A tele-ophthalmology system for remote consultation for urgent eye care problems

NHS Forth Valley is one of 14 regional health boards in Scotland which caters for a population of approximately 300,000.

Situation

Within the NHS, the general practitioner (GP) has usually been the first point of contact for most patients with an eye problem. However, GPs often do not have the necessary equipment, or see a large enough volume of eye emergencies, to effectively diagnose and treat more complex acute eye conditions. Patients also sometimes attend A&E as GP appointments have become more difficult to obtain which has increased pressure on A&E services.

Aspiration

To create a tele-ophthalmology system which allows for a remote consultation and examination with live discussions with the treating optometrist and patient for urgent eye care services.

Solution and impact

The University of Strathclyde and NHS Forth Valley has developed and implemented a tele-ophthalmology system within 13 emergency treatment centres across Scotland (over three trusts) run by optometrists. The tools include iPad camera, optical coherence tomography (OCT) mirroring, Optosmap mirroring, slit lamp mount, video slit lamp/desktop mirroring and Attend Anywhere video consultation (the wider service is known as NHS ‘Near Me’) in combination with OpenEyes.

This tele-ophthalmology system allows for a remote consultation and examination with discussion with the treating optometrist, ophthalmologist and patient in a three-way live interaction. Over 300 video consultations, this obviated 64% of hospital appointments pre-COVID-19, and 86% post-COVID-19. 39% of patients were treated and followed up within primary care (optometrist or GP) and 20% were treated with no further follow-up required.

Most video consultations (63%) took less than five minutes with high satisfaction scores from patients - 98% of patients fed back that they would recommend video consultations. Staff satisfaction assessment showed that all 86 optometrists said they would recommend this format of consultation.

Functionality

  • A tele-ophthalmology system is a combination of tools and set up that uses a live video feed to securely connect doctors, opticians and patients, and allows for a fully integrated remote video consultation with examination
  • Tools used in the tele-consultations system include OCT mirroring, Optosmap mirroring, slit lamp mount, video slit lamp/desktop mirroring and Attend Anywhere video consultation (called the NHS ‘Near Me’ service)

Capabilities

  • Live remote video consultations with examination
  • Assistance and advice are available from Attend Anywhere
  • Runs entirely on a web browser, allowing patients and clinicians to sign in from anywhere
  • Able to embed video call access into websites, existing systems, workflows and patient pathways, or existing software

Scope

  • Remote consultations and communication can be performed with this platform linking patients to clinicians
  • It allows communication from clinician to clinician including between primary and secondary care, with both clinicians live on the video call with the patient. The system can also share the clinical images and examination from the slit lamp

Key figures/quotes

  • Obviated 64% of hospital appointments pre-COVID-19 and 86% post-COVID-19
  • High satisfaction amongst patients, optometrists, and ophthalmologists
  • 91% of consultations took less than 15 minutes, with 63% completed in under five minutes

Find out more

Download further information from the NHS Scotland website (PDF, 1.4 MB)