Dabasia Priya L, Edgar David F, Garway-Heath David F, Lawrenson John G
Centre for Public Health Research, School of Health Sciences, City University London, London, UK.
Ophthalmic Physiol Opt. 2014 Sep;34(5):592-613. doi: 10.1111/opo.12150.
To investigate current and anticipated use of equipment and information technology (IT) in community optometric practice in the UK, and to elicit optometrists' views on adoption of specialist equipment and IT.
An anonymous online questionnaire was developed, covering use of standard and specialist diagnostic equipment, and IT. The survey was distributed to a random sample of 1300 UK College of Optometrists members.
Four hundred and thirty-two responses were received (response rate = 35%). Enhanced (locally commissioned) or additional/separately contracted services were provided by 73% of respondents. Services included glaucoma repeat measures (30% of respondents), glaucoma referral refinement (22%), fast-track referral for wet age-related macular degeneration (48%), and direct cataract referral (40%). Most respondents (88%) reported using non-contact/pneumo tonometry for intra-ocular pressure measurement, with 81% using Goldmann or Perkins tonometry. The most widely used item of specialist equipment was the fundus camera (74% of respondents). Optical Coherence Tomography (OCT) was used by 15% of respondents, up from 2% in 2007. Notably, 43% of those anticipating purchasing specialist equipment in the next 12 months planned to buy an OCT. 'Paperless' records were used by 39% of respondents, and almost 80% of practices used an electronic patient record/practice management system. Variations in responses between parts of the UK reflect differences in the provision of the General Ophthalmic Services contract or community enhanced services. There was general agreement that specialised equipment enhances clinical care, permits increased involvement in enhanced services, promotes the practice and can be used as a defence in clinico-legal cases, but initial costs and ongoing maintenance can be a financial burden. Respondents generally agreed that IT facilitates administrative flow and secure exchange of health information, and promotes a state-of-the-art practice image. However, use of IT may not save examination time; its dynamic nature necessitates frequent updates and technical support; the need for adequate training is an issue; and security of data is also a concern.
UK optometrists increasingly employ modern equipment and IT services to enhance patient care and for practice management. While the clinical benefits of specialist equipment and IT are appreciated, questions remain as to whether the investment is cost-effective, and how specialist equipment and IT may be used to best advantage in community optometric practice.
调查英国社区验光实践中设备及信息技术(IT)的当前使用情况和预期使用情况,并了解验光师对采用专业设备和IT的看法。
设计了一份匿名在线问卷,内容涵盖标准和专业诊断设备以及IT的使用情况。该调查被分发给1300名英国验光师学院成员的随机样本。
共收到432份回复(回复率 = 35%)。73%的受访者提供了强化(本地委托)或额外/单独签约的服务。服务包括青光眼复查测量(30%的受访者)、青光眼转诊优化(22%)、湿性年龄相关性黄斑变性快速转诊(48%)以及直接白内障转诊(40%)。大多数受访者(88%)报告使用非接触式/气动眼压计测量眼压,81%使用戈德曼或珀金氏眼压计。使用最广泛的专业设备是眼底照相机(74%的受访者)。15%的受访者使用光学相干断层扫描(OCT),高于2007年的2%。值得注意的是,预计在未来12个月内购买专业设备的受访者中有43%计划购买OCT。39%的受访者使用“无纸”记录,近80%的诊所使用电子病历/诊所管理系统。英国不同地区的回复差异反映了普通眼科服务合同或社区强化服务提供方面的差异。普遍认为专业设备可提高临床护理水平,允许更多地参与强化服务,促进业务发展,并可在临床法律案件中用作辩护,但初始成本和持续维护可能会带来经济负担。受访者普遍认为IT有助于行政流程和健康信息的安全交换,并提升现代化的业务形象。然而,使用IT可能不会节省检查时间;其动态特性需要频繁更新和技术支持;需要进行充分培训是一个问题;数据安全也是一个关注点。
英国验光师越来越多地采用现代设备和IT服务来改善患者护理和进行业务管理。虽然专业设备和IT的临床益处得到认可,但对于投资是否具有成本效益以及专业设备和IT如何在社区验光实践中发挥最大优势仍存在疑问。