A paper from India on the use of telemedicine for eye health during COVID-19. Citation, abstract and a comment from me below.
CITATION: Indian J Ophthalmol. 2020 Jun; 68(6): 1007–1012.
Published online 2020 May 25. doi: 10.4103/ijo.IJO_1089_20
Tele-consultations and electronic medical records driven remote patient care: Responding to the COVID-19 lockdown in India
Anthony V Das et al.
Purpose: To describe the experience of tele-consultations addressed at the centre of excellence of a multi-tier ophthalmology hospital network in India during the ongoing novel coronavirus (COVID-19) lockdown.
Methods: This cross-sectional hospital-based study included 7,008 tele-consultations presenting between March 23rd and April 19th 2020. A three-level protocol was implemented to triage the calls. The data of patient queries were collected using a Google Form/Sheets and the tele-calls were returned using the patient information retrieved from the electronic medical record system.
Results: Overall, 7,008 tele-calls were addressed, of which 2,805 (40.02%) patients where a clinical-related query was answered were included for analysis. The most common queries were related to redness/pain/watering/blurring of vision (31.52%), closely followed by usage of medications (31.05%). The majority of the queries were directed to the department of cornea (34.15%), followed by retina (24.74%). Less than one-fifth of the patients were from the lower socio-economic class (16.08%) and one-fourth were new patients (23.96%). The most common advice given to the patient was related to management of medications (54.15%) followed by appointment related (17.79%). Emergency requests requiring further evaluation by an ophthalmologist accounted for a small percentage (16.36%) of patients.
Conclusion: Tracking of tele-consultations and access to patient information from the electronic medical records enabled a timely response in an ongoing lockdown due to the COVID-19 pandemic. The current experience provided valuable insights to the possibility of managing patient follow-up visits remotely in the future.
COMMENT (NPW): One of the potential downsides of telemedicine is its potential to increase inequalities in access to care. The authors note that 'less than one-fifth of the patients were from the lower socio-economic class', which can only be interpreted if one knew the proportion of 'lower socio-economic class' in the population. The full text notes also that 75% of the patients accessing the service were men, suggesting a gender divide.