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[Evaluation of an experiment in ophthalmology telemedicine]
E Pot1, L Guenezan1, F Pelen2
1Section santé publique, Epcare, 49, rue Molière, 92120 Montrouge, France.
Purpose:
To meet the need for access to eye care in an area with a lack of physicians, a telemedicine workstation in ophthalmology was created. The main objective was to measure the improved access to eye care via telemedicine consultation.
Methods:
No criteria of age, sex or geographical location were defined. Depending on the cause for the consultation and the results of the examinations conducted by an ophthalmic technician physically present in the center, the patient might be given a telemedicine consultation with an ophthalmologist. Eleven indicators were defined to achieve the study objectives. Data were compared with a reference eye care center.
Results:
The quality, safety of care, and medical benefits of telemedicine consultation were not inferior to those of the reference center. The consultations screened 25 cases of age-related macular degeneration, 240 glaucoma, 229 cataracts and 27 diabetic retinopathy. 88.5% of patients were included in a cooperative ophthalmologist/technician protocol, compared with 27.3% in the reference center (P<0.0001).
Discussion:
The telemedicine workstation must be linked to a main center located at most a one-hour drive away. The equipment must be adapted to the use of telemedicine and to allow the technician to perform the necessary assessments and examinations. The number of emergency department visits after telemedicine consultation at the telemedicine workstation was higher than the reference center, which may lead to a subsequent study.
Conclusion:
Telemedicine consultation improves access to eye care in a medically under-served area.
