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Year : 2020  |  Volume : 58  |  Issue : 4  |  Page : 337-338

History over phone – A safe and innovative idea to reduce chair time with ophthalmologists during COVID-19 pandemic

1 Department of Pediatric Ophthalmology and Strabismology, Aravind Eye Hospital, Puducherry, India
2 Department of Glaucoma, Aravind Eye Hospital, Puducherry, India
3 Department of Cornea and Refractive Services, Aravind Eye Hospital, Puducherry, India

Date of Submission02-Sep-2020
Date of Acceptance10-Nov-2020
Date of Web Publication16-Dec-2020

Correspondence Address:
Dr. Kirandeep Kaur
Department of Pediatric Ophthalmology and Strabismology, Aravind Eye Hospital, Puducherry
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/tjosr.tjosr_130_20

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How to cite this article:
Kaur K, Srinivasan K, Venkatesh R, Gopalakrishna M, Gurnani B, Vedachalam R. History over phone – A safe and innovative idea to reduce chair time with ophthalmologists during COVID-19 pandemic. TNOA J Ophthalmic Sci Res 2020;58:337-8

How to cite this URL:
Kaur K, Srinivasan K, Venkatesh R, Gopalakrishna M, Gurnani B, Vedachalam R. History over phone – A safe and innovative idea to reduce chair time with ophthalmologists during COVID-19 pandemic. TNOA J Ophthalmic Sci Res [serial online] 2020 [cited 2021 Apr 23];58:337-8. Available from: https://www.tnoajosr.com/text.asp?2020/58/4/337/303669

Dear Editor,

COVID-19 infection has spread worldwide. There is a need for constant innovations to ensure quality health care with all possible safety precautions. COVID-19, a highly contiguous disease, is transmitted by airborne droplets either by direct contact or through aerosols suspended in the air.[1] Microdroplets are emitted during conversation between two people and even heavy breaths. A video from Japan made using infrared cameras showed that these droplets remain suspended in air for as long as 3 h.[2] Social distancing is the new norm.[3] This is proven to have a clear benefit to flatten the transmission curve.[4]

Ophthalmologists are at high risk of acquiring the infection because of close contact with the patients while evaluation. Tele-ophthalmology has been proven beneficial as it allows patient care without being at risk of acquiring the infection.[5] But both for ophthalmologists and the patients, tele-ophthalmology does not always come as a rescue option. One-on-one clinical evaluation is a must in many of the ophthalmic conditions. Hence, the close contact on slit lamp becomes unavoidable. History taking is an essential part of clinical evaluation. Most ophthalmic patients are of older age and many have significant hearing issues, and with all the personal protective equipment, the voice gets muffled, making it difficult to understand both for the patients and the doctors. To overcome this, patients have a tendency to go closer to physicians or at times pull their masks down to converse. Our idea of history over phone is a simple yet highly useful solution. It not only minimizes the contact time but also takes care of social distancing.

We engage the patients from the time of registration, conveying that history will be taken on phone. They are advised to keep their mobile phones with them handy. We have allotted a separate station closer to the patients' waiting area for history taking [Figure 1]a. Patient details after registration are accessed on the electronic medical record (EMR), and this is followed by direct phone call to the patient over their mobile phones [Figure 1]b. Apart from recording the complaints, the present, past, systemic, and family histories are also recorded in the EMR. This is followed by refraction and examination. By adopting this method, we noticed that the contact time is reduced from an average of 15 min to 7–8 min in most of the patients. The problem of repeated sanitization is overcome as the patients use their own phones, as compared to microphones or intercom.
Figure 1: (a) Image depicting resident conversing with the patient over the phone and documenting history, while being at a safe physical distance from the patient. (b) Image depicting a patient sitting in a dedicated patient's waiting area and giving history through her personal mobile phone

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Utilizing this technique in a high-volume system has made a significant reduction in chair time for patients, enhancing the safety. Furthermore, this has helped continuing enhancing junior residents' skills of history taking, despite being unable to examine the patients directly. This can further be implemented for counseling the patients. Furthermore, this simple innovation has no extra costs involved, as most patients have a mobile phone. This idea can be used beyond ophthalmology as history taking is an essential component for clinical evaluation and decision-making in every medical field.

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Conflicts of interest

There are no conflicts of interest.

  References Top

Kumar D, Manuel O, Natori Y, Egawa H, Grossi P, Han SH, et al. COVID-19: A global transplant perspective on successfully navigating a pandemic. Am J Transplant 2020;20:1773-9.  Back to cited text no. 1
Available from: https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/social-distancing.html. [Last accessed on 2020 Sep 01].  Back to cited text no. 3
Thunström L, Newbold S, Finnoff D, Ashworth M, Shogren J. The benefits and costs of using social distancing to flatten the curve for COVID-19. J Benefit Cost Anal 2020;11:1-17.  Back to cited text no. 4
Gao Y, Liu R, Zhou Q, Wang X, Huang L, Shi Q, et al. Application of telemedicine during the coronavirus disease epidemics: A rapid review and meta-analysis. Ann Transl Med 2020;8:626.  Back to cited text no. 5


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