Telemedicine has been one of those buzzwords generated over the past year that likely won’t go anywhere anytime soon. Fortunately, it’s also one of the few buzzwords we’re likely not to get sick of — because it represents a truly positive step forward for many aspects of medicine, including all things eye related.
That the COVID-19 crisis accelerated the prevalence and use of telemedicine (or telehealth, whichever you prefer) worldwide is no surprise. One could go so far as to say it’s the exact opposite of a surprise; “expected” is an inappropriate word in this case because this pandemic was unexpected by all but the wingiest of wingnuts.
An additional unsurprise may follow that telemedicine represents an especially valuable practice in Australia due to its immense size and low population density outside of urban areas. Even in normal circumstances, getting to a glaucoma specialist may be tricky for many; in a pandemic, it’s nigh impossible for many rural Australians.
That’s where Dr. George Yu Xiang Kong comes in. In a recent talk with PIE magazine CEO Matt Young, Dr. Kong explained some interesting specifics in Australia that could be copied to great effect.
Opt for Ophthalmic and Optometric Collaboration
One fine example of innovation that Dr. Kong discussed was a collaboration between ophthalmologists and optometrists during the pandemic. Dr. Kong himself is a glaucoma specialist at the Royal Victorian Eye and Ear Hospital, one of the largest such hospitals in the southern hemisphere. Even before the lockdown, they’d had a significant backlog of patients simply due to natural demand that was continually increasing. Yes, before the pandemic. In the before time. The long, long ago.
Once the pandemic hit, however, many patients weren’t able to visit their normal doctor. So, the ophthalmologists and college of optometrists got together to concoct a clever plan to help manage glaucoma treatments.
Essentially, they ended up forming a natural sort of triage unit. Patients with lower visual acuity, i.e. more minor problems, would visit an optometrist. Those with more significant problems would be referred to an ophthalmologist, whether in person or via telemedicine. Optometrists in Australia are licensed to prescribe eye drops necessary for glaucoma, for example, so they have a fair bit of leeway.
In the event a patient ended up at an optometrist and had a more serious case, no worries: The optometrist could be advised by an ophthalmologist via telemedicine.
There have been two significant effects from this practice. First and foremost, Dr. Kong noted that it dropped wait times at the hospital by several thousand patients over 12 months. That’s a lot of eyes saved, as well as the concurrent stress and any other financial and nonfinancial costs associated.
Second, it’s brought the disciplines of ophthalmology and optometry closer together. Rather than regarding each other as natural enemies, many doctors have discovered it to be far more effective to be allies — and that both they and their patients benefit.
Telemedicine Ain’t Going Nowhere
That telemedicine has exploded in popularity recently is no surprise. That was bound to happen. The surprise is really found in just how quickly it happened, and how effective it can be.
Dr. Kong provided one fine example of a patient who had suffered blunt trauma to his eye. He was developing blood around the macula, a potentially dangerous situation. Dr. Kong sent his patient a link he would click to perform a virtual test to gauge his level of vision loss and the location of the blood.
The blood began to shift off center on its own, and the bleeding stopped. Eventually, the patient was fine. But the key takeaway here is that all of this happened remotely using a program on the internet — no doctor’s visit was needed.
Note that the doctor was still certainly needed. It was the visit to the clinic that wasn’t necessary.
Patients are notably concerned about the safety practices of a clinic of any sorts. Even if the entire clinic has been scrubbed top to bottom with bleach moments before the patient enters, some would still be concerned about the virus. Such is the nature of human fear and pandemics.
This is where telemedicine truly shines. Plenty of new developments abound for glaucoma specialists, for example, to monitor patient’s intraocular pressure at home. Doctors can help patients keep tabs on their patients remotely rather than via consistent checkups. And then no one has to worry about going out, or potentially infecting themselves or others — ideal in this emotional climate.
For All and Sundry to See
There are social and economic benefits to telemedicine as well. One chief impediment to many patients is simply taking the time to travel to a doctor, especially if they live in a rural area. This problem is accentuated in massive, sparsely populated countries like Australia where those in the outback may be hundreds of kilometers from the nearest specialist. For those with little time or money to spare, telemedicine is quite nearly a godsend.
Then there’s the physical aspect. Especially with social distancing measures still imposed in many parts of the world, most clinics and hospitals are not physically equipped to handle the number of patients on their waiting list.
Essentially, the more patients that can be served by telemedicine, the better. For truly grave cases, there are always hospital spots and the option to escalate treatment. But for those who need routine checkups or care, telemedicine will quite possibly evolve into the main interaction patients have with their doctors.
Whatever brave new future awaits us, we’ll be happy as long as doctors are treated well and patients are well taken care of. Because of those we know in the ophthalmic field, we have full optimism such will be the case. Onwards and upwards, as they say.
