Secondary Care, Video

Video: Dr Peter Thomas discusses the future of digital ophthalmology

Our HTN Now 2021 webinar sessions got off to a great start on day one. First up on the agenda was Dr Peter Thomas, Digital Innovation and Consultant Paediatric Ophthalmologist at Moorfields Eye Hospital. In a fascinating breakfast-time talk, he gave us his thoughts on the future of digital ophthalmology, covering a broad range of topics from remote monitoring and video consultation software already in use during the COVID-19 pandemic, through to AI.

Peter told us: “One thing we can know is that we can’t build a building that’s big enough, in the long-term, to carry on caring for patients in the traditional way we do. We have to embrace ways of managing patients digitally, in order to match supply for physical space with demand.

“What does the future look like? We need to provide more care at home and in primary care…and we can identify some of those major services; video consultations, shared care with optometry, remote monitoring and clinical AI.”

On how the use of video consultations can benefit patients, Peter added: “We weren’t sure there was going to be a huge role for video consults but we were totally wrong…click on a link and within a couple of minutes you’re speaking to a virtual receptionist. For our 111-style service – that’s the one we run on A&E – there the typical waiting time is a few minutes. If you’re concerned about your eye you generally can be speaking to a highly-trained ophthalmologist within a few minutes, without referral.

“That turned out to be a very popular service. In the early days of the first COVID lockdown we were getting calls from New Zealand and places, just because we did provide expertise in such an accessible way.

“From our A&E service alone we figure that we save, per year, about a quarter of a million kilometres travelled and another quarter of a million from the video outpatient ones [and] almost a million from telephone…that’s the equivalent of almost twice to the moon and back.

“We save patients, we think, over the course of a year about six years of life in terms of travel time, about 11 times the national average salary of saved train tickets and about 51,000 litres of petrol pollution saved by patients not traveling to hospital.”

On the subject of remote vision monitoring and testing, Peter was keen to stress how the technology, including a system using Amazon Alexa for patients to measure vision at distance from home, can lead to much quicker treatment times.

He said: “So what’s the benefit of home vision testing? More convenient for the patient, especially during COVID-19, less costly for the NHS and more responsive…sometimes we can measure the reduction in the vision before the patient is aware that their vision has gone down…that hopefully will let us get more patients in earlier. We’ve got a saying that time is vision, so the earlier we manage to bring a patient in, the more vision we’re able to save.”

Going on to discuss the advent of technology which allows scans of cross-sections of retinas that provide “incredible anatomical detail” and – this was probably our favourite quote of the day –  are “a bit like tiramisu”, Peter spoke of applying AI that can do useful clinical tasks “at the level of our highly-trained specialists. So it outperforms most human specialists.”

He did however, also advise caution, noting that there is a tendency to over-predict when it comes to AI, with progress having been slower than anticipated in the past.

For more detail on the research and technological advances making ophthalmology such an exciting area, as well as the challenges surrounding the training, support and restructuring that may be required to make it work, watch the full video below.

Watch the session here: