Communication between eye care professionals for referral refinement

Moorfields Eye Hospital NHS Foundation Trust is one of the largest providers of ophthalmology services in Europe, seeing around 800,000 outpatient attendances per year. It provides both acute and elective ophthalmic care from more than 20 sites.

Situation

The COVID-19 pandemic led to the suspension of elective eye services which created difficulties in identifying and managing the most critical emergencies, whilst minimising hospital visits and face-to-face assessments. In addition, there was a requirement to involve consultants in decisions about risk and prioritisation whilst reducing face-to-face appointments and facilitating working from home for staff who were shielding or self-isolating.

Aspiration

A solution to offer low cost secure interactions between clinicians to allow consultant input into clinical decision-making. In addition, it was realised that a referral refinement service would reduce patient visit and journey time and minimise staff exposure, or the need to be on the clinical site.

Solution and impact

Moorfields Eye Hospital rapidly deployed the Pando messaging app in the early stages of the COVID-19 lockdown. The initial identified need was to support team-based communication at a time when it was expected that normal staffing and lines of communication would be disrupted. Clinical teams were rapidly able to organise themselves into messaging groups (similar to WhatsApp) allowing discussions about patients to take place in a secure environment, and enabling other colleagues to access the senior clinical team for advice.

The app has the additional benefit of being able to securely access the clinician’s smartphone camera. At Moorfields, this has allowed deployment of ‘bring your own device’ clinical photography with images uploaded to the trust’s electronic document management system. By using relatively low-cost adapters (such as the Celestron NexYZ) smartphones can be attached to slit lamps to capture microscopic images of the front of the eye (the anterior segment).

This capability is supporting improved referrals to sub-specialists, documentation of findings to allow comparison at follow-up, training, and acceleration of patient visits by replacing journeys to clinical photography with slit lamp imaging. It is also possible to use this solution to connect clinicians across different sites and organisations, including primary care. This allows clinical opinions on referrals to be obtained quickly and supports learning and further professional development.

Functionality

Pando is an intuitive communication tool made for health and social care professionals. It is accessible via the NHS Apps library and available to download on the Google Play Store and Apple App Store. The product enables secure messaging, image transfer and sharing of patient lists with individuals or teams. Pando is accessible on both mobile and desktop and is an approved supplier on the NHSX Clinical Communications Framework.

Capabilities

• Secure instant communication
• Simple and effective image capture and sharing
• A smart directory to find exactly who you need
• Patient lists can be created to assist monitoring of patients from clinic or the ward and can also be used to share notes and tasks with other healthcare professionals
• As easy to use as other messaging apps, but built for healthcare
• Handle work-life balance with an ‘unavailable’ status toggle
  

Scope

• The ability to send photos and messages securely from referrer and clinician to clinician
• Can be used for advice and guidance, improved referrals, second opinions

Key figures/quotes 

”Pando allows us to deploy ‘bring-your-own-device’ clinical photography to all clinicians overnight and at virtually zero cost. In my own clinics, I use it to monitor progression of conditions like orbital cellulitis and have even captured images of congenital cataracts in wriggling babies by attaching my phone to a portable slit lamp”.
Peter Thomas, director of digital innovation and consultant paediatric ophthalmologist, Moorfields Eye Hospital.

Find out more

Find out more from the Pando website

Key contact

Peter Thomas, director of digital innovation and consultant paediatric ophthalmologist, Moorfields Eye Hospital

peterthomas2@nhs.net