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Liddy C, Guglani S, Ratzlaff T, Campbell RJ, Cranston L, Miville A, Hove MT, Keely E. Expanding the scope of an eConsult service: acceptability and feasibility of an optometry–ophthalmology pilot project. CANADIAN JOURNAL OF OPHTHALMOLOGY 2022; 58:204-211. [PMID: 35131208 DOI: 10.1016/j.jcjo.2022.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 10/29/2021] [Accepted: 01/05/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To determine the feasibility and acceptability of connecting optometrists to ophthalmologists on an eConsult service. DESIGN Descriptive analysis of utilization data and an anonymous survey. PARTICIPANTS All eConsult cases sent by optometrists between March 2019 and February 2020 (utilization data); optometrists and ophthalmologists participating in the eConsult Vision Pilot Project (survey). METHODS Utilization data for the study period were collected automatically and underwent descriptive analysis. Participating optometrists and ophthalmologists received an email invitation to a survey assessing the project. RESULTS Thirteen optometrists from 5 clinics in the southeast region and 7 ophthalmologists were recruited to participate in the pilot project. Optometrists sent 109 eConsults in a 13-month period, representing 33% of all cases submitted to ophthalmology through the eConsult service provincially (March 2019-March 2020). Sixty-eight percent of respondents to an anonymous online survey valued the recruitment and engagement of eye care professionals from the same health region. The influence of the eConsult service was reported to have a "somewhat positive" (27%) to "very positive" (50%) influence on the relationship between the two professional groups. CONCLUSION The eConsult Vision Pilot Project fills a gap in service and provides an opportunity for patients to get access to specialty advice. We demonstrated that allowing optometrists to solicit specialist advice from ophthalmologists was acceptable and feasible.
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Affiliation(s)
- Clare Liddy
- C. T. Lamont Primary Healthcare Research Centre, Bruyère Research Institute, Ottawa, ON; Department of Family Medicine, University of Ottawa, Ottawa, ON; eConsult Centre of Excellence, The Ottawa Hospital, Ottawa, ON.
| | - Sheena Guglani
- C. T. Lamont Primary Healthcare Research Centre, Bruyère Research Institute, Ottawa, ON; eConsult Centre of Excellence, The Ottawa Hospital, Ottawa, ON
| | - Timothy Ratzlaff
- Department of Ophthalmology, Queens University and Kingston Health Sciences Centre, Kingston, ON
| | - Robert J Campbell
- Department of Ophthalmology, Queens University and Kingston Health Sciences Centre, Kingston, ON
| | - Lacey Cranston
- Canadian Institute for Military and Veteran Health Research, Queen's University, Kingston, ON
| | - Andrea Miville
- eConsult Centre of Excellence, The Ottawa Hospital, Ottawa, ON
| | - Martin Ten Hove
- Department of Ophthalmology, Queens University and Kingston Health Sciences Centre, Kingston, ON
| | - Erin Keely
- eConsult Centre of Excellence, The Ottawa Hospital, Ottawa, ON; Department of Medicine, University of Ottawa, Ottawa, ON; Division of Endocrinology/Metabolism, The Ottawa Hospital, Ottawa, ON
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Gerbutavicius R, Brandlhuber U, Glück S, Kortüm GF, Kortüm I, Navarrete Orozco R, Rakitin M, Strodtbeck M, Wolf A, Kortüm KU. Evaluation of patient satisfaction with an ophthalmology video consultation during the COVID-19 pandemic. Ophthalmologe 2021; 118:89-95. [PMID: 33301067 PMCID: PMC7727093 DOI: 10.1007/s00347-020-01286-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
BACKGROUND We introduced a video consultation (VC) during the coronavirus (COVID-19) pandemic in an ophthalmology practice with eight doctors to ensure continuous ophthalmological care, infection prophylaxis and to compensate a decreased number of patient presentations. OBJECTIVE Evaluation of the most common reasons for patient presentations in the VC, the proportion of re-presentations in the practice despite VC, practical challenges associated with the introduction of VC and patient satisfaction. MATERIAL AND METHODS Patients with a recent acute visual deterioration and severe eye pain were excluded from the VC. The VC were carried out by a trained specialist in ophthalmology. A questionnaire with eight questions was completed after the VC appointment in order to evaluate the proportion of completed VC and patient satisfaction. RESULTS We included 29 (13 male, Ø 52.6 years, 16 female, Ø 64.7 years) patients in this analysis. The VC could be performed with 68.97% of the participants who rated their overall experience with an average grade of 1.6 (1 very good to 6 insufficient) and all of them indicated that they would recommend the VC. Of presentations in VC 70% were related to the symptoms of the anterior eye segment. In 70% of the cases no re-presentations took place in the unit. CONCLUSION Our study represents a significant practical application of VC for the management of non-urgent ocular conditions with maximum infection prophylaxis. The introduction of VC was severely limited by technological or user-related issues by the establishment of video connections. Patient satisfaction with VC was high to very high.
