Teleophthalmology for First Nations Clients at Risk of Diabetic Retinopathy: A Mixed Methods Evaluation

• Published in: JMIR Medical Informatics
• Main Authors: Kim, Julie, Driver, D Dean
• Format: Article in Journal/Newspaper
• Language: English
• Published: JMIR Publications 2015
• Subjects: Computer applications to medicine. Medical informatics; R858-859.7; Canada; British Columbia; First Nations
• Online Access: https://doi.org/10.2196/medinform.3872; https://doaj.org/article/5511636905fb460da98b08c1368637c0

BackgroundAccess to health services is a particular challenge for First Nations (aboriginal Canadians) communities living in remote or underserviced areas. Teleophthalmology can provide them with the same level of retinal screening services provided to those in urban centers. This screening can lead to the identification of high-risk individuals who can then be monitored and receive treatment related to their diabetes or other health issues. ObjectiveThe intent was to develop, implement, and evaluate a service delivery model for teleophthalmology screening and follow-up for at-risk and diabetic First Nations clients on Vancouver Island, British Columbia, Canada. MethodsA highly consultative, culturally appropriate, and collaborative approach was used to develop and deploy a teleophthalmology service delivery model to First Nations communities. This project was evaluated with regard to utilization and operational costs. Also, clinicians and team members involved in the teleophthalmology project provided assessments of the teleopthalmology quality, productivity, and access. Health providers in First Nations communities provided their perceptions of areas of improvement for the remote retinal screening services, areas where expansion of services could be offered, and opportunities to increase client education and health promotion. ResultsAll 51 First Nations communities on Vancouver Island expressed interest in receiving teleopthalmology services. During the 1-year project, teleopthalmology clinics were held in 43 of 51 communities on Vancouver Island. During these clinics, 524 clients were screened and 140 of those clients were referred to a general ophthalmologist, family doctor, retinal specialist, optometrist, or other provider. Ratings of teleopthalmology system quality, information quality, service quality, and system usage were positive. Satisfaction with the teleopthalmology project was high among clinicians involved with the project. Satisfaction was also high among health providers in First Nations ...