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Ann Murchison, Jurij R Bilyk; Feasibility of Ophthalmic telemedicine Consultation in Urgent Settings (FOCUS). Invest. Ophthalmol. Vis. Sci. 2021;62(8):2673.
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Ophthalmologist are not always available for on-site consultation in emergency departments. We performed a prospective, double-masked pilot study to determine the feasibility for an ophthalmologist to provide triage consultation virtually.
This study used a convenience sample of adult patients from an eye emergency department. Ophthalmic telemedicine consultation was provided by an ophthalmology attending physician (OAP) using a synchronous telehealth interface and in-person consultation was provided by second OAP. The remainder of the visit followed usual care. The primary outcomes were feasibility and urgency of recommended in-person ophthalmic examination. Feasibility was measured as the ability to enroll patients and transmit the necessary audiovisual information. Urgency of recommended full ophthalmic examination was collected from both the in-person and virtual ophthalmic triage providers. The secondary outcome was time to perform ophthalmic consultation. An exploratory outcome was concordance of triage-based diagnoses between the in-person and telehealth OAPs. Descriptive statistics were used for evaluation.
This pilot study enrolled 31 of 33 (93.9%) patients. The majority (74.2%) were female and the median age was 57 years (range 24-86; mean 54.2). The majority of patients identified as African American (48.4%) followed by Caucasian (45.2%). There were no dropped calls or audiovisual problems reported with the telemedicine interface. The recommended urgency of in-person full examination between the in-person and telemedicine consultation was concordant 90.3% of the time. The duration range of the consultation was 1.5-6 minutes via telemedicine and 2-7 minutes in person with a mean of 2.5 and 2.7 minutes, respectively. The exploratory outcome of diagnostic concordance was 93.5%.
Telemedicine emergency ophthalmic consultation appear to be feasible, with good patient acceptance and ability to obtain necessary audio and visual data. The duration of the visits was similar for in person and telemedicine consultations, supporting the potential feasibility. The diagnostic concordance was high between both the telemedicine and in person ophthalmic consultation compared to the full ophthalmic evaluation. More data on this approach in general emergency room settings would be useful to aid in expediting urgent ophthalmic care and make ophthalmic consultation more widely available.
This is a 2021 ARVO Annual Meeting abstract.
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