Dr. Robert Wisse
In times of COVID-19, TTT uses E-health technology to offer high quality remote urgent eye care, eye testing and adequate education to optometric students.
TeleTriageTeam was born as a collaboration between students, optometrists, and ophthalmologists from Utrecht University of Applied Sciences and UMC Utrecht in order to provide qualitative remote eye care, a need emphasized by the current world pandemic we are facing. Whereas the primary aim of the initiative is to allow for urgent cases to be treaded accordingly, it has also created an environment where the communication with the patient has been improved, visual function was assessed remotely, and it allowed for students to continue their education.
On its way to provide all ophthalmology patients an equal opportunity of remote eye care, the initiative can address a plethora of diagnoses and there are practically no limitations in terms of patient description. However, the success is reliant on how open-minded towards health innovations the patients are, how well they describe their conditions and if they are able to successfully perform an online eye exam. The online eye exam is developed in a public-private collaboration between the UMC Utrecht and Easee BV, an Amsterdam based medtech startup company. (https://easee.online). To date, Easee is the only CE 1m certified supplier of tests of visual function and refraction.
The program is aimed at remotely triaging medical urgencies and rescheduling appointments, as results have shown that over 60% of the care could safely be a teleconsultation, postponed, or referred to regional professionals. In this initiative, optometry-students reach out to patients in a semi-structured interview, assess whether remote eye testing is indicated and whether the patient would be able to do. Their own clinical educators guide this process, and – in accordance with Dutch law – the supervising ophthalmologist finalizes the clinical decisions. Everything is recorded in the EHR and relayed back to the patient and involved general practitioner or external ophthalmologist.
The results show that a large portion of the needed eyecare has been handled remotely. Currently, 3000 patients have been treated so far. On average; ~50% of the patients still had to visit the ophthalmology department, ~20% of care was deferred, ~10% had their consultation changed to a teleconsultation, and ~20% patients were referred back to the GP or regional eyecare provider, or had their consultation cancelled. Thus, the TTT created room for new patients to get an appointment with an ophthalmologist. The online eye test was indicated most frequently to a group of patients not in need of immediate eyecare. The future of remote eyecare in ophthalmology is bright: the necessary technology is coming to age and the acceptance of remote care is increasing among healthcare suppliers and the general public. The big challenges are maintaining high standards in care & communication, the integration of new tech in existing systems, and aiming at maximum inclusivity. Novel tools or procedures should not be reserved for tech-savvy first-adopters, but rather aimed at the typical ophthalmic patient: somewhat older, somewhat visually compromised, and not so digital native.