Telemedicine screening for diabetic retinopathy: staff and patient satisfaction

Abstract

In a pilot project, telemedicine was used to conduct retinal examinations of diabetic patients in the Alta municipality of Norway. All health-care workers who were involved in the project were interviewed. The ophthalmologists found that the grading of the level of retinopathy was quicker with digital images than with slit-lamp examinations. Fifty patients with type II diabetes were invited to attend a telemedicine check-up and 42 did so. Patients were asked to complete a questionnaire after the telemedicine examination and we received 32 replies (a 76% response rate), of which 12 were from men and 20 from women. The patients expressed a high degree of satisfaction with the telemedicine examination. The results of the evaluation also clearly showed that trust between health personnel was of major importance in engendering positive attitudes. Confidence is the basis of good collaboration between the various professions in the health-care sector, between health-care levels and between patients and treatment providers - in terms not only of individuals' confidence but also of routines, procedures and the system as a whole.

Patient perceived value of teleophthalmology in an urban, low income US population with diabetes

“…In addition, the use of nonmydriatic cameras without dilating the eye and avoiding temporary vision impairment was seen as a major advantage of teleophthalmology as noted in the recent Wisconsin study [30]. PCP recommendation and stronger PCP-patient relationships were important patient motivators for using teleophthalmology, similar to other studies from Norway [21] and Wisconsin, USA [20,30]. The cost of care was the major barrier to obtaining dilated eye exams, as seen in other US based studies [16, 18-20, 31, 34-37].…”

“…We not only identified many of the same barriers to obtaining a dilated eye exam as other US based studies [18-20, 31, 32, 34, 35], but also demonstrated the value of a teleophthalmology service using nonmydriatic retinal cameras in PCP practices in overcoming such barriers. The most common stated value was convenience and the ability to overcome transportation and time management issue, as noted in other international and US studies, including a recent study of a white Caucasian rural population in Wisconsin [21,23,27,30,31,34,35]. Other value included ease of use, ability to detect disease before visual symptoms, and the knowledge provided by the photos and technicians about retinopathy and eye disease, which have been only reported thus far in international studies [21][22][23][24][25][26][27].…”

“…The majority of work evaluating patient experiences with teleophthalmology has focused on international populations using quantitative surveys [21][22][23][24][25][26][27]. One qualitative study from the UK found that participants value teleophthalmology if they understand why it is being recommended and if it is convenient and accessible by safe transportation [28].…”

Provider Utilization of Telemedicine: The Elephant in the Room

“…For example, the competency of the practitioner on the other end and the completeness of the patient records both comprise important considerations for providers. 16 Or, trust among healthcare workers influences and directly affects attitudes toward telemedicine startup. 17 • Make sure administration does more than pay lip service.…”

Service innovation from the edges: enhanced by telemedicine decision support

“…Nilsen [26] looks at the exchange of knowledge between the GPs and the specialists in videoconferences and how collaborative work might close knowledge gaps in daily medical practice; however, patients were not present. This is also the case for other studies [27], while it was the GP who was not involved in other studies [28,29], the exception being a study [30][31][32] where GPs had received special training to perform endoscopic otolaryngological examinations, which were conducted during a synchronous consultation with a specialist. Patient reported being satisfied with this type of consultation, and it offered the patient new ways of taking part in the consultation.…”