National Framework for Action to Promote Eye Health and Prevent Avoidable Blindness and Vision Loss

Key Area for Action 3: Improving access to eye health care services

Action Area: Rural and Remote Communities

Example of a successful initiative – Western Australia
Lions Outback Vision Service and Research
Lions Outback Vision, established in 2010 as a service and research unit, provides comprehensive eye services to patients in rural and remote Western Australia. During the reporting period, services were provided to the Pilbara, Kimberley, Goldfields, Midwest, Southwest and Great Southern regions of Western Australia. In addition, clinics at Derbarl Yerrigan Health Service (DYHS) and Royal Perth Hospital every six weeks provide metropolitan liaison for country patients and Aboriginal patients living in Perth.
Dr Angus Turner, Director of Research, Outback Vision at the Lions Eye Institute was named the 2015 First Amongst Equals in the 40 under 40 Awards³³, for his work in establishing Lions Outback Vision in 2010 to provide specialist eye health services and sustainable models of service delivery in regional, remote and Indigenous communities in WA.
The service emphasises coordination between ophthalmology and optometry, integration with local health services, and the increasing use of telehealth to improve timeliness and access to specialist eye care.

Action Area: Cultural Accessibility

Translator services were available, and all providers of eye health services who work for WA Health completed mandatory Aboriginal Cultural Awareness training provided by the WA Department of Health.

Key Area for Action 4: Improving the systems and quality of care

Action Area: Service Integration

Australian Telehealth Research and Development Group (ATRDG)

In June 2012, the Department of Health WA entered into a Grant Agreement with the Commonwealth Scientific and Industrial Research Organisation (CSIRO) to establish the ATRDG based in Perth. Part of the work programme covers a project that connected ophthalmologists to patients with eye conditions in rural and remote Western Australia and Queensland. The aim was to demonstrate a sustainable delivery and business model to continue service provision after the trial. The project used computer-aided grading of images for diabetic retinopathy – disease (mild, moderate or severe)/no disease.

Implementation of the Central Referral Service (CRS)

On 24 February 2014 the WA Department of Health launched its new CRS to better manage external referrals for patients requiring a first specialist outpatient appointment including ophthalmic referrals within the public health system. In relation to ophthalmic patients the CRS aims to:

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  standardise and streamline the referral process for first specialist outpatient;
  
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  improve access and reduce patient delays for initial outpatient appointment and therefore subsequent downstream services; and
  
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  allocate referrals to the most appropriate site, based on patient location, specialty required, level of service required, and demand measures across the system.
  

Key Area for Action 5: Improving the evidence base

Action Area: Eye Research Workforce Development

State Health Research Advisory Council (SHRAC) Research Translation Projects 2013

This project, titled Cost savings and improvements in accuracy and timeliness of diagnosis as a result of employing molecular diagnostic methods for patients affected with an inherited retinal disease, received $94,000 in funding to establish the feasibility of translating molecular diagnosis findings into clinical practice, and to establish the resulting cost.

WA Department of Health Medical and Health Research Infrastructure Fund

The Fund provides infrastructure funds for researchers as such funds are not generally provided with research grants. These grants cover services such as support staff salaries and overhead costs. A recipient was the Lions Eye Institute, and they received the following funding:

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  2011-12: $305,020 (GST exclusive);
  
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  2012-13: $276,355 (GST exclusive); and
  
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  2013-14: $357,575 (GST exclusive).
  

New research facilities in Western Australia

A total of $50 million from the WA State Government and $100 million from the Commonwealth Government was allocated to establish new research facilities at the QEII Medical Centre and the Fiona Stanley Hospital. The Lions Eye Institute (LEI) is part of the consortium in the QEII Medical Centre facility, which was opened on 11 March 2014. LEI will have access to more space for staff and equipment to undertake specialised eye research. Lotterywest also provided a grant to the LEI of $1 million in May 2014 to help purchase equipment including specialised ocular imaging technology which will help clinicians examine in detail the structure of the eye under normal and disease conditions.

Action Area: Eye Health Data

Honours thesis project 2013-14

The project looked into retinal detachment incidence and characteristics in WA using a linked data set extending over a decade. The study was designed to calculate the incidence of retinal detachment in WA between 1996 and 2008, examine trends in surgical repair types over time and determine the proportion of cases by age, sex, season and comorbid diabetes. The cohort included nearly 2,900 retinal detachment cases, nearly 2,500 of which were incident cases. As well as determining the fact there is no seasonal affect, it was also established that retinal detachment in WA:

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  occurred at a rate of between 7.1 and 12.4 cases per 100,00 persons per year between 1996 and 2008;
  
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  occurred at a significantly higher rate for males, people aged between 40 years and 79 years and for those with diabetes; and
  
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  was treated using two main types of surgical procedure, the preference for which changed over the course of the study period.
  

This research will enable health planners to better prepare for a likely increase in retinal detachment cases due to an ageing population and enable practitioners and health campaigners to target more effectively those at risk. It will also help identify areas for further research.