1
|
Lek JJ, Cham KM, Merolli M. Evaluating perceived technology self-efficacy and telehealth acceptance in optometry students. Clin Exp Optom 2024:1-12. [PMID: 39097971 DOI: 10.1080/08164622.2024.2380080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 03/08/2024] [Accepted: 07/10/2024] [Indexed: 08/06/2024] Open
Abstract
CLINICAL RELEVANCE Constant technological improvements require practitioners to be open to adopting technologies such as telehealth for enhanced patient care. Understanding the barriers and facilitators of telehealth adoption will guide stakeholders in making decisions for safe and effective implementation of telehealth. BACKGROUND Effective use of telehealth improves patient outcomes. It is unclear if optometry students feel supported in using and/or are accepting of telehealth. This study evaluated telehealth acceptance of optometry students, its association with their technology self-efficacy, and whether telehealth training alters this relationship. METHODS Final-year optometry students at the University of Melbourne were invited to participate in a telehealth course. A 22-item online survey adapted from the Technology Proficiency Self-Assessment for twenty-first Century Learning was used to evaluate technology self-efficacy pre- and post-learning. Telehealth acceptance was evaluated using a 34-item survey according to the Unified Theory of Acceptance and Use of Technology-2. A 5-point Likert scale was used for each item, yielding two total scores. Respondent demographics, frequency of usage and number of devices were recorded. Descriptive statistics, ANOVA and Pearson correlation were used to analyse demographic variables and relationship between technology self-efficacy and telehealth acceptance. RESULTS 58 (68%) and 49 (58%) students participated in the pre- and post-learning surveys. Majority were 20-29-year-old females. Students used between two and four devices for online activities, with 62% being online at least hourly. Technology self-efficacy scores (average ± SD) pre- and post-learning were 83.8% ± 8.2 and 87.8% ± 7.1. Telehealth acceptance scores pre- and post-learning were 66.1% ± 9.6 and 73.98% ± 9.9. There was no association with gender, number of devices and frequency of online use for all scores. Correlation between technology self-efficacy and telehealth acceptance was insignificant pre-learning (p = 0.3) but was significant post-learning (p = 0.04). CONCLUSION Optometry students demonstrated high technology self-efficacy compared to telehealth acceptance. Telehealth training resulted in marked improvement in telehealth acceptance.
Collapse
Affiliation(s)
- Jia Jia Lek
- Department of Optometry and Vision Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Kwang Meng Cham
- Department of Optometry and Vision Sciences, The University of Melbourne, Melbourne, Victoria, Australia
| | - Mark Merolli
- Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia
- Centre for Digital Transformation of Health, The University of Melbourne, Melbourne, Victoria, Australia
| |
Collapse
|
2
|
Cardile D, Corallo F, Cappadona I, Ielo A, Bramanti P, Lo Buono V, Ciurleo R, De Cola MC. Auditing the Audits: A Systematic Review on Different Procedures in Telemedicine. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4484. [PMID: 36901491 PMCID: PMC10001883 DOI: 10.3390/ijerph20054484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 02/27/2023] [Accepted: 03/01/2023] [Indexed: 06/18/2023]
Abstract
Telemedicine is a process of delivering health care using information and communication technologies. Audit and feedback (A&F) constitute a systematic intervention that is aimed at collecting data, which are subsequently compared with reference standards and then returned to health care operators through feedback meetings. The aim of this review is to analyse different audit procedures on and by mean of telemedicine services and to identify a practice that is more effective than the others. Systematic searches were performed in three databases evaluating studies focusing on clinical audits performed on and by means of telemedicine systems. Twenty-five studies were included in the review. Most of them focused on telecounselling services with an audit and a maximum duration of one year. Recipients of the audit were telemedicine systems and service users (general practitioners, referring doctors, and patients). Data resulting from the audit were inherent to the telemedicine service. The overall data collected concerned the number of teleconsultations, service activity, reasons for referral, response times, follow-up, reasons why treatment was not completed, technical issues, and other information specific to each telemedicine service. Only two of the considered studies dealt with organizational aspects, and of these, only one analysed communicative aspects. The complexity and heterogeneity of the treatments and services provided meant that no index of uniformity could be identified. Certainly, some audits were performed in an overlapping manner in the different studies, and these show that although attention is often paid to workers' opinions, needs, and issues, little interest was shown in communicative/organizational and team dynamics. Given the importance and influence that communication has in teamwork and care settings, an audit protocol that takes into account intra- and extra-team communication processes could be essential to improving the well-being of operators and the quality of the service provided.
