Delivery of remote otology care: a UK pilot feasibility study

IntroductionThe COVID-19 pandemic has catalysed the need to implement the National Health Service Long-Term Plan to deliver more care in the community and to reduce face-to-face hospital appointments by up to 33%. This study aimed to assess the feasibility of a remote otology service from triage thr...

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Vydáno v:BMJ open quality Ročník 11; číslo 1; s. e001444
Hlavní autoři: Forde, Cillian T, Dimitrov, Lilia, Doal, Suneal, Patel, Jay, Clare, Dawn, Burslem, Michael, Mehta, Nishchay, Manjaly, Joseph G
Médium: Journal Article
Jazyk:angličtina
Vydáno: England British Medical Journal Publishing Group 01.02.2022
BMJ Publishing Group LTD
BMJ Publishing Group
Témata:
Adolescent
Adult
Aged
Coronaviruses
COVID-19
Feasibility Studies
Humans
Medical equipment
Middle Aged
Original Research
Otolaryngology
Otology
outpatients
Pandemics
Patient satisfaction
Quality control
Quality improvement
SARS-CoV-2
State Medicine
Telemedicine
United Kingdom
waiting lists
Young Adult
United Kingdom
United Kingdom > UK
England
COVID-19
telemedicine
outpatients
waiting lists
quality improvement
ISSN:2399-6641, 2399-6641
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Shrnutí:IntroductionThe COVID-19 pandemic has catalysed the need to implement the National Health Service Long-Term Plan to deliver more care in the community and to reduce face-to-face hospital appointments by up to 33%. This study aimed to assess the feasibility of a remote otology service from triage through to delivery.MethodsNew adult otology referrals at a tertiary ear, nose and throat (ENT) hospital aged between 18 and 70 with hearing loss or tinnitus were included. Patients attended an audiology-led community clinic where they underwent a focused history, audiometric testing, and a smartphone-based application and otoscope (Tympa System) was used to capture still and video images of their eardrums. The information was reviewed by ENT clinicians using a remote review platform with a subset of patients subsequently undergoing an in-person review to measure concordance between the two assessments.Results58 patients participated. 75% of patients had their pathways shortened by one hospital visit with 65% avoiding any hospital attendances. 24% required an additional face-to-face appointment due to incomplete views of the tympanic membrane or need for additional examinations. Electronic validation by a blinded consultant otologist demonstrated a diagnosis concordance of 95%, and concordance between remote-review and in-person consultations in the 12 patients who agreed to attend for an in-person review was 83.3%. 98% of patients were satisfied with the pathway.ConclusionThis pilot service is feasible, safe and non-inferior to the traditional outpatient model in the included patient group. There is potential for the development of a community audiology-led service or use for general practioner advice and guidance.
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CTF and LD are joint first authors.
ISSN:2399-6641
2399-6641
DOI:10.1136/bmjoq-2021-001444