title: Improved access and cycle time with an "in-house" patient-centered teleglaucoma program versus traditional in-person assessment.
abstract: BACKGROUND
  To compare access time and cycle time between an "in-house" teleglaucoma program and in-person glaucoma consultation.
  
  
  METHODS
  This was a prospective comparative study of 71 patients seen through the teleglaucoma program (eligible patients were glaucoma suspects or early-stage open-angle glaucoma) and 63 patients seen via a traditional in-person exam with a physician present. Access time was calculated as the time from the patient being referred to the date of a booked visit for either a teleglaucoma or in-person exam. Cycle time was defined as the time from registration until departure during the visit to the hospital; it was calculated for the subset of patients from each study group who completed activity logs on the day of their visit.
  
  
  RESULTS
  The mean access time was significantly shorter for patients seen through teleglaucoma compared with in-person exam: 45±22 days (range, 13-121 days) (n=68) versus 88±47 days (range, 27-214 days) (n=63), respectively (p<0.0001). The cycle time was also reduced for patients seen through teleglaucoma, compared with in-person assessment: 78±20 min (range, 40-130 min) (n=39) versus 115±44 min (range, 51-216 min) (n=39), respectively (p<0.001). The mean percentage time spent in the waiting room was also significantly reduced for patients seen through teleglaucoma versus in-person assessments: 19±13% versus 41±24% (n=39), respectively (p<0.01).
  
  
  CONCLUSIONS
  Teleglaucoma improves access to care and is a more efficient way of managing glaucoma suspects and patients with early-stage glaucoma compared with in-person assessment.
authors.affiliation: Department of Ophthalmology, University of Alberta , Edmonton, Alberta, Canada .
authors.forename: Sourabh
authors.initials: S
authors.lastname: Arora
authors.forename: Chris J
authors.initials: CJ
authors.lastname: Rudnisky
authors.forename: Karim F
authors.initials: KF
authors.lastname: Damji
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000416:Alberta; D001071:Appointments and Schedules; D015331:Cohort Studies; D005260:Female; D005901:Glaucoma / Q000175:diagnosis* / Q000628:therapy; D006297:Health Services Accessibility / Q000458:organization & administration; D006801:Humans; D007297:Inpatients / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009885:Ophthalmology / Q000379:methods; D018802:Patient-Centered Care / Q000458:organization & administration*; D010808:Physical Examination / Q000379:methods*; D015397:Program Evaluation; D011446:Prospective Studies; D058996:Quality Improvement; D012017:Referral and Consultation / Q000458:organization & administration*; D018709:Statistics, Nonparametric; D017216:Telemedicine / Q000458:organization & administration*; D013997:Time Factors