Background: Straight to test (STT) is a recognised pathway for improving the two week waiting time targets for red flag referrals.2,4-6 However STT relies on Telephone Assessment Clinics (TAC) by clinicians or specialist nurse practitioners when determining suitability of referred patients for investigations.4-7 Electronic patient care records (ECR) provide clinicians with a greater volume of clinical information allowing virtual triage and STT with a reduced dependence on TAC therefore improving waiting time for tests and treatment. Methods: A retrospective review of 300 colorectal referrals was performed. Patients awaiting an appointment were reviewed electronically, using ECR, by a single colorectal surgeon and re-triaged STT if appropriate. The delay in time from the referral to initial review was removed to create a second group for statistical comparison to demonstrate time saved if the strategy was adopted at point of original triage. Data was analyzed using SPSS. Results: 300 colorectal referrals were reviewed between February 5th 2018 and July 22nd 2019. 91.3% (n= 274) were red flag, 7% (n= 21) urgent and 1.7% (n=5) routine. 94% (n=282) were sent straight to test. Red flag patients processed via traditional referral and clinic had a median time to scope of 36 days (IQR = 55 days) compared with 22.5 days (IQR = 19.75 days), p < 0.001 if triaged straight to test via virtual clinic. Median time to management for red flag patients was 59 days (IQR = 63.5 days) for traditional and 35 days (IQR 51.5 days) for STT, p < 0.001. 71.7% of patients (n=215) required no follow up clinic appointment. Conclusion: Straight to test using ECR is a safe and effective means of triage and is a useful tool when incorporating STT access for colorectal referrals in order to reduce waiting times for tests and treatments.