June 2020
Volume 61, Issue 7
Free
ARVO Annual Meeting Abstract  |   June 2020
Clinical flow of patients referred from the UK national diabetes eye screening programme through a pathway with virtual clinics
Author Affiliations & Notes
  • Dun Jack Fu
    Moorfields Eye Hospital, London, United Kingdom
  • Livia Faes
    Moorfields Eye Hospital, London, United Kingdom
  • Josef Huemer
    Moorfields Eye Hospital, London, United Kingdom
  • Christoph Kern
    Moorfields Eye Hospital, London, United Kingdom
  • Amanda Charnley
    Moorfields Eye Hospital, London, United Kingdom
  • Sandro Fasolo
    Moorfields Eye Hospital, London, United Kingdom
  • Pearse Keane
    Moorfields Eye Hospital, London, United Kingdom
  • Dawn A Sim
    Moorfields Eye Hospital, London, United Kingdom
  • Footnotes
    Commercial Relationships   Dun Jack Fu, None; Livia Faes, None; Josef Huemer, None; Christoph Kern, None; Amanda Charnley, None; Sandro Fasolo, None; Pearse Keane, Allergan (F), Bayer (F), Carl Zeiss Meditec (F), Haag-Streit (F), Heidelberg Engineering (F), Novartis (F), Topcon (F); Dawn Sim, Allergan (F), Bayer (F), Big Picture Eye Health (C), Haag-Streit (F), Novartis (F)
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2020, Vol.61, 4230. doi:
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      Dun Jack Fu, Livia Faes, Josef Huemer, Christoph Kern, Amanda Charnley, Sandro Fasolo, Pearse Keane, Dawn A Sim; Clinical flow of patients referred from the UK national diabetes eye screening programme through a pathway with virtual clinics. Invest. Ophthalmol. Vis. Sci. 2020;61(7):4230.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : To evaluate the clinical features, assessment, and waiting times of diabetic patients participating in the UK national diabetic eye screening program (DES) when referred to hospital eye services (HES) and are met with either a face-to-face (F2F) or virtual medical retina consultation (VMRC).

Methods : A retrospective cohort study new DES referrals that attended an initial clinical consultation at Moorfields Eye Hospital, NHS Foundation Trust, London, UK between January 2015 and December 2018, either in a F2F or in a VMRC setting. The primary study outcome is the proportion of patients in this cohort that meet current guidelines for triage into VMRC. Secondary outcomes are: rate of attendance for F2F and VMRC settings; mean time from receiving DES referral to first appointment; mean time from referral discharge decision; and mean time from referral treatment (laser and intravitreal anti-VEGF).

Results :
Of all 12563 patients included in this study, 8833 (70.7%) met initial triage criteria for VMRC, and 2306 of these patients were referred to VMRC. Of the other 10,257 patients seen in a F2F setting, initial assessment confirmed that 6287 of 8803 (71.4%) met VMRC criteria. For routine appointments, mean time from referral to initial appointment for VMRC was 66.9 days (SD 35.9 days) and 80.9 days (SD 44.4 days) for the F2F clinics. Mean time from referral to discharge was 71.7 days (SD 30.8 days) for VMRC and 86.3 days (SD 37.0 days) for F2F clinics. Moreover, our observations suggest no difference in time-to-treatment in the sub-cohort that require treatment. The attendance rate of VMRC assessments was non-inferior to F2F.

Conclusions : To date, this is the largest single-centre cohort study comparing F2F and virtual assessments of DES-to-HES referrals. Applying current triage guidelines, a significant proportion of diabetic eye screening patients initially seen in F2F could be substituted with a virtual consultation. A shorter mean time from referral to discharge observed in the virtual setting means that patients who do not need management or monitoring in tertiary services could reduce their time spent in HES. Collectively, our analyses suggest that virtual consultation are a faster and clinically appropriate alternative for a substantial proportion of DES referrals initially seen F2F.

This is a 2020 ARVO Annual Meeting abstract.

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