A store-forward ophthalmic telemedicine case report from deployed U. S. Army forces in Kuwait

This telemedicine test was developed to determine the relative ease with which an off-the-shelf ophthalmic telemedicine package could be successfully applied from within a remote theatre of operations. The project was conducted at the Camp Doha Health Clinic, located just outside Kuwait City, during the period from April 12(th) through April 23(rd), 1998. The deployed signal unit had contracted for a direct T-1 commercial satellite link (via MCI), which allowed for direct internet connectivity using a PCMCIA network card. Digital images were sent via this connection to 140 e-mail sites throughout the world, including an unsolicited image to each of 134 Army optometry officers for their review, analysis, and diagnosis. Return responses to this unsolicited survey were 53 out of 134, for a 39.7% response rate. Half of the respondents were able to view the image with ease and clarity, rendering an accurate clinical diagnosis. The other half of the respondents either did not have the software to display an image on their clinical desktop PC, or did not know how to use their provided software. This project clearly indicates that an off-the-shelf ophthalmic digital system can be successfully used from a remote deployed site. However, the consulting clinicians require up-to-date training, and their computer packages should have as wide a capability base as possible.