Department of Optometry, University of KwaZulu-Natal, College of Health Sciences, Durban, South Africa.
OneSight EssilorLuxottica Foundation, Paris, France.
Sci Rep. 2024 Aug 6;14(1):18170. doi: 10.1038/s41598-024-68993-5.
This study explored the potential of telemedicine integration into the eye health ecosystem with an aim of scaling effective refractive error coverage in Kenya. This exploratory study was conducted telephonically and through online interviews with key opinion leaders, ophthalmologists, optometrists, ophthalmic clinical officers, optical technicians and beneficiaries of the optical technician's services in rural areas. A telemedicine workflow was developed and validated based on the comments from the key opinion leaders using the Delphi technique. Quantitative and qualitative data were analysed using SPSS and NVivo Software respectively. All of the key opinion leaders agreed that telemedicine is relevant in the eye health ecosystem and recognition of primary vision technicians is critical for effective telemedicine integration. The reasons for the need of telemedicine integration were categorized into; good relationship, organized refractive error service delivery, convenience and availability and cost reduction. The possible factors influencing integration of telemedicine identified were categorized into cost, unwillingness, dominance, perception, lack of technical team, policies and network coverage. The limited human resources in the eye health ecosystem in developing countries cannot effectively deliver refractive error services to the growing population. Hence, integration of telemedicine and establishment of policies recognizing telemedicine are desirable to strengthen task shifting and scale effective refractive error coverage.
本研究旨在探讨远程医疗整合到眼健康生态系统中的潜力，以扩大肯尼亚有效屈光不正覆盖率。本探索性研究通过电话和在线访谈的方式，对肯尼亚农村地区的主要意见领袖、眼科医生、验光师、眼科临床医生、光学技师和光学技师服务的受益人进行了调查。基于主要意见领袖的意见，采用德尔菲技术开发并验证了远程医疗工作流程。使用 SPSS 和 NVivo 软件分别对定量和定性数据进行了分析。所有主要意见领袖都认为远程医疗在眼健康生态系统中具有相关性，认可初级视力技术员对于有效远程医疗整合至关重要。需要整合远程医疗的原因可分为：良好的关系、有组织的屈光不正服务提供、便利和可用性以及降低成本。确定影响远程医疗整合的可能因素可分为成本、意愿、主导地位、感知、缺乏技术团队、政策和网络覆盖范围。发展中国家眼健康生态系统中的人力资源有限，无法为不断增长的人口有效提供屈光不正服务。因此，整合远程医疗和制定认可远程医疗的政策是可取的，可以加强任务转移和扩大有效屈光不正覆盖率。
