A technician-delivered ‘virtual clinic’ for triaging low-risk glaucoma referrals

Purpose The purpose of this study is to describe the outcomes of a technician-delivered glaucoma referral triaging service with ‘virtual review’ of resultant data by a consultant ophthalmologist. Patients and methods The Glaucoma Screening Clinic reviewed new optometrist or GP-initiated glaucoma sus...

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Bibliographic Details
Published in:Eye (London) 2017-06, Vol.31 (6), p.899-905
Main Authors: Kotecha, A, Brookes, J, Foster, P J
Format: Article
Language:English
Subjects:
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692/700/228
Allied Health Personnel
Clinical Study
False Negative Reactions
Glaucoma
Glaucoma - diagnosis
Glaucoma - physiopathology
Humans
Intraocular Pressure
Laboratory Medicine
Medicine
Medicine & Public Health
Ophthalmology
Optometry - manpower
Pharmaceutical Sciences/Technology
Referral and Consultation
Retrospective Studies
Risk Factors
Surgery
Surgical Oncology
Telemedicine - methods
Triage - manpower
Vision Screening - methods
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Summary:Purpose The purpose of this study is to describe the outcomes of a technician-delivered glaucoma referral triaging service with ‘virtual review’ of resultant data by a consultant ophthalmologist. Patients and methods The Glaucoma Screening Clinic reviewed new optometrist or GP-initiated glaucoma suspect referrals into a specialist ophthalmic hospital. Patients underwent testing by three ophthalmic technicians in a dedicated clinical facility. Data were reviewed at a different time and date by a consultant glaucoma ophthalmologist. Approximately 10% of discharged patients were reviewed in a face-to-face consultant-led clinic to examine the false-negative rate of the service. Results Between 1 March 2014 and 31 March 2016, 1380 patients were seen in the clinic. The number of patients discharged following consultant virtual review was 855 (62%). The positive predictive value of onward referrals was 84%. Three of the 82 patients brought back for face-to-face review were deemed to require treatment, equating to negative predictive value of 96%. Conclusions Our technician-delivered glaucoma referral triaging clinic incorporates consultant ‘virtual review’ to provide a service model that significantly reduces the number of onward referrals into the glaucoma outpatient department. This model may be an alternative to departments where there are difficulties in implementing optometrist-led community-based referral refinement schemes.
ISSN:0950-222X
1476-5454
DOI:10.1038/eye.2017.9