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 Table of Contents  
INNOVATIONS
Year : 2021  |  Volume : 33  |  Issue : 1  |  Page : 87-90

Innovative utilization of patient's triage with integrated information system during COVID crisis


1 Medical Officer, Department of Glaucoma and Research, Mahathma Eye Hospital Private Limited, Tiruchirappalli, Tamil Nadu, India
2 Director, Sathyan Eye Care Hospital and Coimbatore Glaucoma Foundation, Coimbatore, Tamil Nadu, India
3 Medical Officer, Department of Cataract and Refractive Surgery, Mahathma Eye Hospital Private Limited, Tiruchirappalli, Tamil Nadu, India
4 Chief Medical Officer, Mahathma Eye Hospital Private Limited, Tiruchirappalli, Tamil Nadu, India
5 Head of Department of Cataract and Refractive Surgery, Mahathma Eye Hospital Private Limited, Tiruchirappalli, Tamil Nadu, India

Date of Submission23-Dec-2020
Date of Decision25-Jan-2021
Date of Acceptance29-Jan-2021
Date of Web Publication19-Apr-2021

Correspondence Address:
Dr. Prasanna Venkatesh Ramesh
Mahathma Eye Hospital Private Limited, No 6, Tennur, Seshapuram, Tiruchirappalli - 620 017, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/kjo.kjo_207_20

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How to cite this article:
Ramesh PV, Parthasarathi S, Ramesh SV, Rajasekaran R, Ramesh MK. Innovative utilization of patient's triage with integrated information system during COVID crisis. Kerala J Ophthalmol 2021;33:87-90

How to cite this URL:
Ramesh PV, Parthasarathi S, Ramesh SV, Rajasekaran R, Ramesh MK. Innovative utilization of patient's triage with integrated information system during COVID crisis. Kerala J Ophthalmol [serial online] 2021 [cited 2021 Jun 18];33:87-90. Available from: http://www.kjophthal.com/text.asp?2021/33/1/87/314092



Circuses often feature risky balancing acts. So do eye care professionals, in the form of wait times especially during COVID crises.[1] A patient's negative experience with wait times in hospitals during this pandemic will have a ripple effect that extends from close friends and family to strangers on the Internet. This innovation will serve as a potential cure for wait time frustration and create the awareness of disease and safety measures during triage wait time.

With the advent of the COVID-19 pandemic, we created an isolation cubicle with acrylic [Figure 1] and shifted all outpatient department (OPD) and investigative tools into it. This measure was done to reduce face to face interactions between the doctor and patient. Furthermore, to minimize patient movement inside the hospital premises, triaging was done in the underground basement car parking area outside the hospital OPD block.[2] Although it was successful in creating a barrier for preventing the virus spread, it also; created a physical barrier between the doctor and patient and communication became quite challenging. Hence, we created this do it yourself workflow tool with rapid and intuitive technology, to gather quantified information from the OPD patients, during their triage wait time and used the same data to make incremental improvements in practice delivery.
Figure 1: The acrylic cubicle inside which all gadgets were integrated with analysis of the information technology displayed on the doctor's personal computer required to evaluate the knowledge of the patient before consultation

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We provided specific questionnaires with pictures and WhatsApp educative videos containing items [Figure 2] related to disease knowledge, investigations, management and compliance to the mobile phones of the patients once they have registered and made them answer the Google forms [Figure 3],[Figure 4],[Figure 5],[Figure 6],[Figure 7],[Figure 8] during their waiting time.[3],[4] Their knowledge assessment regarding the disease will be done automatically once they have completed the survey. Answering was done during their triage wait time, and results were automatically generated to the doctor's personal computer [Figure 9] and [Figure 10] inside the isolation cubicle, so practice delivery can be customised according to the patient's knowledge about the disease process.[5] The patient was also sent to their smart phone, video of the safety precautions [Figure 11] taken inside the hospital to alleviate anxiety regarding transmission of infection and was requested to follow the safety protocols. This tool not only helps patients but also does self-evaluation of our practice pattern itself.
Figure 2: Components of the questionnaire that are though Google forms for evaluation

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Figure 3: The basic set of questions put forth to a (glaucoma) patient

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Figure 4: Example of basic questions asked regarding disease awareness

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Figure 5: Example of advanced questions asked regarding disease awareness

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Figure 6: Example of questions asked regarding investigation awareness such as central corneal thickness (CCT), anterior chamber depth (ACD) and lens thickness

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Figure 7: Example of questions asked regarding investigation awareness such as structural evaluation with optical coherence tomography (OCT) and functional evaluation with visual field testing

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Figure 8: Example of basic and advanced questions asked regarding treatment awareness

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Figure 9: The analysis of the patient's awareness profile is projected on the doctor's personal computer inside the cubicle, which is also simultaneously connected with all investigative gadgets through local access network

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Figure 10: The display of patient's awareness profile available before slit-lamp examination for customizing counseling and practice delivery

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Figure 11: Video briefing on the safety measures undertaken inside the hospital premises and investigative instructions sent to the patient's phone during triage wait time for patient's visualisation

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An additional feature of this tool is; it primes the patients with do's and don'ts for smooth performance, before an investigation [Figure 12] needing patient's co-operation (for example, visual fields) during the wait time. Furthermore, there will be an auto-generated SMS/email to the patient for their next investigation/next review due, highlighting the need to analyze the disease's stability (serving as a vigilant medium).
Figure 12: Video briefing on what is expected of the patient during visual field testing sent to the patient's phone during triage wait time for patient's visualization

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In this era of smart phones; for 1.3 billion Indian population, there are atleast 1.8 billion mobile phones being used with 92.03 connections per citizen. Among them, roughly half (49.7%) of the mobile phones users are smart phone users. To prevent triage wait time frustration; simultaneous awareness creation and understanding the understood for customised practice delivery, this simple but effective tool will work wonders, needing just a smart phone from the patient's side. Understanding, how much the patient has understood will not only make them feel special and awe of our services but also throw light, in which category we need to strengthen the counselling for that individual, rather than a diffuse briefing that may not yield fruitful results.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Klein KP, Hannum WH, Fields HW, Proffit WR. Interactive distance learning in orthodontic residency programs: Problems and potential solutions. J Dent Educ 2012;76:322-9.  Back to cited text no. 1
    
2.
Ramesh PV, Ramesh SV, Ramesh MK, Rajasekaran R. Utilization of hospital car parking garage for COVID-19 triage and screening in a high-volume tertiary eye care center. TNOA J Ophthalmic Sci Res 2021;59:114-6.  Back to cited text no. 2
  [Full text]  
3.
How to Create a Survey Using Google Forms | Laptop Mag. Available from: https://www.laptopmag.com/articles/ create-survey-google-forms. [Last accessed on 2020 Dec 01].  Back to cited text no. 3
    
4.
Why video health education messages should be considered for all dental waiting rooms. Available from: https://journals.plos. org/plosone/article? id=10.1371/journal.pone. 0219506. [Last accessed on 2020 Dec 01].  Back to cited text no. 4
    
5.
Ramesh PV, Parthasarthi S, Ramesh SV, Rajasekaran R, Ramesh MK. Interconnecting ophthalmic gadgets (infinity stones) at finger tips (personal computer desktop) with local area network for safe and effective practice during COVID-19 crises. Indian J Ophthalmol 2021;69:449-52.  Back to cited text no. 5
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    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6], [Figure 7], [Figure 8], [Figure 9], [Figure 10], [Figure 11], [Figure 12]



 

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