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Rani PK, Khanna RC, Ravindrane R, Yeleswarapu SC, Panaganti AK, Thakur VS, Sharadi V, Iype V, Rathi VM, Vaddavalli PK. Teleophthalmology at a primary and tertiary eye care network from India: environmental and economic impact. Eye (Lond) 2024; 38:2203-2208. [PMID: 38253864 PMCID: PMC11269633 DOI: 10.1038/s41433-024-02934-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 01/08/2024] [Accepted: 01/12/2024] [Indexed: 01/24/2024] Open
Abstract
OBJECTIVE To evaluate the environmental and economic impact of teleophthalmological services provided by a primary (rural) and tertiary (urban) eyecare network in India. METHODS This prospective study utilised a random sampling method, and administered an environmental and economic impact assessment questionnaire. The study included 324 (primary: 173; tertiary: 151) patients who received teleconsultations from July to September 2022. The primary network (rural) used a colour-coded triage system (Green: eye conditions managed by teleconsult alone; yellow: semi-urgent referral within 1 week to a month, red: urgent referral within a day to a week). The tertiary network (urban) included new and follow-up patients. The environmental impact was assessed by estimating the potential CO2 emissions saved by avoiding travel for various transport modes. Economic impact measured by the potential cost savings from direct (travel) and indirect (food and wages lost) expenses spent by yellow and red referrals (primary) and the first-visit expenses of follow-up (tertiary) patients. RESULTS The primary rural network saved 2.89 kg CO2/person and 80 km/person. The tertiary urban network saved 176.6 kg CO2/person and 1666 km/person. The potential cost savings on travel expenses were INR 19,970 (USD 250) for the primary (average: INR 370 (USD 4.6) per patient) and INR 758,870 (USD 9486) for the tertiary network (average: INR 8339 (USD 104) per patient). Indirect cost savings (food and wages) were of INR 29,100 (USD 364) for the primary and INR 347,800 (USD 4347) for the tertiary network. CONCLUSION Teleophthalmology offers substantial environmental and economic benefits in rural and urban eyecare systems.
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Affiliation(s)
- Padmaja Kumari Rani
- Department of Teleophthalmology, L V Prasad Eye Institute, Hyderabad, Telangana, India.
- Anant Bajaj Retina Institute, L V Prasad Eye Institute, Hyderabad, Telangana, India.
- University of Rochester, School of Medicine and Dentistry, Rochester, NY, USA.
| | - Rohit C Khanna
- University of Rochester, School of Medicine and Dentistry, Rochester, NY, USA
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Hyderabad, India
- Brien Holden Eye Research Centre, L V Prasad Eye Institute, Banjara Hills, Hyderabad, India
- School of Optometry and Vision Science, University of New South Wales, Sydney, NSW, Australia
| | | | - Sarath Chandra Yeleswarapu
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Hyderabad, India
| | - Anand Kumar Panaganti
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Hyderabad, India
| | - Vishal Singh Thakur
- Department of Teleophthalmology, L V Prasad Eye Institute, Hyderabad, Telangana, India
- Shantilal Shanghvi Cornea Institute, L V Prasad Eye Institute, Hyderabad, India
| | - Viresh Sharadi
- Department of Teleophthalmology, L V Prasad Eye Institute, Hyderabad, Telangana, India
- Shantilal Shanghvi Cornea Institute, L V Prasad Eye Institute, Hyderabad, India
| | - Varghese Iype
- Department of Teleophthalmology, L V Prasad Eye Institute, Hyderabad, Telangana, India
- Shantilal Shanghvi Cornea Institute, L V Prasad Eye Institute, Hyderabad, India
| | - Varsha M Rathi
- Allen Foster Community Eye Health Research Centre, Gullapalli Pratibha Rao International Centre for Advancement of Rural Eye Care, L V Prasad Eye Institute, Hyderabad, India
| | - Pravin Krishna Vaddavalli
- Department of Teleophthalmology, L V Prasad Eye Institute, Hyderabad, Telangana, India
- Shantilal Shanghvi Cornea Institute, L V Prasad Eye Institute, Hyderabad, India
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Sung YC, Sheu SJ, Hsu SL. Feasibility Analysis of Teleophthalmology Diagnosis and Referral in Remote Areas of Taiwan. Telemed J E Health 2023; 29:1523-1529. [PMID: 37022780 DOI: 10.1089/tmj.2022.0440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2023] Open
Abstract
Background: Remote areas of Taiwan lack routine and specialized ophthalmology services. This study aimed to analyze feasibility of teleophthalmology service for diseases diagnosis and referral in remote areas of Taiwan. Methods: A retrospective study of medical records from 11 remote teleophthalmology clinics in the Taitung area of Taiwan was conducted from May 2020 to December 2021. Vision and intraocular pressure were checked. Ophthalmic imaging was performed by local trained nurses using a hand-held ophthalmoscope and slit lamp biomicroscope. The images were transmitted by telemedicine system to a medical center. Consultation was conducted via face-to-face real-time video calls. Ophthalmologists in the medical center provided diagnosis and treatment advice based on the real-time images and interactive history taking via the telemedicine system. All the images and data were collected and well-reviewed by ophthalmologists in the medical center, and disease prevalence and referral were analyzed for the program. A small-scale satisfaction questionnaire survey was conducted for efficacy evaluation of the program. Results: A total of 1,401 medical records from 1,094 patients were collected and screened. Patients' ages ranged from 9 months to 94 years, with a mean age of 57.27 (standard deviation ±20.47) years. The most frequent ophthalmologic diagnosis was dry eye disease (20.2%), followed by conjunctivitis (12.4%). Among 322 patients with underlying diseases of diabetes mellitus, 59 patients (18.3%) were diagnosed with diabetic retinopathy. Major diagnosis was made in 102 patients (7.3%) and referral to hospital for further management was suggested. This program had high overall satisfaction score of 89% (mean 4.43 ± 0.52 points) in satisfaction questionnaire survey. Conclusion: Teleophthalmology provides an alternative tool for ocular disease diagnosis and screening for patients in remote areas, especially during the COVID-19 pandemic. This service helps to detect major but undiagnosed diseases and promotes health care accessibility and availability in remote areas that lack specialists.
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Affiliation(s)
- Yu-Chi Sung
- Department of Ophthalmology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Ophthalmology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shwu-Jiuan Sheu
- Department of Ophthalmology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Ophthalmology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shiuh-Liang Hsu
- Department of Ophthalmology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Ophthalmology, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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Rani PK, Das AV. Setting up a primary eye care teleconsultation service. COMMUNITY EYE HEALTH 2022; 35:6-7. [PMID: 36035097 PMCID: PMC9412091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Padmaja Kumari Rani
- Network Associate Director: Teleophthalmology, LV Prasad Eye Institute, Hyderabad, India
| | - Anthony Vipin Das
- Department of eyeSmart EMR & AEye: LV Prasad Eye Institute, Hyderabad, India
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