# Virtual Clinics in Cardiology: Do They Provide Equivalent Care and Reduce Travel?

## TL;DR

Virtual cardiology clinics provide care as effective as in-person visits but only slightly reduce travel and carbon emissions.

## Contribution

Demonstrates equivalence in care quality between virtual and face-to-face cardiology clinics with quantified travel reduction.

## Key findings

- Virtual appointments had no statistical difference in investigations or visits compared to face-to-face.
- Virtual clinics reduced travel by 5002 km and carbon emissions by 784 kgCO2eq for initial appointments.
- Care quality and clinical effectiveness were comparable between virtual and in-person appointments.

## Abstract

Objective: To evaluate whether virtual clinic appointments in cardiology are equivalent to face-to-face appointments in terms of investigations as a consequence of the appointment and a reduction in travel for the whole care episode. Design: Retrospective observational cohort study of 9445 patients. Setting: Wrightington, Wigan and Leigh Teaching Hospitals NHS Foundation Trust, a medium-sized NHS trust in the north-west of England. Participants: 9445 patients referred for new cardiology appointments between 2023 and 2025. Methods: Data were extracted from electronic records and test ordering systems and appointments with corresponding investigations were retrieved. The data was validated using random samples, and the extraction was modified until accuracy was achieved. Principle component analysis was used to compare groups, and Welch t-test was used to statistically analyse the results. Distance travelled was calculated using postcodes and the number of visits was calculated using investigations conducted on separate days. Results: Patients who had virtual appointments showed no statistical difference in the number of investigations or visits for investigations. The care provided via virtual and face-to-face appointments was found to be comparable in terms of clinical effectiveness and quality of care. The distance travelled for both types of appointment is therefore not different, but if the initial appointment is taken into consideration where there was no travel for the virtual appointment patients, then the reduction in miles travelled is 5002 km, resulting in a carbon saving of 784 kgCO2eq. Conclusions: Virtual Clinics in Cardiology offer an equitable service but only a small reduction in travel.