Effectiveness of an Ophthalmic Hospital-Based Virtual Service during the COVID-19 Pandemic

Wu, Xiaohang; Chen, Jingjing; Yun, Dongyuan; Yuan, Meng; Liu, Zhenzhen; Yan, Pisong; Sim, Dawn A; Zhu, Yi; Chen, Chuan; Hu, Weiling; Wu, Zijian; Lin, Huaide; Wang, Yandong; Wu, Yanling; Chen, Mingfei; Zhang, Caoxian; Zheng, Yongxin; Liu, Xialin; Zhong, Xingwu; Diao, Hongyan; Ting, Daniel Shu Wei; Gunasekeran, Dinesh Visva; Li, Yongqiang; Zhang, Jie; Cai, Yaobin; Lao, Zhihao; Liu, Yizhi; Wong, Tien Yin; Lin, Xiaofeng

doi:10.1016/j.ophtha.2020.10.012

Cited by 31 publications

(35 citation statements)

References 7 publications

(8 reference statements)

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“…48 This model has been used by eye care providers to scale up responses and reduce unnecessary encounters during COVID-19, such as the virtual internet hospital model applied by the Zhongshan Ophthalmic Centre in China. 49 In addition to ophthalmology, various AI-based conversational chatbots have been applied with this model in pilot studies, 63 although more robust clinical validation is required. 64,65 Conversely, the hub-and-spoke model augments clinical services in geographically remote settings (the so-called spoke) through patient-provider or provider-provider consultations with providers or specialists based in referral centres or tertiary hospitals serving the catchment area (the so-called hub).…”

Section: Out-of-hospital Operational Modelsmentioning

confidence: 99%

“…Issues from interactions with the existing models of care (either to overlay, augment, replace current models, etc) Ethics and medicolegal constraints Provider acceptance (eg, clinicians, nurses) 54 Pilot validation studies (with a focus on clinical outcomes or performance) 49,55 Guidelines for use, liability for negative outcomes, safety net mechanisms 61,66 Mesosystem (eg, hospital, hub-and-spoke model)…”

Section: Potential Barriersmentioning

confidence: 99%

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Digital health during COVID-19: lessons from operationalising new models of care in ophthalmology

Gunasekeran

Tham

Ting

et al. 2021

The Lancet Digital Health

117

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The COVID-19 pandemic has resulted in massive disruptions within health care, both directly as a result of the infectious disease outbreak, and indirectly because of public health measures to mitigate against transmission. This disruption has caused rapid dynamic fluctuations in demand, capacity, and even contextual aspects of health care. Therefore, the traditional face-to-face patient-physician care model has had to be re-examined in many countries, with digital technology and new models of care being rapidly deployed to meet the various challenges of the pandemic. This Viewpoint highlights new models in ophthalmology that have adapted to incorporate digital health solutions such as telehealth, artificial intelligence decision support for triaging and clinical care, and home monitoring. These models can be operationalised for different clinical applications based on the technology, clinical need, demand from patients, and manpower availability, ranging from out-of-hospital models including the hub-andspoke pre-hospital model, to front-line models such as the inflow funnel model and monitoring models such as the so-called lighthouse model for provider-led monitoring. Lessons learnt from operationalising these models for ophthalmology in the context of COVID-19 are discussed, along with their relevance for other specialty domains.

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Section: Out-of-hospital Operational Modelsmentioning

confidence: 99%

Section: Potential Barriersmentioning

confidence: 99%

Digital health during COVID-19: lessons from operationalising new models of care in ophthalmology

Gunasekeran

Tham

Ting

et al. 2021

The Lancet Digital Health

117

View full text Add to dashboard Cite

show abstract

“…Firstly, non-COVID-19 patients' medical needs have been greatly affected, which may have caused psychological distress. However, the emergence of a virtual hospital, not limited by place or time that enabled patients to see physicians while avoiding a crowded waiting room, became an alternative for many patients ( 7 ). Online consultation can address some patients' needs, but it is uncertain whether seeing a health care provider virtually can affect patients' mental state.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Associated Factors of Depression, Anxiety and Insomnia Symptoms Among Patients Receiving Ophthalmic Consultation Online During the COVID-2019 Pandemic

et al. 2022

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ObjectiveThis study aims to assess the prevalence and associated factors of depression, anxiety and insomnia symptoms among patients undergoing ophthalmic consultation online during the coronavirus disease 2019 (COVID-2019) pandemic.MethodsWe reviewed the data of patients who received online ophthalmic consultations during the lockdown period from February to August 2020, and an online survey was conducted among them. We collected the respondents' demographic data and their attitudes toward the online consultation, assessed the depression, anxiety and insomnia symptoms and estimated associated factors by logistic regression analysis.ResultsThe online service provided 425 consultations during the COVID-19 lockdown period. Of these eligible subjects, 139 patients responded to an invitation to participant in the study (105/75.5% were females, and 40/28.8% were health care workers). More than half of the participants reported that they trusted and were satisfied with the online consultation (109/78.4% and 82/59%, respectively). Fifty-two (37.4%), 32 (23.0%), and 53 (38.1%) patients showed symptoms of depression, anxiety, and insomnia, respectively. Depression was found to be significantly more common in health care workers (P = 0.019) and those who were basically satisfied with online consultation (P = 0.024). Anxiety was more common among participants who had used electronics for a long time (P = 0.038). Binary logistic regression showed health care work as a risk factor for depressive symptoms (odds ratio [OR]: 2.424; 95% CI: 1.143–5.143; P = 0.021).ConclusionPsychological distress is highly prevalent among patients who were involved in online consultation for ocular manifestations during the COVID-19 lockdown period. In the context of a major public health event, ophthalmologists should focus not only on ocular symptoms but also on the mental health of their patients, and appropriate psychological support should be given.

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“…In this respect, the findings of a study on this program demonstrated that the development of a virtual hospital could be an effective strategy to enhance the capacity of hospitals following the rapid spread of COVID-19 (7). Another survey in China showed that using virtual hospitals to deliver ophthalmic services during COVID-19 was very effective and could continue even after the pandemic (9). Providing virtual care can facilitate social distancing measures and decrease patient wait time.…”

mentioning

confidence: 99%

Virtual Hospitals During COVID-19 Pandemic: Pros and Cons

et al. 2021

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Effectiveness of an Ophthalmic Hospital-Based Virtual Service during the COVID-19 Pandemic

Abstract: The management of ophthalmic diseases in the virtual hospital can be implemented and is complementary to those of on-site F2F clinics. Virtual clinical service may be a useful model in the post-COVID-19 pandemic “new normal”.

Cited by 31 publications

References 7 publications

Digital health during COVID-19: lessons from operationalising new models of care in ophthalmology

Digital health during COVID-19: lessons from operationalising new models of care in ophthalmology

Prevalence and Associated Factors of Depression, Anxiety and Insomnia Symptoms Among Patients Receiving Ophthalmic Consultation Online During the COVID-2019 Pandemic

Virtual Hospitals During COVID-19 Pandemic: Pros and Cons

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