What is Rapid Access Endoscopy?

What is Rapid Access Endoscopy?
RAE is a process whereby the patient is able to access endoscopy without the need for a specialist consultation prior. It is also commonly known as Direct Access Endoscopy or Open Access Endoscopy.
Each hospital and doctor runs their RAE program slightly differently, so it is worth asking some questions when inquiring after which program is best suited to you.
The American Society for Gastrointestinal Endoscopy recommended in 2015 that RAE can be safely used if pre-procedure assessment, informed consent, information transfer, patient safety and satisfaction are addressed in all cases.

What types of procedures are eligible for Rapid Access Endoscopy?
Generally, diagnostic gastroscopy and colonoscopy are best suited to RAE. So for example, if you’ve been experiencing some heartburn that doesn’t settle with regular antacids, you may need a gastroscopy; or if you have a positive Faecal Occult Blood Test (FOBT), then you may need to have a colonoscopy. Other examples of situations where patients may be eligible for RAE would include patients with a history of previous colon polyps and are due for routine surveillance, or also patients with a family history of either bowel cancer or colon polyps.
Procedures that are not best suited to RAE include advanced or interventional endoscopy procedures, such as ERCP, which generally require a more detailed discussion with a specialist prior to procedure. These more advanced procedures may involve greater risk to the patient and a thorough discussion of the potential benefits, risks and alternatives needs to be undertaken.

Who is the best candidate for this procedure?
From a clinical perspective, the ideal candidate is a patient with no significant medical problems who requires a diagnostic Gastroscopy or Colonoscopy. For example, a healthy 50 year-old with a positive faecal occult blood test through the National Bowel Cancer Screening Program (NBCSP). Typically these patients are otherwise completely healthy and are not taking regular medications.
Patients with past medical issues may still be eligible for RAE after a careful review of their medical history and medications. Important conditions that would need to be taken into consideration would be heart conditions, respiratory illness or liver or kidney disease. It is important for the specialist to know if a patient is on any blood thinning medications or if they have diabetes and are on medications such as insulin. Other relevant information would include any previous drug reactions or problems with anaesthetics; likewise, it is important for the specialist to know if the patient has had a complicated procedure in the past, such as a difficult colonoscopy or a poor result from the bowel preparation. Such issues may be best dealt with a consultation prior to scheduling a procedure in order to obtain the best outcome.

What are the benefits of Rapid Access Endoscopy?
RAE facilitates timely access to healthcare. This means that a patient can be scheduled for a procedure without needing to wait for a specialist consultation appointment to schedule their endoscopy. Patients don’t need to take time off work or take time away from their busy lives to attend a specialist appointment to schedule their endoscopy procedure.
Also, timely access to healthcare is a significant issue and RAE helps to begin to address that issue. For example, a patient does not need to wait 4-6 weeks to get in to see a specialist to schedule the procedure. In some cases, wait times to see a specialist may be much longer, particularly in regional centres. If you are worried, 6 weeks can be a long time to wait to find out if you have bowel cancer and that’s even before your procedure is scheduled.

Why choose Rapid Access?
RAE allows timely access to healthcare and may suit many patients for a number of personal or clinical reasons. But if you have concerns about your health, or questions regarding the procedure, then these may be best dealt with in a consultation with your specialist. As a point of reassurance, RAE is offered to enhance the access to healthcare and provide an alternative pathway for care; it may not suit everyone. Patients should always discuss the best pathway for them with their GP or specialist.

Do you need a referral from a GP?
Strictly speaking, a GP referral is not required; however, in general, it is advisable to first see your GP as they know your medical history and medications. They are also able to advise you if an endoscopy procedure is indicated for your particular situation.
Also, Medicare/DVA and the health funds will only rebate with a valid referral.