Digital-first postoperative follow-up after cataract surgery: real-world implementation of an integrated automated telephone and home vision-testing pathway in the NHS

Vollständiger Abstract

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Objectives Postoperative outcome data are essential for quality improvement and national audit after cataract surgery, the National Health Service’s (NHS) highest volume elective procedure, yet completion rates using traditional methods remain low. We evaluated whether an integrated digital-first pathway combining automated telephone follow-up and home-based distance visual acuity (DVA) testing could achieve high outcome-data capture with good patient acceptability in routine NHS care. Innovation The pathway integrates two United Kingdom Conformity Assessed (UKCA)-marked digital tools into a multiroute service model with face-to-face care as fallback: Dora (Ufonia), an artificial intelligence-driven automated telephone system collecting patient-reported outcome measures (PROMs) and screening for complications, and DigiVis DVA (CMI), a web-based home vision test. The innovation lies in their integration and real-world implementation. Design and setting Mixed-methods, single-centre service evaluation over 4 weeks (December 2024 to January 2025) at Royal Berkshire NHS Foundation Trust. Results Among 218 patients (mean age 75 years, 58% female), 78% completed the postoperative Dora call, 74% completed PROMs and 14% completed DigiVis DVA. Overall, 85% had at least one postoperative outcome captured through the combined pathway. Patient satisfaction was high (mean 4.69/5; 91.9% rated 4 or 5). Completion was consistent across age groups (70–79 years: 77% Dora, 73% PROMs). Conclusions A multiroute digital-first pathway can achieve high outcome capture with excellent acceptability in a real-world NHS setting. The design principle of combining automated follow-up, remote self-testing and conventional care as overlapping routes is transferable to other outpatient pathways requiring scalable outcome-data capture.