Optometric Referrals to Retina Specialists: Evaluation and Triage via Teleophthalmology
- 1 June 2008
- journal article
- research article
- Published by Mary Ann Liebert Inc in Telemedicine and e-Health
- Vol. 14 (5), 441-445
- https://doi.org/10.1089/tmj.2007.0068
Abstract
A retrospective noncomparative consecutive case series was conducted to evaluate the clinical outcomes of a novel teleophthalmology program linking optometrists to retina specialists in Alberta, Canada. One hundred seventy-one patients, referred by optometrists via teleophthalmology to a group retina practice between June 2004 and May 2006 underwent stereoscopic, mydriatic digital photography. Images were transmitted to a secure Web server and analyzed by a retina specialist. Diagnosis and recommendations were sent back to the optometrist and, if necessary, patients were referred for additional testing and clinical evaluation. A chart review of all clinical encounters was performed and the data was tabulated. Demographic features, diagnosis, testing, treatment, distance and time traveled by patient, durations between telemedicine referral, teleophthalmology consultation, in-person consultation, testing, and treatment were recorded. One hundred seventy patients were assessed via teleophthalmology for a total of 190 consultations. Eighty-nine patients (52.0%) required conventional in-person consultation with a referral completion success of 92.1% (82 patients). Fifty of these patients underwent additional diagnostic testing including fluorescein angiography (41), optical coherence tomography (14), laboratory testing (5), visual fields (2), carotid Doppler ultrasound (2), and ocular ultrasound (2). Twenty-five patients required surgical or medical treatment including focal argon laser (10), photodynamic therapy (8), panretinal photocoagulation (2), vitrectomy (2), scleral buckle (1), and other procedures (8). Average wait time between telemedicine referral and teleophthalmology review of images by the retina specialist was 1.9 days (maximum = 20 days). For those patients requiring office evaluation, the average wait time between teleophthalmology referral and in-person evaluation was 25.1 days. Twenty-one of the 25 patients (84.0%) requiring treatment underwent examination, testing, and treatment in a single day. When compared to conventional consultation methods, teleophthalmology reduced average travel distance and time by 219.1 km and 2.7 hours, respectively. Teleophthalmology reduced office visits to the retina specialist by 48% while improving the efficiency of clinical examination, testing, and treatment. Patients benefited through reduced travel time and distance.Keywords
This publication has 8 references indexed in Scilit:
- Web-Based Grading of Compressed Stereoscopic Digital Photography versus Standard Slide Film Photography for the Diagnosis of Diabetic RetinopathyOphthalmology, 2007
- Is the Future Now?Optometry and Vision Science, 2006
- Comparison of stereoscopic digital imaging and slide film photography in the identification of macular degenerationCanadian Journal of Ophthalmology, 2005
- Improving the quality of eye care with tele-ophthalmology: shared-care glaucoma screeningJournal of Telemedicine and Telecare, 2004
- JPEG compression of stereoscopic digital images for the diagnosis of diabetic retinopathy via teleophthalmologyCanadian Journal of Ophthalmology, 2004
- High-resolution stereoscopic digital fundus photography versus contact lens biomicroscopy for the detection of clinically significant macular edemaOphthalmology, 2002
- Identification of diabetic retinopathy by stereoscopic digital imaging via teleophthalmology: a comparison to slide filmCanadian Journal of Ophthalmology, 2001
- Tele-Ophthalmology via Stereoscopic Digital Imaging: A Pilot ProjectDiabetes Technology & Therapeutics, 2000