Live teleophthalmology avoids escalation of referrals to secondary care during COVID-19 lockdown
| Autor: | Mario Giardini, Olivia B.L. Poyser, Fadi R. Ghazala, Andrew Ferguson, Ruth Hamilton, Iain A. T. Livingstone |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Eye Diseases
Referral Coronavirus disease 2019 (COVID-19) Teleophthalmology Secondary Care Secondary care 03 medical and health sciences 0302 clinical medicine Humans Medicine Pandemics Referral and Consultation SARS-CoV-2 business.industry COVID-19 medicine.disease Telemedicine Ophthalmology Communicable Disease Control Quarantine 030221 ophthalmology & optometry RE Medical emergency business 030217 neurology & neurosurgery Optometry |
| Zdroj: | Clinical and Experimental Optometry. 104:711-716 |
| ISSN: | 1444-0938 0816-4622 |
| DOI: | 10.1080/08164622.2021.1916383 |
| Popis: | Clinical relevance: Following the COVID-19 lockdown, uptake of slitlamp-enabled live teleophthalmology increased. Its use contributed to a reduction of referrals escalated to secondary care during-lockdown (avoided: 64% pre-lockdown vs 86% during-lockdown). Background: Live teleophthalmology using video conferencing allows real-time, three-way consultation between secondary care, community providers and patients, improving interpretation of slit lamp findings and potentially reducing referrals to secondary care. NHS Forth Valley implemented live teleophthalmology in March 2019. In March 2020, the COVID-19 pandemic created urgency to deliver ophthalmic care while minimising the risk of contracting or spreading the disease. We aim to compare the uptake and two outcomes (number of avoided secondary care referrals; pattern of presenting conditions) of live teleophthalmology consultations in NHS Forth Valley before and during the COVID-19 national lockdown. Methods: An NHS secure video conferencing platform connected the video slit lamps of optometrists, or an iPad mounted on a slit lamp and viewing through the eyepieces, to a secondary care ophthalmologist via a virtual live clinic/waiting area. Data about avoiding a secondary care referral were extracted from a post-consultation ophthalmologist survey for 14 months of data. Pre- and during-lockdown intervals were before/after 23 March 2020, when routine eyecare appointments were suspended. Numbers of avoided referrals to secondary care and patterns of presenting conditions were compared for pre- and during-lockdown periods. Results: The COVID-19 pandemic markedly increased use of live teleophthalmology in NHS Forth Valley. Surveys were completed for 164 of 250 (66%) teleophthalmology consultations over the study period. Data from 154 surveys were analysed, 78 and 76 for the pre- and during-lockdown periods, respectively. Significantly more during-lockdown (86%) than pre-lockdown (64%; difference 21%, 95% CI 8–34%, p = 0.001) surveys indicated that referrals to secondary care were avoided. Conclusion: Survey data from ophthalmologists suggest significantly fewer escalations to secondary care due to teleophthalmology use. |
| Databáze: | OpenAIRE |
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