RT Journal Article SR Electronic T1 Implementation of a cloud-based referral platform in ophthalmology: making telemedicine services a reality in eye care JF British Journal of Ophthalmology JO Br J Ophthalmol FD BMJ Publishing Group Ltd. SP bjophthalmol-2019-314161 DO 10.1136/bjophthalmol-2019-314161 A1 Christoph Kern A1 Dun Jack Fu A1 Karsten Kortuem A1 Josef Huemer A1 David Barker A1 Alison Davis A1 Konstantinos Balaskas A1 Pearse A Keane A1 Tom McKinnon A1 Dawn A Sim YR 2019 UL http://bjo.bmj.com/content/early/2019/09/25/bjophthalmol-2019-314161.abstract AB Background Hospital Eye Services (HES) in the UK face an increasing number of optometric referrals driven by progress in retinal imaging. The National Health Service (NHS) published a 10-year strategy (NHS Long-Term Plan) to transform services to meet this challenge. In this study, we implemented a cloud-based referral platform to improve communication between optometrists and ophthalmologists.Methods Retrospective cohort study conducted at Moorfields Eye Hospital, Croydon (NHS Foundation Trust, London, UK). Patients classified into the HES referral pathway by contributing optometrists have been included into this study. Main outcome measures was the reduction of unnecessary referrals.Results After reviewing the patient’s data in a web-based interface 54 (52%) out of 103 attending patients initially classified into the referral pathway did not need a specialist referral. Fourteen (14%) patients needing urgent treatment were identified. Usability was measured in duration for data input and reviewing which was an average of 9.2 min (median: 5.4; IQR: 3.4–8.7) for optometrists and 3.0 min (median: 3.0; IQR: 1.7–3.9) min for ophthalmologists. A variety of diagnosis was covered by this tool with dry age-related macular degeneration (n=34) being most common.Conclusion After implementation more than half of the HES referrals have been avoided. This platform offers a digital-first solution that enables rapid-access eye care for patients in community optometrists, facilitates communication between healthcare providers and may serve as a foundation for implementation of artificial intelligence.