Das Anthony Vipin, Khanna Rohit C, Kumar Niranjan, Rani Padmaja Kumari
Department of eyeSmart EMR & AEye, L V Prasad Eye Institute, Hyderabad, Telangana, India.
Department of Teleophthalmology, L V Prasad Eye Institute, Hyderabad, Telangana, India.
Int J Telemed Appl. 2022 Jan 27;2022:8523131. doi: 10.1155/2022/8523131. eCollection 2022.
To describe the clinical indications and the impact of implementation of specific teleophthalmology referral guidelines in a large rural village vision centre network in India.
This cross-sectional vision centre-based study included 1,016,284 patients presenting between January 2017 and March 2020. Patients who were referred for a teleophthalmology opinion were included as cases. The data were collected using the eyeSmart EMR app on a smart tablet. A training intervention was done to reinforce the implementation of targeted teleophthalmology referral guidelines.
Overall, 63,703 (6.3%) patients were referred for a teleophthalmology opinion and were included for analysis. The median age was 41 (IQR: 26-59) years, and adults (88.4%) were commonly referred for a consult. The two most common age groups were between 31-40 years (17.4%) and 21-30 years (16.3%), and the majority of patients were male (59.1%). The most common clinical indication was cornea and anterior segment disorders (71.05%). The most common queries for teleophthalmology referral before versus after the reinforcement of implementation of guidelines were red eye (33.4% vs. 45.6%) followed by cataract (21.2% vs. 8.1%). There was an increase in the red eye (<0.001) and a decrease in cataract (<0.001) which was statistically significant. The proportion of patients for whom a teleophthalmology consult could have been requested but not sent was minimal (2.3%).
Implementation of targeted teleophthalmology referral guidelines enables an effective triage to seek opinion for more pertinent ocular diseases that require care. Adult male patients with cornea and anterior segment disorders are most commonly referred for a teleophthalmology opinion.
描述印度一个大型乡村视力中心网络中特定远程眼科转诊指南的临床适应症及实施影响。
这项基于视力中心的横断面研究纳入了2017年1月至2020年3月期间就诊的1,016,284名患者。被转诊以获取远程眼科意见的患者被纳入病例组。数据通过智能平板电脑上的eyeSmart EMR应用程序收集。进行了培训干预以加强针对性远程眼科转诊指南的实施。
总体而言，63,703名（6.3%）患者被转诊以获取远程眼科意见并纳入分析。中位年龄为41岁（四分位间距：26 - 59岁），成人（88.4%）是最常被转诊咨询的人群。两个最常见的年龄组是31 - 40岁（17.4%）和21 - 30岁（16.3%），大多数患者为男性（59.1%）。最常见的临床适应症是角膜和眼前节疾病（71.05%）。在加强指南实施之前与之后，远程眼科转诊最常见的问题分别是红眼（33.4%对45.6%），其次是白内障（二十一2%对8.1%）。红眼问题有所增加（<0.001），白内障问题有所减少（<0.001），差异具有统计学意义。本可请求但未发送远程眼科咨询的患者比例极小（2.3%）。
实施针对性的远程眼科转诊指南能够进行有效的分诊，以便为需要治疗的更相关眼部疾病寻求意见。患有角膜和眼前节疾病的成年男性患者最常被转诊以获取远程眼科意见。
