Communication between eye care professionals for advice and guidance
Guy’s and St Thomas’ Hospitals provide services to a local population that is urban, ethnically and culturally diverse, and considerably more deprived than the national average. During 2017/18, the trust had 2.5 million patient contacts, including 111,000 day-case attendances, 89,000 inpatients, 1.28 million outpatient appointments and 205,000 emergency and urgent care attendances.
There has been a steady increase in demand on hospital eye services and recognition that some patients who attend hospital could be managed in the community. The COVID-19 pandemic suspended elective eye care services, creating a further backlog requiring careful risk assessment to identify which patients to prioritise. It is challenging to accurately and safely identify and manage the most critical emergencies whilst minimising hospital visits and avoiding face-to-face assessments for lower-risk patients.
The COVID-19 pandemic also presented difficulties in trying to reduce the number of interactions between clinicians and patients whilst ensuring consultants could input for definitive clinical decisions.
A solution to offer advice and guidance from consultants to non-medical health care professionals and trainee ophthalmologists through a secure messaging service.
Solution and impact
The St Thomas’ ophthalmology service initially piloted the Pando messaging app as an advice and guidance and second opinion one-to-one communication application between on-call ophthalmology trainees and the consultant. It works well for communication and storage of secure images, location of ward patients, and clinical drawings. There has been increased uptake and use of the app since the start of COVID-19.
The group function of Pando has now also been used to connect the Minor Eye Conditions Service (MECS) optometrists in primary care with the St Thomas’ ophthalmologists to support professional development, joined up leadership and clinical governance between primary and secondary care for the service through group interactions. In addition, the one-to-one messaging function works well when an optometrist has a specific question or requires an opinion on an image or clinical sign. This then allows advice and guidance or support with management, and referral decisions for patients seen in primary care optical practices.
Pando is an intuitive communication tool made for health and social care professionals. It is accessible via the NHS Apps library and available to download on the Google Play Store and Apple App Store. It enables secure messaging, image transfer and patient lists to be shared with individuals or teams. Pando is accessible on both mobile and desktop and is an approved supplier on the NHSX Clinical Communications Framework.
- Secure instant communication
- Simple and effective image capture and sharing
- A smart directory to find exactly who you need
- Patient lists can be created to assist monitoring of patients from clinic or the ward and can also be used to share notes and tasks with other healthcare professionals
- As easy to use as other messaging apps, but built for healthcare
- Handle work-life balance with the ‘unavailable’ status toggle
- The ability to send photos and messages securely from referrer and clinician to clinician
- Can be used for advice and guidance, improved referrals and second opinions
“Pando allows us to deploy ‘bring-your-own-device’ clinical photography to all clinicians overnight and at virtually zero cost. In my own clinics, I use it to monitor progression of conditions like orbital cellulitis and have even captured images of congenital cataracts in wriggling babies by attaching my phone to a portable slit lamp”.
Peter Thomas, director of digital innovation and consultant ophthalmologist, Moorfields Eye Hospital.
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Sancy Low, consultant ophthalmic surgeon, Guy’s and St Thomas’ NHS Foundation Trust
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