Muttuvelu Danson Vasanthan, Buchholt Heidi, Nygaard Mads, Rasmussen Marie Louise Roed, Sim Dawn
Department of Ophthalmology, Copenhagen University Hospital, Kobenhavn, Denmark.
mitØje ApS, Aarhus, Denmark.
BMJ Open Ophthalmol. 2021 Mar 18;6(1):e000671. doi: 10.1136/bmjophth-2020-000671. eCollection 2021.
The purpose of this study was to evaluate the stratification of follow-up and referral pathways after implementation of a systematic cloud-based electronic-referral teleophthalmological service for optometry-initiated ocular posterior segment disease referrals to the Danish national eye care system.
A retrospective cohort study was conducted in the period from 1 August 2018 to 31 July 2019. Patients with suspected ocular posterior segment disease reviewed by the telemedical ophthalmology service were included. The service stratified patients into the categories: no need for follow-up, follow-up by optometrist, follow-up by the telemedical service and referral to the national Danish eye care service.
From a pool of 386 361 customers, 9938 patients were enrolled into this study. 19.5% of all patients were referred to the Danish national eye care system, while 80.5% of the patients in the telemedical service were not, in the period from 1 August 2018 to 31 July 2019. 14.4% of the optometrist referrals did not need any follow-up, while a majority of 66.1% needed some follow-up either by the optometrist themselves or within the telemedical service.
Optometrist posterior segment disease referrals can be considerably reduced with a risk stratified approach and optimal use of technology. New models can improve and streamline the healthcare system.
本研究旨在评估在丹麦国家眼保健系统中,实施基于云的系统性电子转诊远程眼科服务(用于验光引发的眼后段疾病转诊)后随访和转诊途径的分层情况。
在2018年8月1日至2019年7月31日期间进行了一项回顾性队列研究。纳入了经远程医疗眼科服务评估的疑似眼后段疾病患者。该服务将患者分为以下几类:无需随访、由验光师随访、由远程医疗服务随访以及转诊至丹麦国家眼保健服务机构。
在386361名客户中,有9938名患者纳入本研究。在2018年8月1日至2019年7月31日期间,所有患者中有19.5%被转诊至丹麦国家眼保健系统,而远程医疗服务中的患者有80.5%未被转诊。验光师转诊的患者中有14.4%无需任何随访,而大多数(66.1%)需要验光师本人或在远程医疗服务中进行某种随访。
采用风险分层方法并优化技术使用,可以大幅减少验光师对眼后段疾病的转诊。新模式可以改善并简化医疗保健系统。