Abstract
Purpose :
There is a steady rise in the number of patients presenting to emergency departments in the United Kingdom with no commensurate rise in the number of clinicians or resources. In this paper, we analyse the usefulness of tele-ophthalmology as a new way of working to improve screening and reduce waiting times, offering real-time expert opinion and feedback, facillitating more effective teaching.
Methods :
This study was undertaken over the period of September 2017 to November 2018 and involved 3 main hospital sites in the Falkirk area of Scotland. There were three phases.
In the first phase we conducted an audit over a 2 week period of the eye casualty looking at the source of referral, diagnosis and outcome for 216 patient notes. spss?
The second phase focused on the set up of the tele-phthalmology system. We designed and 3D printed an adapter for a tablet device (Apple iPad) and fitted this to the A&E slit-lamp. Calls were made to the ophthalmologist via the iPad using Skype for business conference calling.
This system was then trialled in the third phase and users’ satisfaction were evaluated using questionnaires developed by the research team.There were a total of 20 participants.These questionnaires included a combination of closed and open-ended questions, Likert scales and semantic differential scales. Participation was voluntary with the option to opt out at any point. No patient identifiable information was collected. Questionnaires were completed and placed in a pre-labelled envelope which was subsequently sent to a lone analyser for evaluation.
Results :
All clinician respondents (14/14) judged this acute tele-ophthalmology modality to positively alter decision making/follow-up arrangements for acute eye presentations to the Emergency Department. All Patient respondents and Clinician respondents were satisfied with tele-ophthalmology modality as a referral system. >50% tele-ophthalmology consultations were judged to obviate a secondary care clinic appointment.
Conclusions :
Our results suggest that the current tele-ophthalmology system on trial may reduce the number of patients seen unnecessarily within secondary care, and could potentially reduce Falkirk’s annual expenditure without reducing the high level of care currently afforded to its patients. This modality appears to be highly acceptable to patients and clinicians.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.