Virtual Clinic Triage for Glaucoma Care
By Lynda Seminara
Selected by Prem S. Subramanian, MD, PhD
Journal Highlights
Graefe’s Archive for Clinical and Experimental Ophthalmology
Published online March 30, 2023
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As life expectancy grows, so does the volume of health referrals and the need for medical appointments. In specialties such as ophthalmology, human resources are already limited, and wait times for office visits often exceed the recommended period—which can be detrimental to visual outcomes. Telemedicine can help to address these problems. In a recent report, Matos et al. described the results of implementing a virtual clinic triage system for glaucoma care. This system was able to reduce wait times, decrease the number of hospital visits, and increase the speed of data-assisted clinical decisions.
For this work, the authors reviewed and compared medical records for two cohorts: before and after implementation of a virtual triage system in the glaucoma department of Hospital Santa Maria (Lisbon, Portugal), a nationwide tertiary-care referral center. The virtual glaucoma clinic began in 2019 and operates similarly to its predecessor, but the orthoptist technician now conducts all ancillary exams during the same patient visit (i.e., one-stop shop). There was no change to the number of staff members or the number of exams conducted. Main outcome measures included wait times, quantity of visits, and timing of treatment decisions.
Altogether, the authors reviewed charts for 292 patients (132 pre-virtual, 160 virtual). The mean wait time between referral and the first medical contact with the glaucoma department was decreased by 71.3 days, from 286.6 days (in-person contact) to 215.3 days (virtual triage contact). The virtual system reduced the average time from referral to a treatment decision by approximately 327 days. The virtual triage system led to a 63.6% decrease in the number of visits to perform the same exams and make the same clinical decisions. With the triage protocol, 107 cases were labeled nonurgent, 30 were deemed urgent, and 23 required immediate contact. For every patient, the scheduling of future appointments adhered to the U.K.’s National Institute for Health and Care Excellence guidelines.
The authors concluded that triage systems offering remote decision-making capability may be valuable tools for optimizing glaucoma care without requiring extra resources.
The original article can be found here.