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

Eye (Lond). 2017 Jun;31(6):899-905. doi: 10.1038/eye.2017.9. Epub 2017 Feb 17.

Abstract

PurposeThe 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 methodsThe 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.ResultsBetween 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%.ConclusionsOur 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.

MeSH terms

  • Allied Health Personnel*
  • False Negative Reactions
  • Glaucoma / diagnosis*
  • Glaucoma / physiopathology
  • Humans
  • Intraocular Pressure
  • Optometry*
  • Referral and Consultation*
  • Retrospective Studies
  • Risk Factors
  • Telemedicine / methods*
  • Triage*
  • Vision Screening / methods*
  • Workforce