Abstract
Purpose: :
To evaluate a new way to treat and follow retina patients in an era of lack of resources in healthcare by the integration between ophthalmologists working in their offices on the territory and others working on Retina Centers.
Methods: :
A dedicated iRetina physician-to-physician network has been developed on a web application platform using IBM Lotus Notes database technology including an iPad application with a centralised state-of-the-art server and a dedicated booking service for connections. A dedicated Electronic Medical Records (EMR) has been created with space for text and bio-images using in-depth special magnification software. The network system works in asynchrony (off-line), with notification to consultant and consulted ophthalmologists provided by SMS and e-mail messages. The system has been running since November 2009. The project also provided each ophthalmologist with Italian Continuous Medical Education (CME) credits.
Results: :
Up to now, six groups of ophthalmologists in different Italian cities used the network for a total of 72 active ophthalmologists. 260 patients were evaluated. 360 electronic medical records and 187 set of images were used for the opinions’ exchange. Access to the project (entering the network), acceptability (technology satisfaction), data quality and medical efficacy (appropriate care in the right time) were evaluated positive/very positive by a point classification system. The process of care was accelerate in about 25% out of the 260 patients.
Conclusions: :
The project allowed to decrease the number of duplicate visits and calls that are particularly burdensome (no matter who pays: the state, insurance companies, the patient himself) in anti-VEGF therapies, where control visits and therapies have to be carried out on a monthly-basis for years. iHealth could represents a profitable alternative in this era of worldwide healthcare budgetary retrenchment.
Keywords: retina • imaging/image analysis: clinical • clinical (human) or epidemiologic studies: health care delivery/economics/manpower