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Claus Christian Gruber, Rishi Ramessur, Laxmi Raja, Magdalene YL Ting, Benjamin Riley, Dawn Sim, Swan Kang; Exploring barriers and solutions to digital inclusion in outpatient Ophthalmology. Invest. Ophthalmol. Vis. Sci. 2022;63(7):1419 – A0115.
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© ARVO (1962-2015); The Authors (2016-present)
Whilst teleophthalmology has gained increasing importance during the pandemic by providing a novel way of patient-physician encounter, not all of our patients seem to benefit from this new format of access to eye-care. Exploring user perspectives and perceived barriers is crucial for avoiding digital exclusion. This study investigated patients motivation for and factors preventing them from utilizing teleophthalmology.
A 15-item questionnaire was distributed to patients attending face-to-face (F2F) appointments or video-consultations (VC) at Moorfields Eye Hospital. Questions explored participants rationale for (not) using VC, digital literacy skills, confidence online, access to technology and potential demand for support. Anonymised responses were collected and analysed.
Responses were obtained from a total of 92 patients (F2F n=63, VC n=29). Key findings revealed an overall 30.4% had low confidence in diagnostic proficiency of VC. Older patients (38.9% of patients aged ≥65y vs. 14.6% of those aged 35-64y vs. 3.8% of those aged ≤34y) were less comfortable navigating online and were more likely to lack access to internet or devices required to join VC (27.8% vs. 4.2% vs. 0.0%). Avoidance of traveling long distances (51.1%), minimization of disruption of daily life (31.5%) and fast access to eye specialists (25.0%) were the main perceived benefits of VC. Younger patients (aged ≤34y) were more likely to use and prefer VC. Participants having encountered VC at least once were generally more positive about VC. 13.0% of all participants were not aware that healthcare services could be accessed remotely.Participants (19.6%), and particularly older generations (27.8% ≥65y), felt that local community support and technology teaching sessions could bolster engagement with digital healthcare services.
This study found that younger patients and those who have previously used VC are more likely to prefer and benefit from using VC. Lack of digital skills, poor access to technology and low confidence in digital healthcare are factors that must be addressed to ensure that certain patient subgroups do not miss out on the benefits of teleophthalmology. Patients have expressed interest in solutions such as digital skills workshops (delivered in hospital or the community) and schemes to enhance access to the internet and devices.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.
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