1. Eyecare Connect Hub
Designing a hub which coordinates clinical support for consulting, testing, reviewing, diagnosing and referring to improve patient outcomes in an efficient sustainable way.
Digital systems allow for asynchronous review of patient data and clinical decision making
Functionality supports quality assurance of eye care services
Advice and guidance can be shared between professionals across care settings
Where appropriate, there exists a central triage of referrals
This first capability is a key benefit driver for the other capabilities
2. Referrals, triage, advice and review frameworks
Facilitating consistent referral, triage, advice and review frameworks which utilise clinical expertise to speed up processes, reduce workloads and, in some cases, automate tasks.
Consistent rules applied for triaging of patients in secondary care
Consistent rules applied for sending, rejecting and managing referrals across care settings
Where appropriate, second opinion service is available
Where appropriate, imaging and referral processes are automated using emerging technologies e.g. AI
Automated patient communications, such as questionnaires, are utilised in referral and triage management
3. Interaction, feedback and learning channels
Improving interaction and feedback between health and care professionals across care settings to support learning and development.
Feedback on referrals, e.g quality of referral or reason for rejection, is shared between health professionals across different care settings
Learning and development for health professionals is supported through shared communication channels
Relevant updates on the status of patients are shared automatically with GPs and appropriate optometrists
4. Optimisation of appropriate setting for delivery of care
Supporting effective casemix management across all potential eyecare settings and enabling more care to be delivered at or closer to home.
Consistent rules applied to support imaging, diagnostics, monitoring and treatment in a community care setting
Guidance and information for community health and care teams to manage greater levels of appropriate casemix
Where appropriate, virtual clinics are embedded into eyecare health services
Where appropriate, care services are provided at or close to home
Where appropriate, remote consultations are supported in the health pathway
5. Frictionless information, data and image sharing
Delivering a road map for communication and information, data and image sharing across care settings to enhance direct care and referrals.
Live and iterative roadmap is established for communication and information, data and image sharing
Digital referrals and images can be shared between different care settings
Relevant patient status information is accessible to GPs and appropriate optometrists
Information and guidance is available to support optometrists providing direct care services
Secure and verified digital communication between care settings, including by email
6. Patient journey support and information
Transforming the information and support provided to patients so they can better navigate their care journey.
Following a health interaction, patients are directed to support and information relevant to their condition and care interventions
Supplementary, condition-agnostic, logistical information is provided to patients to support their health journey
NHS and voluntary sector support information is collated and shared with patients
Where appropriate, emerging tools are used for collecting and communicating information to patients, e.g. AI automated chat
What insights underpin this pillar?
Previous research has highlighted that eyecare does not have a designated hub where patients can easily access professional help causing confusion on how to start referral journey
"I don't refer patients to community eyecares clinics, that's mostly due to my lack of understanding of what they can do..." GP, MSE_3
"I think ideally the opticians would always be able to refer directly and we are just notified." GP admin staff, MSE_4
What are the principles of the pillar?
The pillar seeks to improve the eyecare experience by implementing an optometrist first approach through a central triage team to ease pressure from primary care
Principles:
  1. digitisation (dedicated email service for referrals)
  2. specialised knowledge - optom led
most relevant to optoms and opthamologists
Guidance & considerations for implementing the pillar
Risk requires training of dedicated email service and constant monitoring to ensure referral requests are not missed mitigation: dedicated staff and training modules
What insights underpin this pillar?
Previous research indicates that eyecare referrals are varied in detail, causing diagnosis delays due to lack of standardization and possibility of rejection.
“I have to go to the Essex LOC website to see the referral pathways. I sometimes get it wrong because it’s not always clear” Optometrist, MSE_6.
What are the principles of the pillar?
The pillar seeks to enforce a standardized approach to referral management to minimize delays.
Principles:
  1. Improve communication between primary and secondary care
  2. Implement digitization for some referral processes, with potential for automation
Most relevant to primary and secondary care
Guidance & considerations for implementing the pillar
Risk: Training is required and potential responsibility ambiguity Mitigation: Establish clear communication between services, define roles, and implement consistent rules across care settings
What insights underpin this pillar?
Previous research reported little to no feedback on referral outcomes, limiting improvement in referral quality and professional growth.
Optometrists expressed desire for feedback from secondary care to improve their referral practices.
Instances of miscommunication between departments regarding patient referrals were noted.
What are the principles of the pillar?
The pillar seeks to establish a feedback loop from secondary to primary care to improve referral efficiency.
Principles:
  1. Communication
  2. Real-time data/digitization
Most relevant to primary and secondary care
Guidance & considerations for implementing the pillar
Risk: Training required to set up feedback loop Mitigation: Set up channels for queries and create accessible training modules for an 'on-the-go' approach
What insights underpin this pillar?
Previous research showed patients were unaware of support and information available outside hospital settings.
Patients expressed desire for more at-home or near-home support.
Travel time to healthcare facilities can be a significant burden for patients.
What are the principles of the pillar?
The pillar seeks to improve patient experience by utilizing digital systems to bring care closer to home.
Principles:
  1. Digitization to enable remote care options
Most relevant to patients
Guidance & considerations for implementing the pillar
Risk: Potential negative perception of digital healthcare Mitigation: Implement robust security measures and develop patient-friendly portals
What insights underpin this pillar?
Previous research highlighted barriers between primary and secondary care in information sharing.
Inefficient information flow between services causes delays in care.
Healthcare professionals reported challenges in accessing patient information across different care settings.
What are the principles of the pillar?
This pillar seeks to bridge the gap in information gathering between multiple services in eyecare.
Principles:
  1. Digitization
  2. Coordination between primary and secondary care
Most relevant to health care professionals such as GPs, optometrists (in primary care) and ophthalmologists (in secondary care)
Guidance & considerations for implementing the pillar
Risk: Requires upgrading of current systems to establish effective communication which may require ongoing training Mitigation: Set up channels for queries and training modules that can be accessed anytime
What insights underpin this pillar?
Previous research has shown patients feel unsupported post-referral and may require help outside of the medical field e.g. charities
"...I was quite scared...I had somebody, one of the nurses holding my hand because I was so worried and nervous..." Patient, WY_1
What are the principles of the pillar?
Pillar seeks to provide readily available information around a condition, support to patient - often may be outside of a primary/secondary care setting
Principles:
  1. Digitisation e.g. support streams through apps
Most relevant to patients
Guidance & considerations for implementing the pillar
Risk: negative digital perception Mitigation: patient friendly portals for scheduling appointments and provide info on security measures taken to enhance trust