction. Appropriate patient selection accounting for IT literacy, English language understanding and preference is crucial for successful virtual consultations. Further consideration should be given to ethical and legal challenges of virtual consultations. TRIAL REGISTRATION: Research Registry, UIN 6912, https://www.researchregistry.com/browse-the-registry.

Modern considerations for perioperative care in gynaecology

Modern lifestyle has led to an increased number of surgical patients having comorbidities, often related to increased perioperative morbidity and mortality. Early recognition of risk factors and preoperative optimization can improve outcomes. The continuous trend of minimal access procedures in gynaecology and the application of enhanced recovery programmes have improved clinical and cost effectiveness. More recently, perioperative medicine has faced the challenges of the COVID-19 pandemic, requiring policies to reduce inpatient transmission. National and global organisations, as the National Institute for Health and Care Excellence (NICE), the World Health Organization (WHO), the Centre for the Perioperative Care (CPOC) and the Enhanced Recovery after Surgery Society (ERAS), are producing guidance, promoting knowledge, understanding and research regarding optimal perioperative care. In this review we summarize the current evidence and discuss applications in modern gynaecology.