Abstract
Purpose :
Ophthalmologic telemedicine is a rapidly expanding field that leverages communication technologies to increase efficiency and patient access to care. Care1 is a tele-glaucoma program operating in Canada that uses a collaborative model to manage glaucoma patients in conjunction with optometrists. Optometrists performed in-person exams and glaucoma testing in their respective offices and uploaded patient data to the Care1 software. Participating ophthalmologists reviewed the patients’ charts and provided management recommendations. We performed a quality assessment and quality assurance (QA/QI) study looking at the efficacy of this model.
Methods :
The Care1 database was queried for all patients seen from February 2016 to March 2017 (14 months). A total of 7,366 unique patients were identified. Of those patients, 4,070 patients were diagnosed with either glaucoma or glaucoma suspect and were included in the study. Data collected included demographics, ocular vitals, and cup-to-disc measurements.
Results :
A total of 4,070 patients with an average age of 57.8 years, range 6-100 years, were identified who were seen across 11 Care1 optometry clinics. Encounters occurred in both urban (74.2%) and rural (25.8%) settings. The most common diagnosis included glaucoma suspect (89%) and primary open angle glaucoma (8.1%). The ophthalmologist cup-to-disc estimate based on stereoscopic fundus photos differed from the in-person optometrist exam by >0.2 in only 3.8% of eyes. An in-person ophthalmologist exam was recommended in 1.9% of cases.
Conclusions :
Care1 shows that tele-glaucoma is a feasible means of managing low-acuity patients. The shared-care model allows ophthalmology to successfully provide specialty care to rural and urban patients closer to their home.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.