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Implementation of medical retina virtual clinics in a tertiary eye care referral centre
  1. Karsten Kortuem1,2,
  2. Katrin Fasler1,3,
  3. Amanda Charnley1,
  4. Hussain Khambati1,
  5. Sandro Fasolo1,
  6. Menachem Katz1,
  7. Konstantinos Balaskas1,4,
  8. Ranjan Rajendram1,5,6,
  9. Robin Hamilton1,5,6,
  10. Pearse A Keane1,5,6,
  11. Dawn A Sim1,5,6
  1. 1Medical Retina Department, Moorfields Eye Hospital NHS Foundation Trust, London, UK
  2. 2Medical Retina Department, University Eye Hospital, Munich, Germany
  3. 3Department of Ophthalmology, University Hospital Zurich, Zurich, Switzerland
  4. 4School of Biological Sciences, University of Manchester, Manchester, UK
  5. 5National Institute for Health and Research (NIHR) Biomedical Center, Moorfields Eye Hospital, London, UK
  6. 6Institute of Ophthalmology, University College of London (UCL), London, UK
  1. Correspondence to Dr Dawn A Sim, Moorfields Eye Hospital, London EC1V 2PD, UK; dawn.sim{at}moorfields.nhs.uk

Abstract

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 fashion

Methods 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.

  • telemedicine
  • public health
  • imaging
  • retina

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Footnotes

  • Contributors KK, DAS: drafted the study, acquired, analysed and interpreted data, drafted the manuscript, gave final approval and is accountable for all aspects of the work. KF, AC, HK: acquired data, revised the manuscript critically, gave final approval and is accountable for all aspects of the work. SF, MK: build the database, revised the manuscript critically, gave final approval and is accountable for all aspects of the work. KB, RR, RH, PAK: drafted the study, revised the manuscript critically, gave final approval and is accountable for all aspects of the work.

  • Competing interests None declared.

  • Ethics approval Moorfields Eye Hospital.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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