Oxford Eye Hospital, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK.
Int Ophthalmol. 2023 Nov;43(11):4019-4025. doi: 10.1007/s10792-023-02806-y. Epub 2023 Jul 8.
The growing capacity-demand imbalance has necessitated the accelerated digital transformation of eye care services. The role of Oxford Eye Hospital's (OEH) email advice service has become even more relevant in the post-Covid era. We sought to evaluate its impact on referrals to secondary care.
The consultant-led OEH email advice service primarily targets primary eye care personnel (optometrists and GPs) requiring clinical advice on patient referral. Emails received between September and November 2020 were analysed for demographic data, contents, characteristics, and outcomes. Thematic analysis was performed. A user feedback survey was conducted.
A total of 828 emails were received over the 3-month study period (mean 9.1/day). They were predominantly from optometrists (77.9%) and general practitioners (16.1%). Of the 81.0% (671) relating to clinical advice, over half (54.8%) included images from a variety of modalities, and following review, over half (55.5%) were deemed suitable for management in the community, while 36.5% were referred directly to appropriate subspecialty clinics. Only 8.1% required urgent assessment in eye casualty. Thematic analysis showed that this service was most useful for retinal lesions, optical coherence tomography abnormalities, and borderline abnormal optic discs. No adverse events were identified. User feedback was very positive.
A secure email advice service is a safe and low-maintenance modality that provides direct and efficient two-way communication between primary and secondary eye care professionals. It allows rapid response to clinical queries, referral filtering and refinement, and streamlining of patient referral pathways. Users (predominantly optometrists) were overwhelmingly positive about its usefulness in clinical practice.
不断增长的能力-需求不平衡使得眼科保健服务加速数字化转型成为必要。在新冠疫情后时代，牛津眼科医院（OEH）电子邮件咨询服务的作用更加重要。我们旨在评估其对二级保健转诊的影响。
顾问主导的 OEH 电子邮件咨询服务主要针对需要患者转诊临床建议的初级眼科保健人员（验光师和全科医生）。分析了 2020 年 9 月至 11 月期间收到的电子邮件的人口统计学数据、内容、特征和结果。进行了主题分析。进行了用户反馈调查。
在 3 个月的研究期间共收到 828 封电子邮件（平均每天 9.1 封）。它们主要来自验光师（77.9%）和全科医生（16.1%）。在 81.0%（671 封）与临床建议相关的电子邮件中，超过一半（54.8%）包含来自各种方式的图像，审查后，超过一半（55.5%）被认为适合在社区管理，而 36.5%被直接转诊到适当的亚专科诊所。只有 8.1%需要在眼科急诊进行紧急评估。主题分析表明，该服务对视网膜病变、光学相干断层扫描异常和边界异常视盘最有用。未发现不良事件。用户反馈非常积极。
安全的电子邮件咨询服务是一种安全且低维护的模式，可在初级和二级眼科保健专业人员之间提供直接和高效的双向沟通。它允许快速响应临床查询、转诊筛选和细化，以及简化患者转诊途径。用户（主要是验光师）对其在临床实践中的有用性给予了压倒性的积极评价。
