Telemedicine Screening for Diabetic Retinopathy Brings the Eye Doctor to You

As part of an ongoing effort to reduce the incidence of diabetic retinopathy, a leading cause of new-onset blindness, healthcare providers urge diabetics to have yearly eye exams. Despite their efforts, however, less than two-thirds of adult diabetics in the U.S. visit the eye doctor for screening. Researchers at the University of Michigan’s Kellogg Eye Center took a different approach: What if eye doctors could go to the patient instead—via telemedicine screening? Would patients participate in such a program?

To answer these questions, they surveyed older adults. Overall, they found that if a telemedicine screening program is convenient, patients are willing to use it. By switching screening to a telemedicine-based program, patients would no longer face obstacles to care such as transportation, taking time off work, a high cost of care, or lack of access to care. Other key factors influencing whether patients would embrace the model include the patient-physician relationship and the length of time patients have been living with diabetes; those with a strong relationship with the doctor or long-standing disease were less likely to welcome screening through telemedicine.

An electronic eye exam works by allowing patients to undergo screening at the primary care physician’s office, eliminating the need to schedule and arrange transportation to a second appointment just for the screening. At the office, a no-dilation retina camera takes retinal photographs of both eyes; these images are sent electronically to an eye care provider, who reviews the images and sends back a report. If necessary, the patient may be scheduled for more photos in the local clinic or referred to an ophthalmologist.

In this study, only the store-and-forward model of telemedicine was examined; the researchers did not investigate the use of real-time video collaboration. We believe that the reluctant patient populations identified by the study may be more amenable to telemedicine screenings if they could build rapport with a provider via live video medicine; such a system would give the eye specialist more presence and relatability to a patient than an anonymous store-and-forward program, thus combining the convenience of telemedicine with both the familiarity of a doctor visit and the comfort of a knowing the doctor personally.

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