Richardson D Russell, Fry Russell L, Krasnow Michael
West Virginia University Eye Institute, Marshall University, Joan C. Edwards School of Medicine, Huntington, WV, USA.
W V Med J. 2013 Jul-Aug;109(4):52-5.
Life in mountainous, rural areas poses unique obstacles for ophthalmic care--notably, a lack of access to ophthalmologists and cost of care. Using telemedicine as a screening tool addresses both issues for diabetic retinopathy (DR) screening, as fundus photography has been determined to be sensitive and specific when screening for DR. The American Diabetes Association places a Grade E recommendation on fundus photography as a screening tool. We analyze the financial impact of ophthalmic telemedicine in a mountainous, rural health clinic in West Virginia over a seven year period from 2003-2009. At-risk patients are screened with a fundus camera during routine clinic visits, and the image is interpreted off-site by an ophthalmologist. Patients are either advised to follow up yearly or receive an immediate opthalmic referral. Considering the number of patients screened, travel costs, work missed, overhead, and billing considerations yields a savings of $153.43 per patient visit.
山区农村地区的生活给眼科护理带来了独特的障碍——尤其是难以接触到眼科医生以及护理费用高昂。将远程医疗用作筛查工具可解决糖尿病视网膜病变（DR）筛查中的这两个问题，因为眼底摄影已被确定在筛查DR时具有敏感性和特异性。美国糖尿病协会对将眼底摄影用作筛查工具给出了E级推荐。我们分析了2003年至2009年的七年时间里，眼科远程医疗在西弗吉尼亚州一个山区农村健康诊所产生的财务影响。高危患者在常规门诊就诊时用眼底相机进行筛查，图像由眼科医生在异地解读。患者要么被建议每年进行随访，要么立即接受眼科转诊。考虑到筛查的患者数量、差旅费、误工费用、管理费用和计费因素，每次患者就诊可节省153.43美元。