Collapse
|
3
|
Chia MA, Turner AW. Enhancing collaborative eye care through telemedicine. Clin Exp Optom 2023; 106:222-224. [PMID: 36336830 DOI: 10.1080/08164622.2022.2079400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Mark A Chia
- NIHR Biomedical Research Centre, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, UK
| | - Angus W Turner
- Centre for Ophthalmology and Visual Science (affiliated with the Lions Eye Institute), University of Western Australia, Perth, Australia
| |
Collapse
|
4
|
Massie J, Block SS, Morjaria P. The Role of Optometry in the Delivery of Eye Care via Telehealth: A Systematic Literature Review. Telemed J E Health 2022; 28:1753-1763. [PMID: 35612473 PMCID: PMC9805855 DOI: 10.1089/tmj.2021.0537] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Objective: Optometrists are increasingly adopting teleoptometry as an approach to delivering eye care. The coronavirus disease 2019 (COVID-19) pandemic has created further opportunities for optometrists to utilize innovation in telehealth to deliver eye care to individuals who experience access barriers. A systematic literature review is presented detailing the evidence to support the use of teleoptometry. Methods: Databases of MEDLINE, Global Health, and Web of Science were searched, and articles were included if they reported any involvement of optometrists in the delivery of telehealth. Findings were reported according to the mode of telehealth used to deliver eye care, telehealth collaboration type, and the format and geographical areas where eye care via telehealth is being delivered. Results: Twenty-seven relevant studies were identified. Only 11 studies included the role of optometrists as a member of the telehealth team where the scope of practice extended beyond creating and receiving referrals, collecting clinical data at in-person services, and continuing in-person care following consultation with an ophthalmologist. Both synchronous and asynchronous telehealth services were commonly utilized. Optometrists were most commonly involved in ophthalmology-led telehealth collaborations (n = 19). Eight studies reported optometrists independently delivering primary eye care via telehealth, and commonly included videoconferencing. Conclusion: The application of teleoptometry to deliver eye care is rapidly emerging, and appears to be a viable adjunct to the delivery of in-person optometry services. The review highlighted the scarcity of evidence surrounding the clinical benefits, safety, and outcomes of teleoptometry. Further research is required in this area.
Collapse
Affiliation(s)
- Jessica Massie
- International Centre for Eye Health, Clinical Research Department, London School of Hygiene and Tropical Medicine, London, United Kingdom.,Address correspondence to: Jessica Massie, BVisSci/MOptom, MScPHEC, International Centre for Eye Health, Clinical Research Department, London School of Hygiene and Tropical Medicine, London WC1E 7HT, United Kingdom
| | | | - Priya Morjaria
- International Centre for Eye Health, Clinical Research Department, London School of Hygiene and Tropical Medicine, London, United Kingdom
| |
Collapse
|
5
|
Kiburg KV, Turner A, He M. Telemedicine and delivery of ophthalmic care in rural and remote communities: Drawing from Australian experience. Clin Exp Ophthalmol 2022; 50:793-800. [PMID: 35975938 DOI: 10.1111/ceo.14147] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 08/07/2022] [Accepted: 08/12/2022] [Indexed: 01/07/2023]
Abstract
Rural and remote communities in Australia are characterised by small but widely dispersed populations. This has been proven to be a major hurdle in access to medical care services with screening and treatment goals repeatedly being missed. Telemedicine in ophthalmology provides the opportunity to increase the availability of high quality and timely access to healthcare within. Recent years has also seen the introduction of artificial intelligence (AI) in ophthalmology, particularly in the screening of diseases. AI will hopefully increase the number of appropriate referrals, reduce travel time for patients and ensure timely triage given the low number of qualified optometrists and ophthalmologists. Telemedicine and AI has been introduced in a number of countries and has led to tremendous benefits and advantages when compared to standard practices. This paper summarises current practices in telemedicine and AI and the future of this technology in improving patient care in the field of ophthalmology.
