Posters

Next-door telemedicine during the COVID-19 outbreak using iPads and iPhones to minimise face-to-face contact: a feasibility study

Poster Details

First Author: C.Gunasekera UK

Co Author(s):    D. Spokes   J. Myerscough   S. Nicolaou   K. Vellenoweth   P. Thomas        

Abstract Details

Purpose:

Ophthalmology cubicles are often confined spaces. The duration of time in a confined space can increase the risk of transmission of pathogens through aerosol or droplet spread like COVID-19. The majority of an ophthalmology consultation consists of either taking a history (4 minutes) or providing an explanation (4 minutes). The slit-lamp examination (1 minute) may put the ophthalmologist at risk as the ophthalmologist is only 20 centimetres from a patient’s face, however, this is the standard of care in making an ophthalmic diagnosis. With modern technology, we can mitigate against unnecessary face-to-face exposure by using video-calling software.

Setting:

Norfolk and Norwich University Hospital NHS Foundation Trust, UK

Methods:

We propose a patient enters a clinic room with an iPad connected to a video call to an ophthalmologist who is in a separate room. An ophthalmologist takes the history in a separate room and then enters the room to examine the patient whilst wearing full personal protective equipment. There is a strict "no talking" policy whilst the slit lamp examination is taking place. The ophthalmologist then leaves the room and completes the rest of the consultation. The iPad, slit lamp, door handles and surrounding area can be wiped clean ready for the next patient.

Results:

Ten patients were piloted using this method consultation using of "Next-door Telemedicine". 9 patients found this method acceptable, however 1 patient with hearing impairment required a regular consultation as they could not hear the iPad clearly. This technique reduced the face-to-face contact time from 9 minutes per patient to 1 minute per patient.

Conclusions:

In the era of airborne and droplet transmissible infections that can cause significant harm to the ophthalmologist and their future patients, we found this technique to be an acceptable method of consultation. There was a high acceptance rate amongst patients and the significant reduction in face-to-face contact will hopefully have an impact on reducing the spread of infections like COVID-19. This technique would be of interest to any ophthalmologist looking to reduce his face-to-face contact and increase patients' safety.

Financial Disclosure:

None