Community Ophthalmic Link

Integrating into practice

In Gloucestershire, we have had Community Ophthalmic Link for around 18 months. The integrated care board (ICB) piloted it in a few practices to start with, and then rolled it out quite quickly. Now, most optometry practices in Gloucestershire and most practitioners have access to it.

At the ICB, there is a small team that looks after Community Ophthalmic Link. For new users, one of the team will visit the practice to install the software, set everything up, explain how it works, and make sure the optometrists are happy with everything.

They have a brilliant support team, contactable via WhatsApp. As long as you’re working during normal practice hours, you have that back-up. That makes it seamless and easy to use.

Source: Gloucestershire Hospitals NHS Foundation Trust

Impact on care

Community Ophthalmic Link had an impact on our practice straightaway. A lot of work to upload imaging was done at the hospital, before we integrated the software in practice. Everything is on one platform, and you can see it in real-time. You don’t have to search separately for the Heidelberg imaging, then the keratometer imaging, then the Humphrey imaging. You can pull up all the field results, or all the GP letters.

From the first patient we saw, we could see everything really easily. The first person I checked was my dad, who has diabetic retinopathy. I could bring in all his images, and all his letters, straightaway.

It gives you real confidence, but also, it’s an easy interface to use with the patient. You can be sitting with the patient, ask if they are happy for you to look at their hospital ophthalmology records, and then bring them up immediately. It’s great from a patient perspective, because you can show them that you’ve got that linked connectivity and that the communication is there. Also, they can see things in real-time. If you’ve done some imaging in the practice, and you want to show them that something is the same as it was when they went to the hospital two years ago, it is easy to do that.

With patients, you get one of two reactions. You sometimes get, ‘oh, I always thought you could do that.’ They assume that we get copies of everything from the hospital. Or, they are really impressed.

We are a 10-minute walk from the hospital. We have had patients who have been in clinic and have come to see us afterwards, and within the time they’ve walked to the practice the information is there. From a patient’s perspective, I think it makes a huge difference.

The first person I checked was my dad, who has diabetic retinopathy. I could bring in all his images, and all his letters, straightaway

A solution to a problem

Before Community Ophthalmic Link, we’d struggled for a lot of years. Optometrists are generally the primary referrer into the hospital eye service, but because of how the hospital system was set up, ophthalmology letters went straight back to the GP. Unless somebody in the ophthalmology department asked the patient who their optometrist was and put those details in, they didn’t come back to us. So, having access to those GP letters, going back years, is fantastic.

In the practice, because it is quick to use, it doesn’t have a huge impact on your time. It’s not an extra thing that you have to check. It makes life so much easier.

For the patient, it is about making appropriate, timely referrals, only when they are needed. With ophthalmology clinics being so over-booked, you can pull up what you have seen in practice and decide whether or not that patient does need to be seen urgently. You can action that in a different way, knowing you’re not wasting hospital resources.

Patients who have got long-term issues might not have been seen in ophthalmology for years, and it might be the first time you’re seeing them in practice. You might notice something and mention it to the patient, and they say, ‘I know something was picked up in the hospital, but I’m not sure what it was.’ If you can look at their scans, you can have more certainty about what the issue is. You can reassure the patient that things are the same, or, if things have changed, you can deal with it appropriately.