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  • Making Telemedicine a Reality

    By Lynda Seminara
    Selected By: Deepak P. Edward, MD
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    Journal Highlights

    British Journal of Ophthalmology
    Published online July 18, 2019

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    Kern et al. implemented a cloud-based referral platform for medical retina hospital eye services (HES) in the United Kingdom, which was designed to alleviate demands on ophthalmology services by improving communication between opticians and ophthalmolo­gists. In this pilot study, the digital-first program drastically reduced the num­ber of unnecessary referrals, decreased referral wait time, and facilitated communication between health care providers. According to the authors, the platform may serve as a foundation for implementing artificial intelligence.

    For their study, the authors initially reviewed records for 103 patients treated at Moorfields Eye Hospital in London. The patients were classified into the HES referral pathway by one of 11 contributing optometrists, who used the cloud-based platform to share data with a single consultant ophthalmol­ogist at Moorfields. The optometrists were instructed to refer all presumable retina cases via the platform. Initial triage was performed by the optome­trist, and other types of referrals (e.g., glaucoma, cataract, or anterior seg­ment conditions) were excluded and sent through the conventional general ophthalmic services pathway. The main outcome measure was the reduction of unnecessary referrals.

    A review of patient data in a web-based interface showed that 54 (52%) of the 103 patients initially classified into the referral pathway did not need referral to a specialist. Fourteen patients who needed urgent treatment were identified. Usability was mea­sured in duration for data input and review, which averaged 9.2 minutes for optometrists and 3.0 minutes for ophthalmologists. The most common diagnoses were dry age-related macular degeneration (AMD; n = 34), wet AMD (n = 9), epiretinal membranes (n = 7), and choroidal nevi (n = 7).

    Data from this and other research suggest that virtual clinic settings are safe for certain ophthalmic conditions. A study of the health economic impact of cloud-based telemedicine services is being planned. Important to the success of such programs is patient satisfaction and acceptability, which should be addressed in future studies, said the au­thors.

    The original article can be found here.