Implementation of medical retina virtual clinics in a tertiary eye care referral centre

Autor: Hussain Khambati, Amanda Charnley, Menachem Katz, Konstantinos Balaskas, Karsten Kortuem, Katrin Fasler, Ranjan Rajendram, Sandro Fasolo, Dawn A Sim, Robin Hamilton, Pearse A. Keane
Přispěvatelé: University of Zurich, Sim, Dawn A
Jazyk: angličtina
Rok vydání: 2018
Předmět:
Male
10018 Ophthalmology Clinic
medicine.medical_specialty
Telemedicine
Eye Diseases
2804 Cellular and Molecular Neuroscience
610 Medicine & health
Diagnostic Techniques
Ophthalmological
Eye care
Ambulatory Care Facilities
Tertiary Care Centers
03 medical and health sciences
Cellular and Molecular Neuroscience
2809 Sensory Systems
0302 clinical medicine
medicine
Electronic Health Records
Humans
030212 general & internal medicine
Referral and Consultation
Aged
Retrospective Studies
medicine.diagnostic_test
Health professionals
business.industry
Incidence (epidemiology)
Public health
Fundus photography
Diabetic retinopathy
Middle Aged
medicine.disease
2731 Ophthalmology
United Kingdom
Sensory Systems
Ophthalmology
Referral centre
030221 ophthalmology & optometry
Female
Medical emergency
business
DOI: 10.5167/uzh-156870
Popis: BackgroundThe increasing incidence of medical retinal diseases has created capacity issues across UK. In this study, we describe the implementation and outcomes of virtual medical retina clinics (VMRCs) at Moorfields Eye Hospital, South Division, London. It represents a promising solution to ensure that patients are seen and treated in a timely fashionMethodsFirst attendances in the VMRC (September 2016–May 2017) were included. It was open to non-urgent external referrals and to existing patients in a face-to-face clinic (F2FC). All patients received visual acuity testing, dilated fundus photography and optical coherence tomography scans. Grading was performed by consultants, fellows and allied healthcare professionals. Outcomes of these virtual consultations and reasons for F2FC referrals were assessed.ResultsA total number of 1729 patients were included (1543 were internal and 186 external referrals). The majority were diagnosed with diabetic retinopathy (75.1% of internal and 46.8% of external referrals). Of the internal referrals, 14.6% were discharged, 54.5% continued in VMRC and 30.9% were brought to a F2FC. Of the external referrals, 45.5% were discharged, 37.1% continued in VMRC and 17.4% were brought to a F2FC. The main reason for F2FC referrals was image quality (34.7%), followed by detection of potentially treatable disease (20.2%).ConclusionVMRC can be implemented successfully using existing resources within a hospital eye service. It may also serve as a first-line rapid-access clinic for low-risk referrals. This would enable medical retinal services to cope with increasing demand and efficiently allocate resources to those who require treatment.
Databáze: OpenAIRE
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