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Affiliation(s)
- R Gerbutavicius
- Augenarztpraxis Dres. Kortüm, Solitudestr. 24, 71638, Ludwigsburg, Germany.
| | - U Brandlhuber
- Augenarztpraxis Dres. Kortüm, Solitudestr. 24, 71638, Ludwigsburg, Germany
| | - S Glück
- Augenarztpraxis Dres. Kortüm, Solitudestr. 24, 71638, Ludwigsburg, Germany
| | - G F Kortüm
- Augenarztpraxis Dres. Kortüm, Solitudestr. 24, 71638, Ludwigsburg, Germany
| | - I Kortüm
- Augenarztpraxis Dres. Kortüm, Solitudestr. 24, 71638, Ludwigsburg, Germany
| | - R Navarrete Orozco
- Augenarztpraxis Dres. Kortüm, Solitudestr. 24, 71638, Ludwigsburg, Germany
| | - M Rakitin
- Augenarztpraxis Dres. Kortüm, Solitudestr. 24, 71638, Ludwigsburg, Germany
| | - M Strodtbeck
- Augenarztpraxis Dres. Kortüm, Solitudestr. 24, 71638, Ludwigsburg, Germany
| | - A Wolf
- Universitätsaugenklinik Ulm, Ulm, Germany
| | - K U Kortüm
- Augenarztpraxis Dres. Kortüm, Solitudestr. 24, 71638, Ludwigsburg, Germany
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Lahaie Luna G, Parel JM, Gonzalez A, Hopman W, Rowaan C, Khimdas S, Hove MT. Validating the use of a stereoscopic robotized teleophthalmic drone slit lamp. Can J Ophthalmol 2020; 56:191-196. [PMID: 33164766 DOI: 10.1016/j.jcjo.2020.10.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 09/30/2020] [Accepted: 10/05/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To validate the use of a mechanized remotely operated stereoscopic drone slit lamp (DSL) in assessing anterior segment pathology in ophthalmology patients compared with conventional slit lamp (CSL). METHODS Patients were recruited from eye clinics at Hotel Dieu Hospital in Kingston, Ontario, Canada. Each patient was assessed by 2 examiners. Examiners consisted of ophthalmology residents and staff attendings. Each examiner assessed the anterior chamber (AC) depth, presence or absence of cells, and/or presence of flare of the patient first using the DSL, followed by CSL. Qualitative data were collected on the ability to assess corneal integrity, infiltrates, foreign bodies, epithelial defects, and conjunctival injection using the DSL. RESULTS 48 eyes of 42 participants were examined using the DSL and CSL. No significant within-examiner differences in AC depth or cell were detected. There was substantial agreement between the DSL and CSL when assessing AC cell and flare (κ = 72.6 and κ = 60.4, respectively) and moderate agreement when assessing AC depth (κ = 42.5). The DSL compared with CSL had a sensitivity and specificity of 98.3% (95% confidence interval [CI] 94-100) and 100% (95% CI 98.7-100), respectively, for detecting AC cell. The DSL had sensitivity and specificity of 100% (95% CI 97.5-100) and 88.2% (95% CI 80.2-96.1), respectively, for detecting AC flare. CONCLUSIONS There was substantial agreement between the DSL and CSL when assessing AC depth, cell, and flare. Sensitivity and specificity for assessing these findings ranged from 88.2% to 100%. This DSL provides excellent capability for examination of anterior segment pathology in live patients, performing similarly to a CSL.