Collapse
Affiliation(s)
- Katerina V Kiburg
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia.,Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia
| | - Angus Turner
- Lions Outback Vision, Lions Eye Institute, Nedlands, Western Australia, Australia.,Centre for Ophthalmology and Visual Science, University of Western Australia, Nedlands, Western Australia, Australia
| | - Mingguang He
- Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia.,Ophthalmology, Department of Surgery, University of Melbourne, Melbourne, Victoria, Australia
| |
Collapse
|
6
|
Azzopardi M, Prokosch-Willing V, Michelessi M, Fea AM, Oddone F, Mercieca K. The current use of glaucoma virtual clinics in Europe. Eye (Lond) 2022; 37:1350-1356. [PMID: 35690678 PMCID: PMC9188015 DOI: 10.1038/s41433-022-02111-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 04/26/2022] [Accepted: 05/13/2022] [Indexed: 11/12/2022] Open
Abstract
Objectives To assess and describe current utilisation, characteristics and perspectives on virtual glaucoma clinics (VGCs) amongst European glaucoma specialists. Methods Cross-sectional, anonymized, online questionnaire distributed to all European Glaucoma Society-registered specialists. Questions were stratified into five domains: Demographics, Questions about VGC use, Questions for non-VGC users, COVID-19 effects, and VGC advantages/disadvantages. Results 30% of 169 participants currently use VGCs, with 53% based in the United Kingdom. Of those using VGCs, 85% reported higher patient acceptance compared to traditional care. The commonest virtual model was asynchronous remote monitoring (54%). Nurses (49%) and ophthalmic technicians (46%) were mostly responsible for data collection, with two-thirds using a mixture of professionals. Consultant ophthalmologists were the main decision-makers in 51% of VGCs. Preferred cohorts were: ocular hypertension (85%), glaucoma suspects (80%), early/moderate glaucoma in worse eye (68%), stable glaucoma irrespective of treatment (59%) and stable glaucoma on monotherapy (51%). Commonest investigations were: IOP (90%), BCVA (88%), visual field testing (85%) and OCT (78%), with 33 different combinations. Reasons for face-to-face referral included: visual field progression (80%), ‘above-target’ IOP (63%), and OCT progression (51%). Reasons for not using VGCs included: lack of experience (47%), adequate systems in place (42%), no appropriate staff (34%) and insufficient time/money (34%). 55% of non-VGC users are interested in their use with 38% currently considering future implementation. 83% stated VGC consultations have increased during the COVID-19 pandemic; 86% of all participants felt that the pandemic has highlighted the importance of VGCs. Conclusions A significant proportion of European glaucoma units are currently using VGCs, while others are considering implementation. Financial reimbursement and consensus guidelines are potentially crucial steps in VGC uptake.
Collapse
Affiliation(s)
| | | | | | - Antonio Maria Fea
- Dipartimento di Scienze Chirurgiche, Universita degli Studi di Torino, Torino, Italy
| | | | - Karl Mercieca
- University Hospital Bonn, Eye Clinic, Ernst Abbe Strasse 2, Bonn, Germany. .,Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.
| |
Collapse
|
7
|
Chia MA, Turner AW. Benefits of Integrating Telemedicine and Artificial Intelligence Into Outreach Eye Care: Stepwise Approach and Future Directions. Front Med (Lausanne) 2022; 9:835804. [PMID: 35391876 PMCID: PMC8982071 DOI: 10.3389/fmed.2022.835804] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 02/15/2022] [Indexed: 11/13/2022] Open
Abstract
Telemedicine has traditionally been applied within remote settings to overcome geographical barriers to healthcare access, providing an alternate means of connecting patients to specialist services. The coronavirus 2019 pandemic has rapidly expanded the use of telemedicine into metropolitan areas and enhanced global telemedicine capabilities. Through our experience of delivering real-time telemedicine over the past decade within a large outreach eye service, we have identified key themes for successful implementation which may be relevant to services facing common challenges. We present our journey toward establishing a comprehensive teleophthalmology model built on the principles of collaborative care, with a focus on delivering practical lessons for service design. Artificial intelligence is an emerging technology that has shown potential to further address resource limitations. We explore the applications of artificial intelligence and the need for targeted research within underserved settings in order to meet growing healthcare demands. Based on our rural telemedicine experience, we make the case that similar models may be adapted to urban settings with the aim of reducing surgical waitlists and improving efficiency.
