Developing a pediatric ophthalmology telemedicine program in the COVID-19 crisis

Abstract

Purpose To describe our methodology for implementing synchronous telemedicine during the 2019 novel coronavirus (COVID-19) pandemic. Methods A retrospective review of outpatient records at a single children’s hospital from March 21 to April 10, 2020, was carried out to determine the outcome of already-scheduled face-to-face outpatient appointments. The week leading up to the March 21, all appointments in the study period were categorized as follows: (1) requiring an in-person visit, (2) face-to-face visit that could be postponed, and (3) consultation required but could be virtual. Teams of administrators, schedulers, and ophthalmic technicians used defined scripts and standardized emails to communicate results of categorization to patients. Flowcharts were devised to schedule and implement telemedicine visits. Informational videos were made accessible on social media to prepare patients for the telemedicine experience. Simultaneously our children’s hospital launched a pediatric on-demand e-consult service, the data analytics of which could be used to determine how many visits were eye related. Results A total of 237 virtual ophthalmology consult visits were offered during the study period: 212 were scheduled, and 206 were completed, of which 43 were with new patients and 163 with returning patients. Following the initial virtual visit, another was required on average in 4 weeks by 21 patients; in-person follow-up was required for 170 patients on average 4.6 months after the initial virtual visit. None needed review within 72 hours. The pediatric on-demand service completed 290 visits, of which 25 had eye complaints. Conclusions With proper materials, technology, and staffing, a telemedicine strategy based on three patient categories can be rapidly implemented to provide continued patient care during pandemic conditions. In our study cohort, the scheduled clinic e-visits had a low no-show rate (3%), and 8% of the on-demand virtual access for pediatric care was eye related.

Telemedicine utilization by pediatric ophthalmologists during the COVID-19 pandemic

“…Because virtual options will likely remain important as the pandemic continues to ebb and flow, more work is needed to better integrate telemedicine for remote ophthalmic care and to learn from existing models of teleophthalmology. 9,10 This study was limited by the low response rate. We could not ascertain whether respondents overlapped in the two surveys.…”

COVID-19 outbreak and increased risk of amblyopia and epidemic myopia: Insights from EUROCOVCAT group

“…However, for most of these applications, parameters around safety, efficacy, cybersecurity, privacy, and interoperability still need to be carefully tested before their approval. 50…”

Pediatric otolaryngology telemedicine amid a pandemic – And beyond

“…As a future direction, effective communication strategies must be deployed. Providers in all disciplines were forced to learn how to provide telemedicine to patients quickly and as a result of this, many different platforms, guidelines, checklists, and pathways were implemented [ [25] , [26] , [27] , [28] ]. Patel et al implemented a Surgical Telemedicine Encounter Checklist to decrease the risk for errors and privacy concerns pre-visit, when starting the visit, and closing the visit [ 29 ].…”