Email a Friend
Print Article
LIVE! Long Distance Eye Exam
Hard to believe it, but not everybody has immediate access to an eye doctor. Despite those billboards mounted on the sides of buses and the full-page phonebook advertisements, everybody cannot see the eye doctor tomorrow. Or even next month!Folks in rural locations have limited access to health care specialists. Who wants to drive six hours for an eye exam when the patient has no symptoms? This is especially true for Type 2 adult diabetics. Although there may be dangerous changes to the fragile retinal blood vessels, changes that warrant immediate treatment, the patient may have no visual symptoms whatsoever.
There are many other comparable scenarios. How can effective health care be delivered over such long distances?
The answer is simple: Be in two places at once!
Telemedicine is real medicine simultaneously practiced in two locations. Live clinical images from a remote site are transmitted to an observer physician far away. A primary care physician or nurse is usually present with the patient. Concurrent voice communications are also utilized so that the expert can ask questions of the patient. The central observer can view images from many different clinics across a network to maximize specialist availability. Examinations can also include microscopic slides of biopsies, CT/MRI scans, and mammograms. Telemedicine is also frequently used to provide specialty care to incarcerated prisoners.
Now, back to our diabetic model. Does telemedicine provide quality eye care for rural diabetics? A recently published study looked at 495 adult volunteers who were given the choice between commuting to a far-away medical center versus expert telemedicine eye evaluations for their retinas. 67% opted for the camera instead of the toll booth!
When the telemedicine volunteers were examined half had no abnormal retinal findings and were advised to return in one year. Nearly 40% were referred to the medical center clinic for non-urgent treatment and in 11% of volunteers the telemedicine camera documented serious changes that necessitated immediate treatment. Overall, the telemedicine failure rate was less than 1% (meaning a volunteer had to travel to the medical center for a confirmatory eye exam because the camera equipment could not adequately image the diabetic retina).
Insurers and Medicare now reimburse for live and stored telemedicine examinations, so it is likely more and more institutions and practices will embrace this technology. Time for your eye exam, say "Cheese!"
SOURCE: Diabetes Care March 2007:574
Related Topics:
Technorati Tags: telemedicine, vision, diabetes