Collapse
Affiliation(s)
- Mark A. Chia
- Lions Outback Vision, Lions Eye Institute, Nedlands, WA, Australia
- Institute of Ophthalmology, Faculty of Brain Sciences, University College London, London, United Kingdom
| | - Angus W. Turner
- Lions Outback Vision, Lions Eye Institute, Nedlands, WA, Australia
- Centre for Ophthalmology and Visual Science, University of Western Australia, Nedlands, WA, Australia
| |
Collapse
|
8
|
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.
Collapse
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
| |
Collapse
|
9
|
Walsh L, Hong SC, Chalakkal RJ, Ogbuehi KC. A Systematic Review of Current Teleophthalmology Services in New Zealand Compared to the Four Comparable Countries of the United Kingdom, Australia, United States of America (USA) and Canada. Clin Ophthalmol 2021; 15:4015-4027. [PMID: 34675470 PMCID: PMC8500493 DOI: 10.2147/opth.s294428] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 08/18/2021] [Indexed: 12/20/2022] Open
Abstract
Background Over 700,000 New Zealanders (NZ), particularly elderly and Māori, live without timely access to specialist ophthalmology services. Teleophthalmology is a widely recognised tool that can assist in overcoming resource and distance barriers. Teleophthalmology gained unprecedented traction in NZ during the COVID-19 pandemic and subsequent lockdown. However, its provision is still limited and there are equity issues. The aim of this study was to conduct a systematic review identifying, describing and contrasting teleophthalmology services in NZ with the comparable countries of Australia, USA, Canada and the United Kingdom. Methods The electronic databases Embase, PubMed, Web of Science, Google Scholar and Google were systemically searched using the keywords: telemedicine, ophthalmology, tele-ophthalmology/teleophthalmology. The searches were filtered to the countries above, with no time constraints. An integrative approach was used to synthesise findings. Results One hundred and thirty-two studies were identified describing 90 discrete teleophthalmology services. Articles spanned from 1997 to 2020. Models were categorised into general eye care (n=21; 16%); emergency/trauma (n=6; 4.5%); school screening (n=25; 19%); artificial intelligence (AI) (n=23; 18%); and disease-specific models of care (MOC) (n=57; 43%). The most common diseases addressed were diabetic retinopathy (n=23; 17%); retinopathy of prematurity (n=9; 7%); and glaucoma (n=8; 6%). Programs were mainly centred in the US (n=72; 54.5%), followed by the UK (n=29; 22%), then Canada (n=16; 12%), Australia (n=13; 10%), with the fewest identified in NZ (n=3; 2%). Models generally involved an ophthalmologist consultative service, remote supervision and triaging. Most models involved local clinicians transmitting fed-forward or live images. Conclusion Teleophthalmology will likely play a crucial role in the future of eye care. COVID-19 has offered a unique opportunity to observe the use of teleophthalmology services globally. Feed-forward and, increasingly, live-based teleophthalmology services have demonstrated feasibility and cost-effectiveness in similar countries internationally. New Zealand’s teleophthalmology services, however, are currently limited. Investing in strategic partnerships and technology at a national level can advance health equities in ophthalmic care.
