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User-acceptability of an automated telephone call for post-operative follow-up after uncomplicated cataract surgery

Eye volume 37, pages 2069–2076 (2023)Cite this article

Subjects

Abstract

Background

Innovative technology is recommended to address the current capacity challenges facing the NHS. This study evaluates the patient acceptability of automated telephone follow-up after routine cataract surgery using Dora (Ufonia Limited, Oxford, United Kingdom), which to our knowledge is the first AI-powered clinical assistant to be used in the NHS. Dora has a natural-language, phone conversation with patients about their symptoms after cataract surgery.

Methods

This is a prospective mixed-methods cohort study that was conducted at Buckinghamshire Healthcare NHS Foundation Trust. All patients who were followed up using Dora were asked to give a Net Promoter Score (NPS), and 24 patients were randomly selected to complete the validated Telephone Usability Questionnaire (TUQ) as well as extended semi-structured interviews that underwent thematic analysis.

Results

A total of 170 autonomous calls were completed. The median NPS score was 9 out of 10. The TUQ (scored out of 5) showed high rates of acceptability, with an overall mean score of 4.0. Simplicity, time saving, and ease of use scored the highest with a median of 5, whilst ‘speaking to Dora feels the same as speaking to a clinician’ scored a median of 3. The main themes extracted from the qualitative data were ‘I can see why you’re doing it’, ‘It went quite well actually’, ‘I just trust human beings I suppose’.

Conclusion

We found high levels of patient acceptability when using Dora across three acceptability measures. Dora provides a potential solution to reduce pressure on hospital capacity whilst also providing a convenient service for patients.

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Fig. 1: Dora call overview summary diagram.
Fig. 2: Net Promoter Score (NPS) distribution.
Fig. 3: Telehealth Usability Questionnaire (TUQ) results.

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Acknowledgements

This project was funded by Innovate UK. UK Research and Innovation: 27236.

Author information

Author notes

  1. These authors contributed equally: Sarah Khavandi, Ernest Lim, Aisling Higham.

Authors and Affiliations

  1. Imperial College School of Medicine, Imperial College London, London, UK

    Sarah Khavandi

  2. Ufonia Limited, 3-5 Hythe Bridge Street, Oxford, UK

    Sarah Khavandi, Ernest Lim, Nick de Pennington & Guy Mole

  3. Imperial College Healthcare NHS Trust, London, UK

    Ernest Lim

  4. Oxford University Hospital NHS Foundation Trust, Oxford, UK

    Aisling Higham & Guy Mole

  5. Buckinghamshire Healthcare NHS Trust, Buckinghamshire, UK

    Mandeep Bindra, Sarah Maling & Mike Adams

  6. Royal College of Ophthalmology, London, UK

    Mike Adams

  7. United Kingdom & Ireland Society of Cataract & Refractive Surgeons, Wirral, UK

    Mike Adams

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Contributions

GM was the principal investigator of this study. EL, AH and GM supervised patient calls. SK conducted the patient interviews. SK, EL, AH and GM performed data collection, interpretation and analysis. SK authored the initial manuscript along with EL and AH who provided revisions for subsequent drafts. Figures by EL. All co-authors were actively involved in reviewing the manuscript.

Corresponding author

Correspondence to Ernest Lim.

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Competing interests

At the time of this work, GM and NdeP were employees of Ufonia Limited. NdeP is a shareholder at Ufonia Limited. SK has been an employee of Ufonia Limited since August 2021. EL and AH were clinical fellows at Imperial College London and Oxford University Hospitals funded by an NIHR AI in Health and Care Award, of which Ufonia Limited is the grant holder. Since February 2022 both are Ufonia employees.

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Khavandi, S., Lim, E., Higham, A. et al. User-acceptability of an automated telephone call for post-operative follow-up after uncomplicated cataract surgery. Eye 37, 2069–2076 (2023). https://doi.org/10.1038/s41433-022-02289-8

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