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Glaucoma triage system: results of implementing a virtual clinic

2023Journal article Open access
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dc.contributor.authorMatos, Diogo Bernardo
dc.contributor.authorCorreia Barão, Rafael
dc.contributor.authorJosé, Patrícia
dc.contributor.authorLima-Cabrita, Afonso
dc.contributor.authorBarata, Andre
dc.contributor.authorPinto, Luis
dc.date.accessioned2023-07-31T13:46:10Z
dc.date.available2023-07-31T13:46:10Z
dc.date.issued2023
dc.description© The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.pt_PT
dc.description.abstractPurpose: This study describes the virtual clinic triage system implementation process at Hospital Santa Maria-Centro Hospitalar Universitário Lisboa Norte (HSM-CHULN) and analyzes its results regarding healthcare outcomes for the patients and the system. Methods: A retrospective analysis was performed, comparing two cohorts (pre-virtual cohort; virtual triage cohort). Outcomes related to waiting time, number of hospital visits, decisions at first contact, and ancillary exam-based decisions were reported. Results: Two hundred and ninety-two charts were reviewed (pre-virtual cohort: 132; virtual cohort: 160). Mean waiting time between referral and the first medical contact with the glaucoma department decreased on average by 71.3 days (human contact: 286.6 days; virtual triage contact: 215.3 days). Triage system significantly decreased waiting time for glaucoma patients, with an average decrease of 326.8 days between referral and treatment decision. Triage staging allowed to label 107 (66.9; 95% confidence intervals (CI): 59.6%, 74.2%) as non-urgent; 30 (18.8%; 95% CI: 12.7%, 24.9%) as urgent, and 23 (14.3%; 95% CI: 8.9%, 19.7%) as immediate contact, with the scheduling of future appointments reflecting National Institute for Health and Care Excellence (NICE) guidelines in every patient. Moreover, the number of visits to perform the same exams and obtain the same clinical decisions was reduced by 63.6%. Conclusion: Our virtual screening strategy significantly decreased waiting time, number of hospital visits, and increased chances of data-assisted clinical decision. While results can be further improved, this system can add value in an overburdened healthcare system, where triage systems with remote decision-making may be valuable tools in optimizing glaucoma care, even without allocation of extra resources.pt_PT
dc.description.sponsorshipOpen access funding provided by FCT|FCCN (b-on).pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationGraefes Arch Clin Exp Ophthalmol. 2023 Aug;261(8):2367-2374pt_PT
dc.identifier.doi10.1007/s00417-023-06039-8pt_PT
dc.identifier.eissn1435-702X
dc.identifier.issn0721-832X
dc.identifier.urihttp://hdl.handle.net/10451/58802
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherSpringer Naturept_PT
dc.relation.publisherversionhttps://www.springer.com/journal/417pt_PT
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/pt_PT
dc.subjectGlaucomapt_PT
dc.subjectModel of carept_PT
dc.subjectService deliverypt_PT
dc.subjectTriage servicept_PT
dc.subjectVirtual clinicpt_PT
dc.titleGlaucoma triage system: results of implementing a virtual clinicpt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage2374pt_PT
oaire.citation.issue8pt_PT
oaire.citation.startPage2367pt_PT
oaire.citation.titleGraefe's Archive for Clinical and Experimental Ophthalmologypt_PT
oaire.citation.volume261pt_PT
person.familyNameMatos
person.familyNameCorreia Barão
person.familyNameLima-Cabrita
person.familyNameBarata
person.familyNameAbegão Pinto
person.givenNameDiogo Bernardo
person.givenNameRafael
person.givenNameAfonso
person.givenNameAndre
person.givenNameLuis
person.identifier.ciencia-idF216-4AFA-8E65
person.identifier.orcid0000-0002-6929-4524
person.identifier.orcid0000-0002-3102-1969
person.identifier.orcid0000-0002-9186-3826
person.identifier.orcid0000-0002-0976-5603
person.identifier.orcid0000-0002-9960-7579
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT
relation.isAuthorOfPublication605188d8-40e6-434d-bedd-650f1ff46519
relation.isAuthorOfPublication1d6be9e4-74a8-43e2-9e87-ea67c834f019
relation.isAuthorOfPublication25ab1f19-623d-48ba-8584-0c78d1235d7b
relation.isAuthorOfPublicationa8788f82-1531-4cba-a941-f4a501f4ae81
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relation.isAuthorOfPublication.latestForDiscoveryac0af1be-ba49-41eb-9e2f-8d22afb92af0

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