[AVBC 2025] Redesigning Fatty Liver Care
Care Continuum
Care Process & Redesign
Appropriate & Value-based Care Conference
National University Health System
10 November 2025
Reduce the number of encounters required for evaluation and management of steatotic liver disease (SLD) to the specialist. Virtual triage with frontloaded Fibroscan reduced unnecessary SOC visits for fatty liver referrals, enhancing patient experience and.
Year Submitted: 2025
Published Date: 10 November 2025
Tags: Care Continuum, Care Process ＆ Redesign, Quality Improvement, Workflow Redesign, Productivity, Cost Saving, Time Saving, Operational Management, Resource Allocation, Access To Care, Referral Rate, Specialist Outpatient Care
About this Content
Aims
Reduce the number of encounters required for evaluation and management of steatotic liver disease (SLD) to the specialist outpatient clinic (SOC) at Alexandra Hospital (AH).
Background
The rising incidence of steatotic liver disease (SLD) has led to an increase in referrals to specialist outpatient clinics. Following Fib-4 stratification, indeterminate and high-risk patients are typically evaluated with a Fibroscan (transient elastography). Many of these patients eventually test low-risk (kPa 8) and can be managed in primary care with lifestyle advice, without specialist follow-up.
Methods
A 'fatty liver pathway' was introduced to streamline referral workflows. All referrals to AH were virtually triaged, and suitable patients had a Fibroscan arranged before or on the same day as their first SOC appointment. Those with low-risk Fibroscan results were discharged directly to primary care during the first visit.
Results
Over five months, AH received 283 referrals. 205/283 (72.4%) patients were included in the pathway. 155/205 (75.6%) of patients in the pathway underwent a pre-appointment Fibroscan, of which 111/155 (71.6%) of patients tested low-risk, and 82/155 (52.9%) were discharged on first visit. 82/205 (40%) of patients included in the pathways saved an SOC encounter through this pathway.
Conclusion
Virtual triage with frontloaded Fibroscan reduced unnecessary SOC visits for fatty liver referrals, enhancing patient experience and optimizing clinic resources
Lessons Learnt
The implementation of virtual triage and frontloaded Fibroscan can effectively reduce unnecessary SOC visits and optimize clinic resources.
Keywords
Fibroscan, SOC, primary care, fatty liver, virtual triage
Innovators' Details
Innovators' Details
Healthcare Cluster(s) | National University Health System |
Organization(s) Involved | Alexandra Hospital |
Platform(s) | Appropriate & Value-based Care Conference |
Healthcare Professional Group(s) | Medical |
Applicable Specialty or Discipline | Gastroenterology |
Project Lead(s) | Wang Zhemin |
Project Member(s) | Readon Teh |
Connect with this contributor!
Wang Zhemin - zhemin_wang@nuhs.edu.sg