Abstract
BackgroundDue to the many restrictions imposed during the COVID-19 emergency, the normal clinical activities have been stopped abruptly in view of limiting the circulation of the virus. The extraordinary containment measures have had a dramatic impact on the undertaking and follow-up of ophthalmic outpatients.ObjectiveIn order to guarantee proper monitoring and routine care, the Pediatric Ophthalmology equipe of Rovereto Hospital (North-East of Italy) supported by the Competence Center on Digital Health TrentinoSalute4.0, designed and implemented a digital platform, TreC Oculistica, enabling teleophthalmology. We report our innovative—albeit restricted—experience aiming at testing and maximizing the efficacy of remote ophthalmic and orthoptic visits.MethodsA multidisciplinary team created the TreC Oculistica platform and defined a teleophthalmology protocol. The system consists of a clinician web interface and a patient mobile application. Clinicians can prescribe outpatients with the App and some preliminary measurements to be self-collected before the televisit. The App conveys the clinician’s requests (i.e. measurements) and eases the share of the collected information in a secure digital environment, promoting a new health care workflow.ResultsFour clinicians took part in the testing phase (2 ophthalmologists and 2 orthoptists) and recruited 37 patients (mostly pediatric) in 3 months. Thanks to a continuous feedback between the testing and the technical implementation, it has been possible to identify pros and cons of the implemented functionalities, considering possible improvements. Digital solutions such as TreC Oculistica advance the digitalization of the Italian health care system, promoting a structured and effective reorganization of the workload supported by digital systems.ConclusionsThe study tested an innovative digital solution in the teleophthalmology context and represented the first experience within the Italian healthcare system. This solution opens up new possibilities and scenarios that can be effective not only during the pandemic, but also in the traditional management of public health services.
Highlights
In December 2019, the first cases of Coronavirus disease (COVID-19) emerged as a consequence of SARS-CoV-2 virus
Countries have worked to stem the spread of the infection using social distancing and stay-at-home orders [2, 3], whilst healthcare systems around the world have been forced to rapidly integrate telehealth and digital innovations to mitigate the risk of virus transmission
In this paper we described the genesis and the evolution of an innovative approach to teleophthalmology that took place during the COVID-19 outbreak in the Province of Trento
Summary
In December 2019, the first cases of Coronavirus disease (COVID-19) emerged as a consequence of SARS-CoV-2 virus. Countries have worked to stem the spread of the infection using social distancing and stay-at-home orders [2, 3], whilst healthcare systems around the world have been forced to rapidly integrate telehealth and digital innovations to mitigate the risk of virus transmission. Teleophthalmology enables clinicians to evaluate at a distance patients’ ocular diseases. In principle, this approach can have a positive impact as it can facilitate a more efficient and equitable distribution of often limited healthcare resources compared to the standard healthcare delivery. During the outbreak of COVID-19, telemedicine allowed triaging patients even before their access to the medical facilities, avoided unnecessary visits by monitoring and performing remote visits, and reduced infection risks in the healthcare setting [5]. The extraordinary containment measures have had a dramatic impact on the undertaking and follow-up of ophthalmic outpatients
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