Abstract
Purpose :
Emergency eye care is often limited by insufficient access to resources, remote location and few available ophthalmologists. Though studies have demonstrated high diagnostic efficiency and patient satisfaction in clinical settings, teleophthalmology is not yet the standard of care. We characterized the need for teleophthalmology through a cross-sectional telephone survey ofFlorida emergency departments (EDs) to assess for ophthalmology on-call coverage and perceived value of teleophthalmology by ED nurse managers and physicians.
Methods :
All EDs in Florida were contacted (n=209). Inclusion criteria included being an ED nurse manager or ED physician. There were no exclusion criteria. Telephone surveys were administered from March 2017 to March 2018. Individuals were asked about currently available resources, as well as experiences with and perceptions of teleophthalmology in the ED.
Results :
Of the 209 EDs contacted, 96/209 (45.9%) providers participated in the survey. 31.3% of surveys were answered by physicians (n=30) and 68.8% were answered by nurse managers (n=66). Rural hospitals and non-rural hospitals comprised 12.4% and 87.6% of respondents, respectively. The majority of providers (95.8%) had never used tele-ophthalmology services. The average distance from ED to closest ophthalmology referral service was 40.0 miles for rural and 13.9 miles for nonrural sites. No on-call ophthalmologist was available in 92.9% and 39.2% of rural and non-rural EDs, respectively. On a 1 to 5 scale (5 being very high), perceived value for full remote consult ranked high or very high at 92.8% and 69.6% of rural and nonrural EDs, respectively.
Conclusions :
Rural EDs reported further distance to referral sites and fewer on-call ophthalmologists than non-rural EDs in Florida. Both rural and non-rural EDs survey responses indicated substantial interest in teleophthalmology services. Compared to a recent study of California EDs by Wedekind L, et al., medical providers at rural Florida EDs reported greater overall perceived value of teleophthalmology, further distance to the nearest referral centers and less after-hours ophthalmology coverage.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.