PT  - JOURNAL ARTICLE
AU  - Christoph Kern
AU  - Dun Jack Fu
AU  - Karsten Kortuem
AU  - Josef Huemer
AU  - David Barker
AU  - Alison Davis
AU  - Konstantinos Balaskas
AU  - Pearse A Keane
AU  - Tom McKinnon
AU  - Dawn A Sim
TI  - Implementation of a cloud-based referral platform in ophthalmology: making telemedicine services a reality in eye care
AID  - 10.1136/bjophthalmol-2019-314161
DP  - 2020 Mar 01
TA  - British Journal of Ophthalmology
PG  - 312--317
VI  - 104
IP  - 3
4099  - http://bjo.bmj.com/content/104/3/312.short
4100  - http://bjo.bmj.com/content/104/3/312.full
SO  - Br J Ophthalmol2020 Mar 01; 104
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.