Experiences with developing and implementing a virtual clinic for glaucoma care in an NHS setting.
BACKGROUND
This article describes the development of a virtual glaucoma clinic, whereby technicians collect information for remote review by a consultant specialist.


METHODS
This was a hospital-based service evaluation study. Patients suitable for the stable monitoring service (SMS) were low-risk patients with "suspect", "early"-to-"moderate" glaucoma who were deemed stable by their consultant care team. Three technicians and one health care assistant ran the service. Patients underwent tests in a streamlined manner in a dedicated clinical facility, with virtual review of data by a consultant specialist through an electronic patient record.


METHODS
Feasibility of developing a novel service within a UK National Health Service setting and improvement of patient journey time within the service were studied.


RESULTS
Challenges to implementation of virtual clinic include staffing issues and use of information technology. Patient journey time within the SMS averaged 51 minutes, compared with 92 minutes in the glaucoma outpatient department. Patient satisfaction with the new service was high.


CONCLUSIONS
Implementing innovation into existing services of the National Health Service is challenging. However, the virtual clinic showed an improved patient journey time compared with that experienced within the general glaucoma outpatient department. There exists a discrepancy between patient management decisions of reviewers, suggesting that some may be more risk averse than others when managing patients seen within this model. Future work will assess the ability to detect progression of disease in this model compared with the general outpatient model of care.
Glaucoma Service, Moorfields Eye Hospital National Health Service Foundation Trust ; NIHR BRC, Moorfields Eye Hospital, NHS Foundation Trust and UCL Institute of Ophthalmology, University College London, London, UK.
Aachal
A
Kotecha
Glaucoma Service, Moorfields Eye Hospital National Health Service Foundation Trust.
Alex
A
Baldwin
Glaucoma Service, Moorfields Eye Hospital National Health Service Foundation Trust.
John
J
Brookes
Glaucoma Service, Moorfields Eye Hospital National Health Service Foundation Trust ; NIHR BRC, Moorfields Eye Hospital, NHS Foundation Trust and UCL Institute of Ophthalmology, University College London, London, UK.
Paul J
PJ
Foster
glaucoma; implementation; service delivery; virtual clinic