Implementation of medical retina virtual clinics in a tertiary eye care referral centre
Implementation of medical retina virtual clinics in a tertiary eye care referral centre
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DOI：
10.1136/bjophthalmol-2017-311494
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发表时间：
2018-10-01
影响因子：
4.1
通讯作者：
Sim, Dawn A.
中科院分区：
文献类型：
--
作者：
Kortuem, Karsten;Fasler, Katrin;Sim, Dawn A.
背景：越来越多的医学视网膜疾病的发病率在英国造成了能力问题。在这项研究中，我们描述了虚拟医学视网膜诊所（VMRCs）在伦敦穆尔菲尔德眼科医院的实施和结果。它代表了一个有希望的解决方案，以确保患者及时就诊和治疗。方法纳入了VMRC（2016年9月- 2017年5月）的首次就诊人数。它对非紧急外部转诊和面对面诊所（F2FC）的现有患者开放。所有患者均接受视力测试、眼底扩张摄影和光学相干断层扫描。评分由顾问、研究员和联合医疗保健专业人员执行。评估了这些虚拟咨询的结果和F2FC转诊的原因。结果共纳入1729例患者，其中内科转诊1543例，外部转诊186例。大多数被诊断为糖尿病视网膜病变（内部转诊75.1%，外部转诊46.8%）。在内部转介中，14.6%出院，54.5%继续在VMRC， 30.9%转到F2FC。在外部转介中，45.5%出院，37.1%继续在VMRC， 17.4%被带到F2FC。F2FC转诊的主要原因是图像质量（34.7%），其次是检测到潜在的可治疗疾病（20.2%）。结论利用医院眼科现有资源，可以成功实施VMRC。它也可以作为低风险转诊的一线快速访问诊所。这将使视网膜医疗服务能够应付日益增长的需求，并有效地将资源分配给需要治疗的人。
Background The increasing incidence of medical retinal diseases has created capacity issues across UK. In this study, we describe the implementation and outcomes of virtual medical retina clinics (VMRCs) at Moorfields Eye Hospital, South Division, London. It represents a promising solution to ensure that patients are seen and treated in a timely fashionMethods First attendances in the VMRC (September 2016-May 2017) were included. It was open to non-urgent external referrals and to existing patients in a face-to-face clinic (F2FC). All patients received visual acuity testing, dilated fundus photography and optical coherence tomography scans. Grading was performed by consultants, fellows and allied healthcare professionals. Outcomes of these virtual consultations and reasons for F2FC referrals were assessed.Results A total number of 1729 patients were included (1543 were internal and 186 external referrals). The majority were diagnosed with diabetic retinopathy (75.1% of internal and 46.8% of external referrals). Of the internal referrals, 14.6% were discharged, 54.5% continued in VMRC and 30.9% were brought to a F2FC. Of the external referrals, 45.5% were discharged, 37.1% continued in VMRC and 17.4% were brought to a F2FC. The main reason for F2FC referrals was image quality (34.7%), followed by detection of potentially treatable disease (20.2%).Conclusion VMRC can be implemented successfully using existing resources within a hospital eye service. It may also serve as a first-line rapid-access clinic for low-risk referrals. This would enable medical retinal services to cope with increasing demand and efficiently allocate resources to those who require treatment.