New digital models of care in ophthalmology, during and beyond the COVID-19 pandemic

Abstract

COVID-19 has led to massive disruptions in societal, economic and healthcare systems globally. While COVID-19 has sparked a surge and expansion of new digital business models in different industries, healthcare has been slower to adapt to digital solutions. The majority of ophthalmology clinical practices are still operating through a traditional model of 'brick-and-mortar' facilities and 'face-to-face' patient-physician interaction. In the current climate of COVID-19, there is a need to fuel implementation of digital health models for ophthalmology. In this article, we highlight the current limitations in traditional clinical models as we confront COVID-19, review the current lack of digital initiatives in ophthalmology sphere despite the presence of COVID-19, propose new digital models of care for ophthalmology and discuss potential barriers that need to be considered for sustainable transformation to take place.

Keywords: Covid-19; diagnostic tests/investigation; public health; telemedicine; vision.

Figure 1

Illustrations of patient journey in the traditional model, its limitations and proposed new digital solutions to alleviate these limitations. (Image icons extracted and modified from Flaticon.com, performed by YCT.) AI, artificial intelligence; IOP, intraocular pressure; VA, visual acuity.

Figure 2

New IUC with teleconsultation model for stable glaucoma or low-risk glaucoma suspects. Red box denotes high exposure risk to COVID-19, orange box denotes moderate risk and green box denotes low risk. (Image icons extracted and modified from Flaticon.com, performed by YCT.) HVF, Humphrey visual field; IOP, intraocular pressure; IUC, investigative unit in community; OCT, optical coherence tomography; SNEC, Singapore National Eye Centre; VA, visual acuity; VF, visual field.

Figure 3

New IUC with teleconsultation model for stable retinal diseases. (Image icons extracted and modified from Flaticon.com, performed by YCT.) IUC, investigative unit in community; OCT, optical coherence tomography; VA, visual acuity; SNEC, Singapore National Eye Centre.

Figure 4

New home-based monitoring and teleconsultation model for management of postcataract surgery cases. (Image icons extracted and modified from Flaticon.com, performed by YCT.) IOP, intraocular pressure; IUC, investigative unit in community; VA, visual acuity; SNEC, Singapore National Eye Centre.