Posters

Surgical rates following new medicare reimbursement for telehealth service in Western Australia

Poster Details

First Author: A.Turner AUSTRALIA

Co Author(s):    S. Bartnik                    

Abstract Details

Purpose:

To evaluate impact of a new telehealth Medicare reimbursement on an established outback surgical service in Western Australia. The Lions Outback Vision Teleophthalmology Service has been providing teleophthalmology consultations to rural Western Australia since 2011. The service augments regular ophthalmology and optometry outreach clinics. New Medicare reimbursement was introduced in 2015 for Optometrists facilitating video-conferencing with a specialist.

Setting:

The Lions Outback Vision telehealth service is based at the Lions Eye Institute affiliated with the University of Western Australia.

Methods:

Methods: Analysis of two audits of all optometry referred teleophthalmology consultations over the same five-month period in 2014 and 2016. Descriptive comparison and statistical analysis to assess the rates of cataract surgery bookings. The nature of referrals including frequency of imaging supporting the referrals and the clinical outcomes of teleophthalmology booked cataract surgery.

Results:

Results: The average monthly frequency of consultations increased significantly between 2014 and 2016 (p-value = 0.04). There was more likely to be imaging associated with a referral (OR 1.84, 95% CI 1.29 – 2.62) in the 2016 audit period compared to 2014. There was more imaging associated with referrals in 2016 compared to 2014 (p-value < 0.01). Significantly more patients were booked for surgery following teleophthalmology consultation in 2016 compared to 2014 (p-value < 0.01). Significantly more patients went on to have their cataract surgery in 2016 compared to 2014 (p-value = 0.01).

Conclusions:

Discussion: The introduction of Medicare reimbursement appears to have had a significant impact on telehealth referrals from optometrists. Resident optometrists with comprehensive imaging equipment is one factor that may have resulted in a greater number of referrals being accompanied by relevant imaging or investigations. Surgical management as an outcome has increased since 2014 with a greater proportion of patients booked for cataract surgery are having their operation. This highlights the need to embed a telehealth program within an outreach or visiting ophthalmology service.

Financial Disclosure:

None