Optometry Research Today is a free monthly online journal that collates and summarizes the latest research about Optometry, including details on myopia, optometric practice, therapy. | ||||||||
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Impact of direct electronic optometric referral with ocular imaging to a hospital eye service.Cameron JR, Ahmed S, Curry P, Forrest G, Sanders R 1Department of Ophthalmology, Queen Margaret Hospital, Dunfermline, Fife, UK. AimsA study to assess the feasibility, safety, and clinical effectiveness of electronic referral-with and without images-of patients directly from optometrists in primary care to the hospital eye service (HES) in contrast to the traditional paper-based referral, through the general practitioner (GP).MethodsThree optometry practices sent consecutive referrals with images through the NHS Net to the HES. The standard General Ophthalmic Service form was electronically redesigned with additional information on patient choice for advice, appointment, or surgery. All paper referrals to the HES from the same three optometry practices before the study period were analysed (control group A) as were all paper referrals from the remaining optometrists in Fife (control group B).ResultsA total of 346 electronic referrals were received over 18 months. 218 (63%) were classified as requiring and 128 (37%) as not requiring a HES appointment. The latter were subsequently examined with unexpected pathology found in three cases (glaucoma, macular pigment epithelial detachment, and possible peripheral retinal tear). In both groups, the major pathologies reported were macular degeneration, cataract, glaucoma, diabetic retinopathy, and abnormal retinal appearances. A total of 17 (15%) patients in group A and 26 (8.4%) patients in group B were classified as not requiring HES appointment. These control groups indicate that approximately 10-15% of paper referrals are not seen in the HES. To summarise, therefore, 63% of people referred by the optometrist directly using electronic referral (with or without images) were given a HES appointment compared to 85% of people referred through the traditional paper method (without images) through their GP.ConclusionElectronic referral with images to the HES is safe, speedy, efficient, and clinically accurate given some limitations and avoids unnecessary consultation in 37% of referrals.Eye advance online publication, 4 July 2008; doi:10.1038/eye.2008.196. Published 4 July 2008 in Eye.
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