Collapse
Affiliation(s)
- Liam Walsh
- Department of Ophthalmology, Southern District Health Board, Dunedin, Otago, New Zealand
| | - Sheng Chiong Hong
- Department of Ophthalmology, Southern District Health Board, Dunedin, Otago, New Zealand
| | - Renoh Johnson Chalakkal
- Research and Development, oDocs Eye Care, Dunedin, Otago, New Zealand.,Electrical and Computer Engineering, University of Auckland, Auckland, New Zealand
| | - Kelechi C Ogbuehi
- Department of Medicine, University of Otago, Dunedin, Otago, New Zealand
| |
Collapse
|
10
|
Khou V, Khan MA, Jiang IW, Katalinic P, Agar A, Zangerl B. Evaluation of the initial implementation of a nationwide diabetic retinopathy screening programme in primary care: a multimethod study. BMJ Open 2021; 11:e044805. [PMID: 34408028 PMCID: PMC8375720 DOI: 10.1136/bmjopen-2020-044805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVES The Australian Government funded a nationwide diabetic retinopathy screening programme to improve visual outcomes for people with diabetes. This study examined the benefits and barriers of the programme, image interpretation pathways and assessed the characteristics of people who had their fundus photos graded by a telereading service which was available as a part of the programme. DESIGN Multimethod: survey and retrospective review of referral forms. SETTING Twenty-two primary healthcare facilities from urban, regional, rural and remote areas of Australia, and one telereading service operated by a referral-only eye clinic in metropolitan Sydney, Australia. PARTICIPANTS Twenty-seven primary healthcare workers out of 110 contacted completed a survey, and 145 patient referrals were reviewed. RESULTS Manifest qualitative content analysis showed that primary healthcare workers reported that the benefits of the screening programme included improved patient outcomes and increased awareness and knowledge of diabetic retinopathy. Barriers related to staffing issues and limited referral pathways. Image grading was performed by a variety of primary healthcare workers, with one responder indicating the utilisation of a diabetic retinopathy reading service. Of the people with fundus photos graded by the reading service, 26.2% were reported to have diabetes. Overall, 12.3% of eyes were diagnosed with diabetic retinopathy. Photo quality was rated as excellent in 46.2% of photos. Referral to an optometrist for diabetic retinopathy was recommended in 4.1% of cases, and to an ophthalmologist in 6.9% of cases. CONCLUSIONS This nationwide diabetic retinopathy screening programme was perceived to increase access to diabetic retinopathy screening in regional, rural and remote areas of Australia. The telereading service has diagnosed diabetic retinopathy and other ocular pathologies in images it has received. Key barriers, such as access to ophthalmologists and optometrists, must be overcome to improve visual outcomes.
Collapse
Affiliation(s)
- Vincent Khou
- Centre for Eye Health, Sydney, New South Wales, Australia
- School of Optometry and Vision Science, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Muhammad Azaan Khan
- Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Ivy Wei Jiang
- Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Paula Katalinic
- Centre for Eye Health, Sydney, New South Wales, Australia
- School of Optometry and Vision Science, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Ashish Agar
- Centre for Eye Health, Sydney, New South Wales, Australia
- Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
- Department of Ophthalmology, Prince of Wales Hospital, Sydney, New South Wales, Australia
| | - Barbara Zangerl
- School of Optometry and Vision Science, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
- Coronary Care Unit, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| |
Collapse
|
11
|
Conway MP, Forristal MT, Treacy MP, Duignan ES. Investigating the Role of Optometrists in Teleophthalmology and the Implications of Increasing Access to Advanced Imaging Techniques and Digital Referral: A Systematic Search and Review. Telemed J E Health 2020; 27:974-981. [PMID: 33275866 DOI: 10.1089/tmj.2020.0284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Introduction: The objective of this systematic search and review was to investigate the role of optometrists in teleophthalmology and digital referral. We examine the implications of the optometric communities' increasing access to advanced imaging, such as optical coherence tomography (OCT), in ophthalmic telemedicine schemes. Methods: A systematic search was conducted, using PubMed and Embase, in April of 2019. Eight hundred eight (n = 808) texts were retrieved and 99 articles were deemed eligible for full-text review. Twenty-six (n = 26) studies were included in the qualitative synthesis. All studies involved optometrists as principal service providers. Results: Findings demonstrate that optometrist-facilitated teleophthalmology results in consistent reductions in hospital referrals and waiting times, as well as high patient satisfaction. Optometrists are identified as crucial to the success of many projects and their access to advanced imaging technology is observed to position optometry practices as the most convenient location to establish a teleophthalmology program. OCT imaging demonstrated the potential to increase diagnostic accuracy and is increasingly prevalent in optometry practice. The importance of additional training for optometrists participating in teleophthalmology schemes is highlighted, as is the need for appropriate remuneration for those involved. Conclusion: The role of community-based ophthalmic care in reducing demands on hospital eye services (HES) is highlighted by our results, demonstrating that optometrist-facilitated teleophthalmology can dramatically reduce referrals and streamline care. In addition, the increasing prevalence of OCT in optometric practice represents an underutilized resource for HES.
