<p>Digital ophthalmology in Scotland: benefits to patient care and education</p>

Abstract

Tackling visual impairment remains an important public health issue. Due to limited resources and the increasing demand on hospital eye services (HES), delivery of quality eye care within the community is essential. Training of clinical ophthalmic specialists and allied health-care professionals in the detection and management of common eye conditions can thus help to reduce the burden of eye disease and improve prognostic outcomes. Digital imaging has become a useful tool in facilitating eye-care delivery in both the community and hospital setting. In the last decade, the advent of electronic image exchange via a centralized referral unit in Scotland has revolutionized screening for ophthalmic disease, referrals, and shared care between community and HES clinicians. A government-led initiative known as the Scottish Eyecare Integration Project introduced electronic transfer of digital images within referrals from community optometrists to HES, which greatly reduced outpatient waiting times and improved patient satisfaction. The catalogue of live clinical information and digital images that resulted from the project led to the creation of a virtual learning platform through the University of Edinburgh. Participating professionals involved in eye care have interactive discussions about common eye conditions by sharing digital images of cases and investigations on a global online platform. This has received worldwide attention and inspired the creation of other university courses, e-learning platforms in eye-health education, and shared-care schemes in the screening of eye disease. We show that digital ophthalmology plays a vital role in the integration of community and HES partnership in delivery of patient care and in facilitating eye-health education to a global audience.

Assessing the effect of Independent Prescribing for community optometrists and referral rates to Hospital Eye Services in Scotland

“…Following the introduction of the Scottish Eyecare Integration Project, electronic referrals allow easily accessible national statistics for ophthalmic professionals and policy makers regarding community eyecare in Scotland. 9 Current and historical data pertaining to community optometry visits and outpatient hospital attendances since 2010 was obtained from the Information Services Division (ISD), an online statistics warehouse which forms part of NHS Scotland. 10 Through freedom of information (FOI) requests to the GOC and NES in March 2019, a list of all the currently registered IP optometrists in Scotland with their respective practice addresses (postcodes) was obtained.…”

Digital Education in Ophthalmology

“…The role of telemedicine and its potential to promote high- quality care has been well-established, and it lends itself to the expansion of web-based educational efforts. For example, the Scottish Eyecare Integration Project was created to expedite the referral of urgent cases 51 . This program functions using imaging and clinical data uploaded to a web-based platform.…”

“…This program functions using imaging and clinical data uploaded to a web-based platform. Over the years, the data collected culminates into a repository of information that can be easily extracted for educational purposes 51 . As a result, 2 online master's degree courses were created, one geared towards ophthalmology trainees and a second towards allied professio- nals 51 .…”

“…Over the years, the data collected culminates into a repository of information that can be easily extracted for educational purposes 51 . As a result, 2 online master's degree courses were created, one geared towards ophthalmology trainees and a second towards allied professio- nals 51 . Furthermore, with regard to education and telemedicine, the Accreditation Council for Graduate Medical Education set milestones for ophthalmology residents, which includes telehealth as one component.…”

“…51 As a result, 2 online master's degree courses were created, one geared towards ophthalmology trainees and a second towards allied professio-nals. 51 Furthermore, with regard to education and telemedicine, the Accreditation Council for Graduate Medical Education set milestones for ophthalmology residents, which includes telehealth as one component. Cole et al 52 iterate that the role of telemedicine extends beyond triage and diagnosis and is a powerful tool that serves as a medium to address patient concerns, provide education, and ensure medical management is followed.…”