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Military Teleophthalmology in Afghanistan Using Mobile Phone Application
William G Gensheimer1,2, Kyle E Miller2,3, Jennifer Stowe4
1Warfighter Eye Center, Malcolm Grow Medical Clinics and Surgery Center, Joint Base Andrews, Maryland.
JAMA Ophthalmology
|August 28, 2020
Summary
A secure mobile app for teleophthalmology was tested in Afghanistan, showing high satisfaction and accurate diagnoses. This technology can extend eye care services in combat zones, improving patient outcomes and potentially preventing unnecessary evacuations.
Area of Science:
- Ophthalmology
- Telemedicine
- Mobile Health
Background:
- The COVID-19 pandemic underscored the need for expanded telemedicine solutions.
- Military treatment facilities require robust methods for delivering specialized care, such as ophthalmology, in remote or combat environments.
Purpose of the Study:
- To conduct a beta test of a secure teleophthalmology mobile application.
- To evaluate the feasibility and effectiveness of using mobile technology for remote eye consultations in military settings.
Main Methods:
- A prospective case series involving 16 military treatment facilities in Afghanistan.
- Thirty medical professionals utilized a mobile eye care application for teleophthalmology consults over a 6-week period.
- Consults were assessed for response time, diagnostic agreement, adherence to clinical guidelines, impact on aeromedical evacuation, user satisfaction, and security compliance.
Main Results:
- 28 teleophthalmology consults were completed with a mean initial response time of under 4 minutes.
- An 86% agreement rate was observed between teleophthalmology and final diagnoses.
- 14% of consultations prevented the need for aeromedical evacuation, and 54% of patients returned to duty.
- Overall user satisfaction was high (median score of 5/5), and all consults were secure and HIPAA compliant.
Conclusions:
- Mobile teleophthalmology apps show promise for enhancing ophthalmic care delivery in austere military environments.
- The technology is secure, user-friendly, and can provide timely, accurate consultations, potentially improving patient outcomes and operational readiness.
- Further research with larger sample sizes is warranted to confirm these findings.