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Affiliation(s)
- Gabriela Lahaie Luna
- Department of Ophthalmology, Kingston Health Sciences Centre, Queen's University, Kingston, Ont
| | - Jean-Marie Parel
- Bascom Palmer Eye Institute, Department of Ophthalmology, Ophthalmic Biophysics Center, University of Miami Miller School of Medicine, Miami, FL
| | - Alex Gonzalez
- Bascom Palmer Eye Institute, Department of Ophthalmology, Ophthalmic Biophysics Center, University of Miami Miller School of Medicine, Miami, FL
| | - Wilma Hopman
- Department of Ophthalmology, Kingston Health Sciences Centre, Queen's University, Kingston, Ont
| | - Cornelis Rowaan
- Bascom Palmer Eye Institute, Department of Ophthalmology, Ophthalmic Biophysics Center, University of Miami Miller School of Medicine, Miami, FL
| | | | - Martin Ten Hove
- Department of Ophthalmology, Kingston Health Sciences Centre, Queen's University, Kingston, Ont..
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Gerbutavicius R, Brandlhuber U, Glück S, Kortüm GF, Kortüm I, Navarrete Orozco R, Rakitin M, Strodtbeck M, Wolf A, Kortüm KU. [Evaluation of patient satisfaction with an ophthalmology video consultation during the COVID-19 pandemic]. Ophthalmologe 2020; 117:659-667. [PMID: 32524194 PMCID: PMC7284667 DOI: 10.1007/s00347-020-01143-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND We introduced a video consultation (VC) during the coronavirus (COVID-19) pandemic in an ophthalmology practice with eight doctors to ensure continuous ophthalmological care, infection prophylaxis and to compensate a decreased number of patient presentations. OBJECTIVE Evaluation of the most common reasons for patient presentations in the VC, the proportion of re-presentations in the practice despite VC, practical challenges associated with the introduction of VC and patient satisfaction. MATERIAL AND METHODS Patients with a recent acute visual deterioration and severe eye pain were excluded from the VC. The VC were carried out by a trained specialist in ophthalmology. A questionnaire with eight questions was completed after the VC appointment in order to evaluate the proportion of completed VC and patient satisfaction. RESULTS We included 29 (13 male, Ø 52.6 years, 16 female, Ø 64.7 years) patients in this analysis. The VC could be performed with 68.97% of the participants who rated their overall experience with an average grade of 1.6 (1 very good to 6 insufficient) and all of them indicated that they would recommend the VC. Of presentations in VC 70% were related to the symptoms of the anterior eye segment. In 70% of the cases no re-presentations took place in the unit. CONCLUSION Our study represents a significant practical application of VC for the management of non-urgent ocular conditions with maximum infection prophylaxis. The introduction of VC was severely limited by technological or user-related issues by the establishment of video connections. Patient satisfaction with VC was high to very high.
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Affiliation(s)
- R Gerbutavicius
- Augenarztpraxis Dres. Kortüm, Solitudestr. 24, 71638, Ludwigsburg, Deutschland.
| | - U Brandlhuber
- Augenarztpraxis Dres. Kortüm, Solitudestr. 24, 71638, Ludwigsburg, Deutschland
| | - S Glück
- Augenarztpraxis Dres. Kortüm, Solitudestr. 24, 71638, Ludwigsburg, Deutschland
| | - G-F Kortüm
- Augenarztpraxis Dres. Kortüm, Solitudestr. 24, 71638, Ludwigsburg, Deutschland
| | - I Kortüm
- Augenarztpraxis Dres. Kortüm, Solitudestr. 24, 71638, Ludwigsburg, Deutschland
| | - R Navarrete Orozco
- Augenarztpraxis Dres. Kortüm, Solitudestr. 24, 71638, Ludwigsburg, Deutschland
| | - M Rakitin
- Augenarztpraxis Dres. Kortüm, Solitudestr. 24, 71638, Ludwigsburg, Deutschland
| | - M Strodtbeck
- Augenarztpraxis Dres. Kortüm, Solitudestr. 24, 71638, Ludwigsburg, Deutschland
| | - A Wolf
- Universitätsaugenklinik Ulm, Ulm, Deutschland
| | - K U Kortüm
- Augenarztpraxis Dres. Kortüm, Solitudestr. 24, 71638, Ludwigsburg, Deutschland
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