HCI for ophthalmology: Tele-ophthalmology-enabled and AI-ready referral between community optometry and hospital-based eye clinics for retinal disease

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Brief description of the context of the research including potential impact Hospital eye clinics receive a very large number of referrals for patients who had an eye check-up at a high street optometrist. Of those a significant proportion relate to problems with the retina. The best way to detect problems of the retina is by doing a quick, non-invasive scan called Optical Coherence Tomography (OCT). Increasingly, high street opticians are equipped with this technology, but there is a shortage of trained staff for interpreting these scans. The result can be a 'deluge' of referrals that overwhelm hospital eye clinics and delay access to care for patients that do require treatment. Recently, revolutionising technology based on Artificial Intelligence and tele-ophthalmology has been developed that can read OCT scans in an automated way and/or by a specialist and offer advice on whether a referral to hospital clinics is needed and how urgently. This research project aims to investigate the facilitators and barriers to implementing the AI and tele-ophthalmology platform at scale. The project will involve a number of high street optometry practices with OCT that refer patients to hospital based clinics, as well as two hospital based clinics. This project should enable the smooth adoption of novel interventions for triaging referrals between primary and secondary ophthalmology at scale. Aims and Objectives The specific objectives are to: review relevant literature on AI in healthcare, ophthalmology referral, and related topics; conduct studies to identify factors at different levels that affect the implementation of novel interventions; and propose best practice in the design of technology and workflows to facilitate the integration of novel technologies in routine ophthalmology practice. Novelty of Research Methodology The research methodology will adapt established techniques from HCI and Human Factors to address the specific needs of the work contexts (primary and secondary ophthalmology care), take into account the perceptions, expectations and experiences of patients as well as clinicians, and develop best practices in "explainable AI" interfaces as appropriate to the context. Alignment to EPSRC's strategies and research areas The project particularly addresses the EPSRC Health Technologies strategy of accelerating the translation of EPSRC research to healthcare applications, with a particular focus on AI-enabled healthcare. Any companies or collaborators involved The project is in collaboration with the Moorfields BRC, and will involve Moorfields Eye Hospital and referring primary care ophthalmology practices.