Retina Labs

iVision provides organisation of seamless and reliable management of screening through teleophthalmology.

Introduction

Teleophthalmology for screening by digital imaging of the eyes and interpretation at distance by medical specialists has shown to result in significant visual health results and savings of medical resources in urban as well as in remote communities ^1,2. Although data and image capture and their electronic transfer are relatively straightforward, management and overview of the organisational process of screening is necessary in order to insure and monitor all of the steps of the screening process from the creation of an imaging appointment, to the follow-up with an ophthalmologist, to yearly patient recall.

Methods

Management tools are needed to insure that any patient scheduled for screening that has not followed on his/her examination is retrieved, that prompt interpretation of the data by the medical specialists is done with an automated redistribution towards other chosen medical specialists when agreed delays for interpretation are not met, to flag amongst a large volume of patients any individual presenting with a condition dictating a rapid intervention and enable easy surveillance of more urgent pathologies. Over viewing of timely and appropriate follow-up for each screened individual as well as quality control of the medical diagnostics are also needed.

A management tool for DR screening must also insure security and confidentiality with easy management of protected levels of access for specific tasks for imagers, ophthalmologists, computer technicians , administrators as well as tracing of any action to any individual responsible for its origin. Continuing care needs be insured by systematic transmission of screening results to all medical doctors involved in the care of the diabetic individuals as well as a feedback to and recall of the screened individuals. Organized and easily retrievable data of screening available for public health analysis that can provide a prospective registry for DR is also pertinent. Finally management tools should be compatible with any digital camera used for screening and be usable in conditions with no immediate access to internet.

Using iVison software offering all of the above characteristics, screening for DR through teleophthalmology since 2005 has been performed in urban, semi urban and remote communities in over 8,000 diabetics screened through mobile and permanently located cameras, with and without immediate access to internet³.

Results

The iVision management software permits easy overview of and reliable and safe management of patients screened for DR, monitoring of every step of the screening process from the creation of an imaging appointment, to the follow-up with an ophthalmologist, to yearly patient recall while insuring significant health result and epidemiological data.

References

Lee P. Telemedicine: Opportunities and challenges for the remote care of diabetic retinopathy. Arch Ophthalmol 1999;117:1639-40.

National Screening Programme for Diabetic Retinopathy. National Health Services, U.K. Available at: http://www.retinalscreening.nhs.uk. Accessed November 22, 2008.

Boucher MC, Desroches G, Garcia-Salinas R, Kherani A, Maberley D, Olivier S. Oh M, Stockl F: Teleopthalmology screening for diabetic retinopathy through mobile imaging units within Canada. Can J Ophthalmol 2008;43:658-68