Abstract
Purpose: :
To describe the Stanford University Network for Diagnosis of Retinopathy of Prematurity (SUNDROP) telemedicine screening initiative.
Methods: :
Small and underserved neonatal intensive care units (NICUs) with either intermittent or no ophthalmologic services were offered the opportunity to participate in the SUNDROP telemedicine screening initiative for screening for retinopathy of prematurity (ROP). Lucile Packard Children’s Hospital at Stanford University offered to purchase 3 RetCam II (Clarity Medical Systems, Pleasanton, CA) for three of its affiliated NICUs. Additionally, the Santa Clara county hospital arranged for purchase of one unit, anticipating conversion from the author’s screening examinations to telemedicine techniques. Following receipt of the RetCam II units, Clarity Medical Systems volunteered to train medical personnel at each site and to develop a certification program granted by their own certified ophthalmic photographer on staff. A competency and proficiency protocol was created for personnel to be trained in RetCam II usage. Standard image sets were identified as ideal for screening, and this was incorporated into the training of personnel. Images were saved onto the DVD–RAM. These images were downloaded along with demographic patient data onto compact discs and then sent by overnight mail to the author for evaluation. Re–screening was ordered based upon findings at the central reading center. The smallest NICU was brought on–line first to evaluate the feasibility and to help identify potential problems in the process. Upon discharge from the NICU, all patients were sent for examination by the author at Stanford University Medical School.
Results: :
One of the four sites has been successfully enrolled for 1 month. Images have been of high–quality photography. All of Zone I and most of Zone II has been readily identifiable on the RetCam II images. Additionally, the largest site has been trained and operational ready for 2 months. Patients that need more frequent than weekly examination have been successfully screened in the intervening period using the RetCam II. The two remaining sites are scheduled for training in early December 2005 and will be brought on–line in early 2006.
Conclusions: :
The initial results of the SUNDROP telemedicine screening initiative for ROP indicate that it is not only feasible, but practical, and even potentially economical method for screening at risk infants in underserved communities.
Keywords: retinopathy of prematurity • imaging/image analysis: clinical • clinical (human) or epidemiologic studies: health care delivery/economics/manpower