The Indian Health Service Primary Care-Based Teleophthalmology Program for Diabetic Eye Disease Surveillance and Management
| Autor: | Stephanie J. Fonda, Sven-Erik Bursell, Dawn Clary, Mark B. Horton, Drew Lewis, Dara Shahon |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Telemedicine 020205 medical informatics telehealth Population teleophthalmology Teleophthalmology Health Informatics 02 engineering and technology Telehealth Diabetic Eye Disease Health Information Management Epidemiology Diabetes Mellitus 0202 electrical engineering electronic engineering information engineering Government Performance and Results Act Humans Medicine education Original Research education.field_of_study Diabetic Retinopathy Primary Health Care business.industry General Medicine medicine.disease United States Ophthalmology Family medicine United States Indian Health Service telemedicine business Retinopathy |
| Zdroj: | Telemedicine Journal and e-Health |
| ISSN: | 1556-3669 1530-5627 |
| Popis: | Background: Historically, fewer than half of American Indians and Alaska Natives (AI/AN) with diabetes received the annual diabetic retinopathy (DR) examination that is considered the minimum standard of care; this rate is similar to that of the general United States (U.S.) population with diabetes. Solution: The Indian Health Service-Joslin Vision Network (IHS-JVN) Teleophthalmology Program in 2000 to increase compliance with DR standards of care among AI/AN through validated, primary care-based telemedicine. The IHS-JVN provides remote diagnosis of DR severity, with a report including management recommendations that is returned to the patient's primary care provider. The program conforms with the American Telemedicine Association (ATA) Practice Guidelines for Ocular Telehealth-Diabetic Retinopathy. Outcomes: The IHS-JVN has been expanding incrementally since the first patients were recruited in 2000; this expansion coincides with large improvements in the annual DR examination rates reported as part of local, regional, and national regulatory compliance under the Government Performance and Results Act (GPRA). Currently, with 99 clinical implementations in 23 states, IHS-JVN is the largest primary care-based ATA validation category three telemedicine program in the U.S. Summary: This article describes the program's workflow, imaging and reading technologies, diagnostic protocols, reports to providers, training, quality assurance processes, and geographical distribution. In addition to its clinical use, the program has been utilized in research on utilization of diabetic eye care, cost-effectiveness, technology development, and DR epidemiology of the AI/AN population. Potential next steps for this program are discussed. |
| Databáze: | OpenAIRE |
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