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. 2021 Apr:34:100818.
doi: 10.1016/j.eclinm.2021.100818. Epub 2021 Apr 5.

Safety of video-based telemedicine compared to in-person triage in emergency ophthalmology during COVID-19

Ji-Peng Olivia Li  1   1 , Alice A P Thomas  1 , Caroline L S Kilduff  1   1 , Abison Logeswaran  1 , Rishi Ramessur  1 , Anton Jaselsky  1 , Dawn A Sim  2   3 , Gordon R Hay  1   4 , Peter B M Thomas  2   3
Affiliations

Safety of video-based telemedicine compared to in-person triage in emergency ophthalmology during COVID-19

Ji-Peng Olivia Li et al. EClinicalMedicine. 2021 Apr.

Abstract

Background: the need for social distancing midst the COVID-19 pandemic has forced ophthalmologists to innovate with telemedicine. The novel process of triaging emergency ophthalmology patients via videoconsultations should reduce hospital attendances. However, the safety profile of such services were unknown.

Methods: in this retrospective cohort study, we reviewed case notes of 404 adults who used our videoconsultation service from 20/04/2020 to 03/05/2020. We compared these to 451 patient who attended eye casualty in person at the same time who were deemed not to require same day ophthalmic examination.

Findings: patients seen by videoconsultations tended to be younger (Median = 43 years, Inter-quartile range = 27 vs Median= 49 years, Inter-quartile range = 28)'. More males used the face-to-face triage (55%) while more females used videoconsultation (54%)%. Fewer patients seen by videoconsultations required specialist review compared to face-face triage [X 2 (1, N = 854) = 128.02, p<0.001)]. 35.5% of the patients initially seen by videoconsultation had unplanned reattendance within 1 month, compared to 15.7% in the group initially seen in person. X 2 (1, N = 234) = 7.31, p = 0.007). The rate of actual harm was no different (at 0% for each method), with perfect inter-grader correlation when graded independently by two senior ophthalmologists. 97% of patients seen on the video platform surveyed were satisfied with their care.

Interpretation: we demonstrate comparable patient safety of videoconsultations at one-month follow-up to in person review. The service is acceptable to patients and reduces the risk of COVID-19 transmission. We propose that videoconsultations are effective and desirable as a tool for triage in ophthalmology.

Funding: the research supported by the National Institute for Health Research (NIHR) Biomedical Research Centre based at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology who fund PT and DS's time to conduct research. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.

Keywords: Digital health; Ophthalmology; Tele-ophthalmology; Telemedicine; Triage.

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Conflict of interest statement

Li: The author declares no competing interests., A Thomas: The author declares no competing interests., Kilduff: The author declares no competing interests., Logeswaran: The author declares no competing interests., Ramessur: The author declares no competing interests., Jaselsky: The author declares no competing interests., Sim: Dr. Sim reports other from Bayer, Allergan, Novartis, Roche, grants from Health Education England, grants from Moorfields Eye Charity, personal fees from Big Picture Medical Ltd, grants from Oculocare Ltd, outside the submitted work., Hay: The author declares no competing interests., P Thomas: Dr. Thomas reports personal fees from Novartis, personal fees from Abbvie, personal fees from Go Visibly, personal fees from Santen, outside the submitted work.

Figures

Fig 1
Fig. 1
The triage process.
Fig 2
Fig. 2
Comparison of the age distribution between those attending face-to-face versus videoteleconsultation.
Fig 3
Fig. 3
Comparison of the presenting complaints between those attending face-to-face versus videoconsultation.
See this image and copyright information in PMC

References

    1. Ting D.S.W., Carin L., Dzau V., Wong T.Y. Digital technology and COVID-19. Nat Med. 2020;26(4):459–461. - PMC - PubMed
    1. Caffery L.J., Taylor M., Gole G., Smith A.C. Models of care in tele-ophthalmology: a scoping review. J Telemed Telecare. 2019;25(2):106–122. - PubMed
    1. Tang R.A., Morales M., Ricur G., Schiffman J.S. Telemedicine for eye care. J Telemed Telecare. 2005;11(8):391–396. - PubMed
    1. Li J.O., Lam D.S.C., Chen Y., Ting D.S.W. Novel Coronavirus disease 2019 (COVID-19): the importance of recognizing possible early ocular manifestation and using protective eyewear. Br J Ophthalmol. 2020;104(3):297–298. - PubMed
    1. Li J.O., Shantha J., Wong T.Y. Preparedness among ophthalmologists: during and beyond the COVID-19 Pandemic. Ophthalmology. 2020;127(5):569–572. - PMC - PubMed

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