JMIR Publications

ABSTRACT

Background:

If anything, the COVID-19 pandemic learned us how to rethink care delivery. It catalysed creative solutions to amplify the potential of personnel and facilities. This paper presents and evaluates an acutely introduced triaging solution, that evolved into a tool to tackle the ever-growing waiting lists at an academic ophthalmology department: the TeleTriageTeam. A team of undergraduate optometry students, tutor-optometrists, and ophthalmologists collaborate to maintain continuity of eye care. In this ongoing project, we combine innovative inter-professional task allocation, teaching, and remote care delivery.

Objective:

This paper describes this novel approach, and reports on its clinical effectiveness, its impact on waiting lists, and discusses its transformation to a sustainable method for delivering remote eye care.

Methods:

Real-world clinical data of all patients assessed by the TeleTriageTeam between April 16, 2020, and December 31, 2021 are covered in this paper. Business data about waiting lists and patient portal access were collected from our hospital’s capacity management team and IT department. Interim analyses were performed at different time points during the project and this paper will present a synthesis of these analyses.

Results:

A total of 3,658 cases were assessed by the TeleTriageTeam. For approximately half (48%) of the assessed cases, an alternative to a conventional face-to-face consultation was found. The waiting lists that had been built up during the first months of the pandemic diminished and have been stable since the end of 2020, even in periods of imposed lockdown restrictions and reduced capacity. Patient portal access decreased with age and patients who were invited to perform a remote, home-based eye exam at home were on average younger than patients wo were not invited.

Conclusions:

Our acutely introduced approach to remotely review cases and prioritise urgency has been successful in maintaining continuity of care and education throughout the pandemic and evolved into a telemedicine service that is of great interest for future purposes, especially in the routine follow-up of chronic patients. TeleTriage appears as a potentially preferred practice for other clinics and medical specialties. The paradox is that judicious clinical decision making based on remotely collected data actually is possible, lest we as care-givers are willing to change our routines and cognitions regarding face-to-face care delivery.