Addenbrooke’s has become the first UK hospital to use digital technology that enables patients to test their own vision in minutes while waiting to see their eyecare clinician.
DigiVis DVA is a web application running on a free-standing plinth or wall-mounted tablet computer as a ‘kiosk’ in the waiting area. Posters displayed in the waiting area provide information and direct patients to the kiosk.
It has the potential to be set up anywhere, and supports the Government’s new 10-year plan for the NHS by dovetailing with the three main pillars – hospital to community, from analogue to digital, and from treatment to prevention.
Watch: How it works
Link: https://youtu.be/nLd3SvwflV0
Eye clinics are the busiest hospital outpatient service and often lack space for clinicians and patients. Self-testing technology helps clinics run more efficiently, frees up clinical space, and reduces waiting times.
Patients can also receive an email or text with a link to use DigiVis DVA at home on two of their own devices, enabling the test to be carried out before or during a video or phone consultation. Patients at risk of deteriorating vision can monitor their results at home between clinic visits, and keep track of their own eye health.
DigiVis DVA was invented by CUH by consultant paediatric ophthalmologist, Dr Louise Allen, to enable accurate home vision testing for remote consultation and as a substitute for school vision screening missed during school closures caused by the Covid 19 pandemic.
Patients start the test by pairing their smartphone with the tablet over Wi-Fi, without having to download anything on their device. Standing or sitting two metres away from the display screen, patients follow simple instructions and voice prompts to guide them through the test.
The kiosk screen displays a line of letters similar to those on a traditional eye test chart, with one highlighted for the patient to match from a selection on their smartphone.
The application automatically changes the letter size displayed, with children under ten rewarded with motivational cartoon farm animals, and sounds.
An algorithm directs the test and calculates the smallest letter consistently recognised - an important measure of eye health called distance visual acuity (DVA).
The results can be sent to the patient by text, or email, or captured using a screenshot, and will be explained by the eyecare professional who sees them.
There is support for patients who run into difficulty, and nurse-led vision testing will still be available to patients who prefer it.
Early development and validation work was possible thanks to support from the Medical Research Council, Addenbrooke’s Charitable Trust and Cambridge University Hospital Partners, and a National Institute for Health and Care Research (NIHR) Invention for Innovation grant.
The test was brought rapidly into use at CUH during the Covid crisis and successfully trialled and improved over four years in paediatric clinics, so that the commercial version is now spreading to other NHS trusts.
Dr Allen likened the DigiVis DVA test to scanning your own shopping at the supermarket – it seems awkward at first, but shoppers soon get used to the idea.
She said:
This is a great example of how digital innovation can help make the NHS more efficient and help patients to be more involved in their care.
Trying the test in clinic gives patients the confidence to do it at home before a remote consultation. Patients suitable for this service won’t need to travel to hospital so regularly. This is particularly important for those in rural locations without transport, and those who find attending a clinic stressful.
In future, we hope DigiVis DVA can be used for vision screening and home monitoring for all ages and in multiple areas of our communities to ensure early detection of treatable eye problems
Dr Louise Allen