Collapse
|
12
|
Horton MB, Brady CJ, Cavallerano J, Abramoff M, Barker G, Chiang MF, Crockett CH, Garg S, Karth P, Liu Y, Newman CD, Rathi S, Sheth V, Silva P, Stebbins K, Zimmer-Galler I. Practice Guidelines for Ocular Telehealth-Diabetic Retinopathy, Third Edition. Telemed J E Health 2020; 26:495-543. [PMID: 32209018 PMCID: PMC7187969 DOI: 10.1089/tmj.2020.0006] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 01/11/2020] [Accepted: 01/11/2020] [Indexed: 12/24/2022] Open
Abstract
Contributors The following document and appendices represent the third edition of the Practice Guidelines for Ocular Telehealth-Diabetic Retinopathy. These guidelines were developed by the Diabetic Retinopathy Telehealth Practice Guidelines Working Group. This working group consisted of a large number of subject matter experts in clinical applications for telehealth in ophthalmology. The editorial committee consisted of Mark B. Horton, OD, MD, who served as working group chair and Christopher J. Brady, MD, MHS, and Jerry Cavallerano, OD, PhD, who served as cochairs. The writing committees were separated into seven different categories. They are as follows: 1.Clinical/operational: Jerry Cavallerano, OD, PhD (Chair), Gail Barker, PhD, MBA, Christopher J. Brady, MD, MHS, Yao Liu, MD, MS, Siddarth Rathi, MD, MBA, Veeral Sheth, MD, MBA, Paolo Silva, MD, and Ingrid Zimmer-Galler, MD. 2.Equipment: Veeral Sheth, MD (Chair), Mark B. Horton, OD, MD, Siddarth Rathi, MD, MBA, Paolo Silva, MD, and Kristen Stebbins, MSPH. 3.Quality assurance: Mark B. Horton, OD, MD (Chair), Seema Garg, MD, PhD, Yao Liu, MD, MS, and Ingrid Zimmer-Galler, MD. 4.Glaucoma: Yao Liu, MD, MS (Chair) and Siddarth Rathi, MD, MBA. 5.Retinopathy of prematurity: Christopher J. Brady, MD, MHS (Chair) and Ingrid Zimmer-Galler, MD. 6.Age-related macular degeneration: Christopher J. Brady, MD, MHS (Chair) and Ingrid Zimmer-Galler, MD. 7.Autonomous and computer assisted detection, classification and diagnosis of diabetic retinopathy: Michael Abramoff, MD, PhD (Chair), Michael F. Chiang, MD, and Paolo Silva, MD.
Collapse
Affiliation(s)
- Mark B. Horton
- Indian Health Service-Joslin Vision Network (IHS-JVN) Teleophthalmology Program, Phoenix Indian Medical Center, Phoenix, Arizona
| | - Christopher J. Brady
- Division of Ophthalmology, Department of Surgery, Larner College of Medicine, University of Vermont, Burlington, Vermont
| | - Jerry Cavallerano
- Beetham Eye Institute, Joslin Diabetes Center, Massachusetts
- Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Michael Abramoff
- Department of Ophthalmology and Visual Sciences, The University of Iowa, Iowa City, Iowa
- Department of Biomedical Engineering, and The University of Iowa, Iowa City, Iowa
- Department of Electrical and Computer Engineering, The University of Iowa, Iowa City, Iowa
- Department of Ophthalmology, Stephen A. Wynn Institute for Vision Research, The University of Iowa, Iowa City, Iowa
- Iowa City VA Health Care System, Iowa City, Iowa
- IDx, Coralville, Iowa
| | - Gail Barker
- Arizona Telemedicine Program, The University of Arizona, Phoenix, Arizona
| | - Michael F. Chiang
- Department of Ophthalmology, Casey Eye Institute, Oregon Health and Science University, Portland, Oregon
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, Oregon
| | | | - Seema Garg
- Department of Ophthalmology, University of North Carolina, Chapel Hill, North Carolina
| | | | - Yao Liu
- Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, Wisconsin
| | | | - Siddarth Rathi
- Department of Ophthalmology, NYU Langone Health, New York, New York
| | - Veeral Sheth
- University Retina and Macula Associates, University of Illinois at Chicago, Chicago, Illinois
| | - Paolo Silva
- Beetham Eye Institute, Joslin Diabetes Center, Massachusetts
- Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts
| | - Kristen Stebbins
- Vision Care Department, Hillrom, Skaneateles Falls, New York, New York
| | | |
Collapse
|
13
|
Fatehi F, Jahedi F, Tay-Kearney ML, Kanagasingam Y. Teleophthalmology for the elderly population: A review of the literature. Int J Med Inform 2020; 136:104089. [DOI: 10.1016/j.ijmedinf.2020.104089] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Revised: 12/13/2019] [Accepted: 01/27/2020] [Indexed: 11/30/2022]
|
14
|
Gan K, Liu Y, Stagg B, Rathi S, Pasquale LR, Damji K. Telemedicine for Glaucoma: Guidelines and Recommendations. Telemed J E Health 2020; 26:551-555. [PMID: 32209001 DOI: 10.1089/tmj.2020.0009] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Background: Glaucoma is the leading cause of irreversible blindness worldwide. Access to glaucoma specialists is challenging and likely to become more difficult as the population ages. Introduction: Using telemedicine for glaucoma (teleglaucoma) has the potential to increase access to glaucoma care by improving efficiency and decreasing the need for long-distance travel for patients. Results: Teleglaucoma programs can be used for screening, diagnostic consultation, and long-term treatment monitoring. Key components of teleglaucoma programs include patient history, equipment, intraocular pressure measurement, pachymetry, anterior chamber imaging/gonioscopy, fundus photography, retinal nerve fiber layer imaging, medical record and imaging software, and skilled personnel. Discussion: Teleglaucoma has tremendous potential to improve patient access to high-quality cost-effective glaucoma care. Conclusions: We have reviewed some special considerations needed to address the complexity of providing guideline-concordant glaucoma care.
