During the pandemic, access for patients with urgent and semi-urgent ophthalmic complaints was fragmented and often led to patients being funnelled to emergency departments in regional hospitals throughout the Lower Mainland. This highlighted the urgent need to innovate how such ophthalmic care is delivered. Drs. Zaid Mammo, Salina Teja, and Vivian Yin sought to develop a model for rapid access to eye care that crossed health authority boundaries through an online referral system available to all community physicians and optometrists. They applied for and received funding for their idea from VPSA’s Small Steps, Big Idea. The initiative provides $1,000 to $5,000 to selected applicants to develop concepts that meet VPSA criteria.

“With the funding, we were able to run a pilot program from May 2020 to April 2021,” said Dr. Teja. “Over that time, there were 125 processed referrals from general practitioners and optometrists. All patients were matched with an ophthalmologist within one week of the referral. The referral network we created was used when the referring provider could not find a consultant to take an urgent appointment, and they wanted to avoid sending a patient to an emergency department.”

The physicians who created the model calculated that it so far has resulted in an estimated savings of $40,000 in direct costs over its initial 11-month trial period. Additional indirect cost savings included potentially reduced investigations in emergency departments and by community physicians (e.g., neuroimaging). Significant subspecialty referrals were also initiated directly that reduced potential redundant assessments by comprehensive ophthalmology.

“Every single referring provider was extremely satisfied with the system, and they all reported that they are likely to recommend it to colleagues,” said Dr. Teja. “Given the high level of satisfaction, we expect word of mouth will continue to increase the system’s usage in the community. Looking forward, we’re hoping to create an online platform that will match patients with available ophthalmology appointments automatically to minimize administrative load and triage hours.”

If you have a big idea that could use funding, check out VPSA’s Small Steps, Big Idea initiative. Applications are accepted on an ongoing basis.