Arora Sourabh, Rudnisky Chris J, Damji Karim F
Department of Ophthalmology, University of Alberta , Edmonton, Alberta, Canada .
Telemed J E Health. 2014 May;20(5):439-45. doi: 10.1089/tmj.2013.0241. Epub 2014 Feb 25.
To compare access time and cycle time between an "in-house" teleglaucoma program and in-person glaucoma consultation.
This was a prospective comparative study of 71 patients seen through the teleglaucoma program (eligible patients were glaucoma suspects or early-stage open-angle glaucoma) and 63 patients seen via a traditional in-person exam with a physician present. Access time was calculated as the time from the patient being referred to the date of a booked visit for either a teleglaucoma or in-person exam. Cycle time was defined as the time from registration until departure during the visit to the hospital; it was calculated for the subset of patients from each study group who completed activity logs on the day of their visit.
The mean access time was significantly shorter for patients seen through teleglaucoma compared with in-person exam: 45±22 days (range, 13-121 days) (n=68) versus 88±47 days (range, 27-214 days) (n=63), respectively (p<0.0001). The cycle time was also reduced for patients seen through teleglaucoma, compared with in-person assessment: 78±20 min (range, 40-130 min) (n=39) versus 115±44 min (range, 51-216 min) (n=39), respectively (p<0.001). The mean percentage time spent in the waiting room was also significantly reduced for patients seen through teleglaucoma versus in-person assessments: 19±13% versus 41±24% (n=39), respectively (p<0.01).
Teleglaucoma improves access to care and is a more efficient way of managing glaucoma suspects and patients with early-stage glaucoma compared with in-person assessment.
比较“内部”远程青光眼项目与面对面青光眼会诊的就诊时间和周期时间。
这是一项前瞻性对照研究,纳入了71例通过远程青光眼项目就诊的患者(符合条件的患者为青光眼疑似患者或早期开角型青光眼患者)以及63例通过传统面对面检查且有医生在场的患者。就诊时间计算为从患者被转诊至预约远程青光眼或面对面检查就诊日期的时间。周期时间定义为从登记到就诊期间离开医院的时间;针对每个研究组中在就诊当天完成活动日志的患者子集进行计算。
与面对面检查相比,通过远程青光眼就诊的患者平均就诊时间显著更短:分别为45±22天(范围13 - 121天)(n = 68)和88±47天(范围27 - 214天)(n = 63)(p<0.0001)。与面对面评估相比,通过远程青光眼就诊的患者周期时间也缩短了:分别为78±20分钟(范围40 - 130分钟)(n = 39)和115±44分钟(范围51 - 216分钟)(n = 39)(p<0.001)。与面对面评估相比,通过远程青光眼就诊的患者在候诊室花费的平均时间百分比也显著降低:分别为19±13%和41±24%(n = 39)(p<0.01)。
与面对面评估相比,远程青光眼改善了医疗服务的可及性,是管理青光眼疑似患者和早期青光眼患者的更有效方式。