title: A technician-delivered 'virtual clinic' for triaging low-risk glaucoma referrals.
abstract: PurposeThe purpose of this study is to describe the outcomes of a technician-delivered glaucoma referral triaging service with 'virtual review' of resultant data by a consultant ophthalmologist.Patients and methodsThe Glaucoma Screening Clinic reviewed new optometrist or GP-initiated glaucoma suspect referrals into a specialist ophthalmic hospital. Patients underwent testing by three ophthalmic technicians in a dedicated clinical facility. Data were reviewed at a different time and date by a consultant glaucoma ophthalmologist. Approximately 10% of discharged patients were reviewed in a face-to-face consultant-led clinic to examine the false-negative rate of the service.ResultsBetween 1 March 2014 and 31 March 2016, 1380 patients were seen in the clinic. The number of patients discharged following consultant virtual review was 855 (62%). The positive predictive value of onward referrals was 84%. Three of the 82 patients brought back for face-to-face review were deemed to require treatment, equating to negative predictive value of 96%.ConclusionsOur technician-delivered glaucoma referral triaging clinic incorporates consultant 'virtual review' to provide a service model that significantly reduces the number of onward referrals into the glaucoma outpatient department. This model may be an alternative to departments where there are difficulties in implementing optometrist-led community-based referral refinement schemes.
authors.affiliation: Glaucoma Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK.|NIHR Biomedical Research Centre (BRC) at Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, UK.
authors.forename: A
authors.initials: A
authors.lastname: Kotecha
authors.affiliation: Glaucoma Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK.
authors.forename: J
authors.initials: J
authors.lastname: Brookes
authors.affiliation: Glaucoma Service, Moorfields Eye Hospital NHS Foundation Trust, London, UK.|NIHR Biomedical Research Centre (BRC) at Moorfields Eye Hospital and UCL Institute of Ophthalmology, London, UK.
authors.forename: P J
authors.identifier: http://orcid.org/0000-0002-4755-177X
authors.initials: PJ
authors.lastname: Foster
mesh_terms: D000488:Allied Health Personnel; D005188:False Negative Reactions; D005901:Glaucoma / Q000175:diagnosis* / Q000503:physiopathology; D006801:Humans; D007429:Intraocular Pressure; D009907:Optometry; D012017:Referral and Consultation; D012189:Retrospective Studies; D012307:Risk Factors; D017216:Telemedicine / Q000379:methods*; D014218:Triage; D015351:Vision Screening / Q000379:methods*; D000078329:Workforce