Use of Teleophthalmology for Evaluation of Ophthalmic Emergencies by Ophthalmology Residents in the Emergency Department.

Yesha S Shah, Michael J Fliotsos, Abdulaziz Alaqeel, Michael V Boland, Sidra Zafar, Divya Srikumaran, Fasika A Woreta
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引用次数: 3

Abstract

Background:Utilizing telemedicine is one approach to reduce the ever-increasing burden of patients on emergency departments (EDs) and consulting physicians. Utilization of telemedicine services in the ED may also benefit resident education.Materials and Methods:Ten first-year ophthalmology residents were trained to use a Topcon 3D Optical Coherence Tomography (OCT)-1 Maestro to capture OCT images and fundus photos in patients presenting to the ED with urgent ophthalmic concerns. Findings were communicated to the supervising ophthalmologist. Retrospective chart review was conducted to obtain patient characteristics and final ophthalmologist diagnosis. Residents rated ease of use, technical reliability, and educational value through a survey.Results:From December 1, 2019, to December 1, 2020, the device was used in 109 patient encounters, capturing 887 images (average 8.1 images per encounter). Patients on whom the device was used were on average 48.5 years old (±17.2, range 17-90) and 59.6% were female. The imaging device was utilized most commonly for evaluating papilledema (n = 21, 18.6%), new-onset visual acuity/visual field defects (n = 12, 10.6%), retinal detachment/tear (n = 8, 7.1%), and ophthalmic trauma workup (n = 8, 7.1%). Eight residents completed the survey and most (n = 7) agreed or strongly agreed that the device helped them diagnose patients more accurately. Technical issues such as machine malfunction, image artifacts, and problems syncing with the electronic health record and computer were noted by survey respondents.Conclusions:The most common use of teleophthalmology in the ED setting was evaluation of papilledema; the majority of residents perceived an educational benefit from this tool. Efforts should be made to address the technical challenges to increase the utility of this device.

急诊科眼科住院医师使用远视技术评估眼科急诊情况。
背景:利用远程医疗是减轻急诊科(ed)和会诊医生日益增加的患者负担的一种方法。在急诊科利用远程医疗服务也可能有利于住院医师教育。材料和方法:对10名一年级眼科住院医师进行培训,学习如何使用Topcon 3D光学相干断层扫描(OCT)-1 Maestro,为就诊于急诊科的眼科患者拍摄OCT图像和眼底照片。检查结果被告知监督眼科医生。回顾性图表复习,以获得患者的特点和最终的眼科医生诊断。居民们通过一项调查对易用性、技术可靠性和教育价值进行了打分。结果:2019年12月1日至2020年12月1日,该设备共用于109例患者就诊,采集图像887张(平均每次就诊8.1张)。使用该装置的患者平均年龄为48.5岁(±17.2岁,范围17-90岁),其中59.6%为女性。该成像设备最常用于评估乳头水肿(n = 21, 18.6%)、新发视力/视野缺损(n = 12, 10.6%)、视网膜脱离/撕裂(n = 8, 7.1%)和眼外伤检查(n = 8, 7.1%)。8名住院医生完成了调查,大多数(n = 7)同意或强烈同意该设备帮助他们更准确地诊断患者。调查受访者指出了机器故障、图像伪影以及与电子健康记录和计算机同步的问题等技术问题。结论:在急诊科中,最常用的远距眼科检查是评估视乳头水肿;大多数居民认为这个工具对教育有好处。应努力解决技术上的挑战,以提高这一装置的效用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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