By Craig Smith

A FIFE project which referred eye patients to hospital by Email rather than conventional ‘snail’ mail could save the NHS millions of pounds each year, it has been claimed.

Medical staff at NHS Fife made the claim after a pilot study examining the issue scooped second prize in the Scottish Clinical Information in Practice awards in Dunblane earlier this month.

During the study, optometrists photographed the eyes of 346 patients aged between five and 93 years old and sent the images electronically to hospital eye specialists.

Hospital doctors examining the images were then able to confirm eye problems needing attention in almost two out of three cases—preventing the need for a hospital appointment in 128 cases.

In addition, patients believed to have conditions requiring urgent attention were seen sooner than they normally would have been—potentially saving their sight in some circumstances.

Since out-patient appointments in Scotland cost between £108 and £307 each, NHS Fife believes the savings through electronic referral could run into hundreds of thousands of pounds per year for individual hospitals.

Eye specialist Roshini Sanders said all patients involved were later invited to attend the hospital eye service where they were seen by doctors to ensure nothing was missed and to validate the study’s results.

However she revealed that researchers concluded that electronic referral was “safe, speedy, efficient, clinically accurate and avoids unnecessary consultations” and suggested that the technique could be more widely used.

“The obvious benefit is patients get speedier diagnosis and treatment, but it also avoids unnecessary hospital appointments,” she said.

“I am delighted that the innovative work carried out by members of the hospital eye service and by optometrists has been recognised.

“We are particularly grateful to NHS Fife’s E-health directorate which funded the project and provided expert help and advice.”

Traditional practice is for optometrists to send patients’ results to GPs who then forward them to hospital along with the patient’s medical history.

During the project, however, GPs received a copy of the referral and were able to send on relevant medical information electronically.

Out of the 346 patients examined throughout the study, 218 or 63% were classified as needing a hospital eye service appointment, but the remainder could simply be reassured by their optometrist.

Tele-ophthalmology, or diagnosing eye disease from images sent electronically to a specialist, has been used successfully in rural Australia.

Since the success of the pilot study NHS Fife has gone on to develop its use of the technique by creating a central ophthalmic electronic referral unit.

The vast majority of GPs and optometrists are now part of the computerised system, with all said to be in favour of it.