Collapse
Affiliation(s)
- Kenman Gan
- Department of Ophthamology and Visual Sciences, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada.,Department of Ophthalmology and Visual Sciences, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Yao Liu
- Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, Wisconsin
| | - Brian Stagg
- John Moran Eye Center, University of Utah, Salt Lake City, Utah
| | | | - Louis R Pasquale
- Department of Ophthalmology, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Karim Damji
- Department of Ophthamology and Visual Sciences, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| |
Collapse
|
15
|
Nguyen AA, Baker A, Turner AW. On-call telehealth for visiting optometry in regional Western Australia improves patient access to eye care. Clin Exp Optom 2019; 103:393-394. [PMID: 31646665 DOI: 10.1111/cxo.12979] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 07/19/2019] [Accepted: 09/09/2019] [Indexed: 11/27/2022] Open
Affiliation(s)
| | | | - Angus W Turner
- Lions Outback Vision, Lions Eye Institute, Perth, Australia.,The University of Western Australia, Perth, Australia
| |
Collapse
|
16
|
Bartnik SE, Copeland SP, Aicken AJ, Turner AW. Optometry-facilitated teleophthalmology: an audit of the first year in Western Australia. Clin Exp Optom 2018; 101:700-703. [PMID: 29444552 DOI: 10.1111/cxo.12658] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 12/17/2017] [Accepted: 12/18/2017] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Lions Outback Vision has run a state-wide teleophthalmology service since 2011. In September 2015 the Australian federal government introduced a Medicare reimbursement for optometry-facilitated teleophthalmology consultations under specific circumstances. This audit demonstrates the first 12 months experience with this scheme. We aim to provide practical insights for others looking to embed a telemedicine program as part of delivering outreach clinical services. METHODS A 12-month retrospective audit was performed between September 2015 and August 2016, inclusive. A research officer used a specifically designed data extraction tool to record information from all teleophthalmology consultations performed in the time period. The primary outcome was the diagnosis at the end of the teleophthalmology consultation. Secondary outcome measures included the number of teleconsultations, cataract surgery rate, remoteness area of patients referred and imaging accompanying the referral. RESULTS In the 12-month period, 709 patients were referred resulting in 683 teleophthalmology teleconsultations. Cataract was the most frequent diagnosis (n = 287, 42.7 per cent), followed by glaucoma (n = 77, 11 per cent), age-related macular degeneration (n = 30, 4.4 per cent) and diabetic retinopathy (n = 26, 3.8 per cent). Of those who had teleconsultations, 98.6 per cent were from Outer Regional, Remote or Very Remote Australia. One or more accompanying images or investigations were part of 349 (49 per cent) teleconsultations, most commonly optical coherence tomography (215, 30 per cent) and fundus photography (148, 21 per cent). Face-to-face consultations were undertaken at an outreach clinic in 23 (3.4 per cent) cases, to determine the diagnosis. There were no statistically significant factors associated with attendance at teleophthalmology consultation, or for successfully undergoing cataract surgery. CONCLUSION Teleophthalmology is a valuable adjunct to regional outreach ophthalmology services, providing patients with increased access to specialist care for a wide range of ophthalmic conditions, and more efficient access to surgical care.
