Table 1.

Points to Consider for Effective Virtual Clinics; a Consensus View Based on the Experience of All Members of the Working Group

Redesign of Invitation-To-Appointment Letters	Patient Outcome Letters	Patient Information Leaflets	Nurse/Technician Triage for Comorbidities in Virtual Data Collection Clinics	Clarification of Management Practice and Key Performance Indicators
Explain to patients that an update of diagnosis may not be given on the date of attendance at a virtual clinic - specialists will review the data and then plan the next appointment.	May facilitate service tariffs (ie claiming reimbursement for virtual assessments). Outcome letters reassure patients with low-grade pathology that an urgent review is not needed. For example, patients that have been referred as fast-track nAMD but who actually have a low-grade epiretinal membrane (ERM), can be booked routinely into VR clinics.	Traditionally given out at baseline in most patient pathways. Patients in virtual clinics may have less time to ask questions and have reduced access to senior staff members. So patient information leaflets may need distributing frequently later on in the pathway. Patients need to understand the virtual clinic is no less rigorous than a face to face visit, Consider using a different term to describe these clinics eg Digital Assessment.	Helps to pick up problems that could impact on treatment, such as recent cerebrovascular accident (CVA) or ocular infection. Consider compiling a list of FAQs for nurses in these clinics. EPR can facilitate this if available. For example, symptoms of a recent CVA, signs and symptoms of conjunctivitis.	Virtual clinic staff are often re-deployed to face-to-face services to cover sick leave or peaks in activity. Consider protecting staff against this with a formal policy that might include locally agreed internal key performance indicators (KPIs) for virtual review timings. For example, 48 hours for data review from a virtual clinic event in order to protect reviewing staff.