Collapse
Affiliation(s)
- Stephen E Bartnik
- Lions Outback Vision, Lions Eye Institute, Perth, Western Australia, Australia
| | - Stephen P Copeland
- Lions Outback Vision, Lions Eye Institute, Perth, Western Australia, Australia
| | - Angela J Aicken
- Lions Outback Vision, Lions Eye Institute, Perth, Western Australia, Australia
| | - Angus W Turner
- Lions Outback Vision, Lions Eye Institute, Perth, Western Australia, Australia.,The Centre for Vision and Ophthalmic Science, The University of Western Australia, Perth, Western Australia, Australia
| |
Collapse
|
17
|
Caffery LJ, Taylor M, Gole G, Smith AC. Models of care in tele-ophthalmology: A scoping review. J Telemed Telecare 2017; 25:106-122. [DOI: 10.1177/1357633x17742182] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The objective of this review was to identify and describe telehealth models of care for ophthalmic services. We conducted a scoping review of the literature to identify how ophthalmic care can be delivered by telehealth. We searched the PubMed database to identify relevant articles which were screened based on pre-defined inclusion criteria. For included articles, data were extracted, categorised and analysed. Synthesis of findings was performed narratively. The scoping review included 78 articles describing 62 discrete tele-ophthalmic models of care. Tele-ophthalmic models of care can be used for consultative service, screening, triage and remote supervision. The majority of services were for general eye care and triage ( n = 17; 26%) or emergency services ( n = 8; 12%). The most common conditions for disease-specific models of care were diabetic retinopathy ( n = 14; 21%), and glaucoma ( n = 8; 12%). Most models of care involved local clinicians capturing images and transmitting them to an ophthalmologist for assessment. This scoping review demonstrated tele-ophthalmology to be feasible for consultation, screening, triage and remote supervision applications across a broad range of ophthalmic conditions. A large number of models of care have been identified and described in this review. Considerable collaboration between patient-end clinicians and substantial infrastructure is typically required for tele-ophthalmology.
Collapse
Affiliation(s)
- Liam J Caffery
- Centre for Online Health, The University of Queensland, Australia
| | - Monica Taylor
- Centre for Online Health, The University of Queensland, Australia
| | - Glen Gole
- Children’s Health Queensland, Queensland Children’s Hospital, Australia
| | - Anthony C Smith
- Centre for Online Health, The University of Queensland, Australia
| |
Collapse
|
18
|
Ayatollahi H, Nourani A, Khodaveisi T, Aghaei H, Mohammadpour M. Teleophthalmology in Practice: Lessons Learned from a Pilot Project. Open Med Inform J 2017; 11:20-28. [PMID: 29081869 PMCID: PMC5633703 DOI: 10.2174/1874431101711010020] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 05/21/2017] [Accepted: 06/02/2017] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION Ophthalmology is a medical specialty which may benefit from using telemedicine and teleophthalmology services. Such services are significantly important in the poor, remote, and impassable geographical areas, where there is no access to the ophthalmology services and ophthalmologists. This study aimed to design and implement a teleophthalmology system using the method of store-and-forward. METHODS The study was conducted in 2015 and consisted of two main phases. The first phase was based requirement analysis, and in the second phase, after designing the prototype, an initial usability testing was undertaken in a teaching hospital. The participants of the study were 10 optometrists and 10 ophthalmologists (cornea specialists). For each phase of the research, a questionnaire was used to collect data, and the collected data were analyzed using descriptive statistics. RESULTS In this study, users' requirements were initially investigated. Then, the teleophthalmology system was designed based on the literature review and the results derived from the requirements' analysis. Finally, usability testing showed that the users were relatively satisfied with the system. CONCLUSION According to the results, it can be concluded that the teleophthalmology technology can be used in the country by optometrists and ophthalmologists to improve eye health care services and to prevent the prevalence of curable eye diseases.
Collapse
Affiliation(s)
- Haleh Ayatollahi
- Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Aynaz Nourani
- Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Taleb Khodaveisi
- Department of Health Information Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Hossein Aghaei
- Eye Research Center, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Mehrdad Mohammadpour
- Farabi Eye Hospital, Eye Research Center, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|