Patient Attitudes Toward Telemedicine for Diabetic Retinopathy (original) (raw)
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Internatoinal Journal of Telemedicine Applications, 2018
Objective: The purpose of the study is to extend research on patient satisfaction with telemedicine services by employing the theoretical framework of Expectation Disconfirmation Theory (EDT) for diabetic retinopathy screenings focusing on rural patients. Method: Adult subjects (n=220) with diabetes were recruited from a single-family practice office in rural Iowa. Subjects completed a "pre" survey concerning their forward-looking perceptions of telemedicine prior to using telemedicine for detection of diabetic retinopathy and a "post" survey after they received recommendations from the distant ophthalmologists. Results: All hypotheses of the EDT model were supported. Patient satisfaction is influenced by both patients' expectations (P<.001) and disconfirmation of expectations (P<.001), and patient satisfaction has a positive impact on patient preference for telemedicine services (P<.001). Overall, patients who received telemedicine services were highly satisfied with telemedicine and developed a favorable disposition towards telemedicine services. Conclusions. The EDT model is a viable framework to study patient satisfaction of telemedicine services. While previous feasibility studies have shown that telemedicine for diabetic retinopathy screenings yields diagnostic efficacy, this study applies a theoretical framework to demonstrate the viability of telemedicine for diabetic retinopathy screenings in rural areas.
Examining the Role of Telemedicine in Diabetic Retinopathy
Journal of Clinical Medicine
With the increasing prevalence of diabetic retinopathy (DR), screening is of the utmost importance to prevent vision loss for patients and reduce financial costs for the healthcare system. Unfortunately, it appears that the capacity of optometrists and ophthalmologists to adequately perform in-person screenings of DR will be insufficient within the coming years. Telemedicine offers the opportunity to expand access to screening while reducing the economic and temporal burden associated with current in-person protocols. The present literature review summarizes the latest developments in telemedicine for DR screening, considerations for stakeholders, barriers to implementation, and future directions in this area. As the role of telemedicine in DR screening continues to expand, further work will be necessary to continually optimize practices and improve long-term patient outcomes.
Factors influencing the acceptance of telemedicine for diabetes management
Cluster Computing, 2014
Telemedicine service is effective intervention in blood glucose management and reducing the progression of diabetic complications. While telemedicine service for the enhanced management of diabetes has been known for its usefulness, there is little understanding regarding which factors should be considered when diabetic patients accept telemedicine. Thus, this study aimed to examine the factors that influence the acceptance of telemedicine service for the enhanced management of diabetes mellitus based on the Unified Theory of Acceptance and Use of Technolog (UTAUT) model. Data were collected from a paperbased survey of 116 diabetic patients who were outpatients in six different university hospitals. This study used partial least squares regression to determine the causal relationship between the five variables. Demographic variables, such as age and gender, as moderating variables for behavioral intention to use were analyzed. The results indicate that facilitating factors have effects on the behavioral intention to use telemedicine service through the performance expectancy (p < 0.05). In addition, facilitating factors have effects on the behavioral intention to use telemedicine service through
Using Telemedicine to Increase Eye Care Screening Referral for People with Diabetes
Journal of Public Health Issues and Practices, 2019
Diabetes is the leading cause of preventable blindness among adults aged 20-74 years. Millions of Americans are affected by the complications and premature morbidity and mortality rates associated with diabetes mellitus (DM). We deal with two of these complications, visual impairment and blindness from diabetic retinopathy, that imposes a significant, increasing burden on patients, providers, and the health care system. These burdens are predicted to approximately triple over the next few decades.A major issue is that many people with diabetic retinopathy do not seek eye care, even if they are covered by insurance, because the disease is often symptom free until vision is significantly compromised. At this late stage, visual impairment is more difficult and more expensive to manage and often the damage is irreversible. A possible solution to increasing screening for diabetic retinopathy is Digital Teleretinal Imaging. We review the literature on this technology and offer a screening...
Eye Care Providers' Attitudes Towards Tele-Ophthalmology
Telemedicine journal and e-health : the official journal of the American Telemedicine Association, 2015
Background: The rapid rise of e-health and remote care systems will likely change the practice patterns of ophthalmologists. Although telemedicine practices are thriving in many specialties of medicine, telemedicine for ophthalmology has been limited primarily to asynchronous care for diabetic retinopathy. The goal of this research was to evaluate perspectives on and familiarity with telemedicine among eye care providers at a large tertiary-care medical center via an anonymous, descriptive survey. Results: In total, 58 eye care physicians completed surveys (response rates of 86% for physicians-in-training and 49% for faculty physicians, respectively). Although a majority of both faculty and physicians-in-training were willing to participate in telemedicine services, trainees were more likely to be willing to interpret photographs than faculty (p=0.04). Most respondents (71%) indicated that they did not use telemedicine. Over half had received photographs (via phone or e-mail) for in...
American Journal of Ophthalmology, 2005
To extend access to diabetic eye care and characterize the extent of diabetic retinopathy {DR) and other ocular findings using the Joslin Vision Network (JVN). • DESIGN: Retrospective observational cohort study. • METHODS: Outpatients at the Togus VA Medical Center with diabetes mellitus, impaired fasting glucose, or impaired glucose tolerance underwent JVN protocol imaging. Images were transmitted to the Joslin Diabetes Center for grading and recommended treatment plan. • RESULTS: The study included 1,219 patients (2,437 eyes); 1,536 eyes (63.0%) had no (DR), 389 (16.0%) had mild nonproliferative DR (NPDR), 105 (4.3%) moderate NPDR, 35 (1.4%) severe NPDR, 20 (0.8%) very severe NPDR, and 21 (0.9%) had proliferative DR (PDR). Regarding diabetic macular edema (DME), 1,907 eyes (78.3%) had no DME, 34 (1.4%) had early DME, and 16 (0.7%) had clinically significant macular edema
Primary Care Providers? Perceptions of Home Diabetes Telemedicine Care in the IDEATel Project
The Journal of Rural Health, 2007
elemedicine is the use of telecommunication in the delivery of health services to surmount geographical and other barriers by enabling provider-patient and providerprovider consultation. 1 In recent years, there has been a rapid expansion of the use of informatics, and specifi cally, telemedicine that can be used for health care delivery to patients. 2 A number of systematic reviews of different combinations of the 455 studies of the use of telemedicine have examined clinical benefi ts, patient satisfaction, feasibility, and costs. 1,3-7 These reviews concluded that most of the studies were short term, most were small, very few focused on the Medicare population comprising the majority of patients with type 2 diabetes, and most had not evaluated their interventions rigorously. In addition, none had systematically examined referring ABSTRACT : Context: Few telemedicine projects have systematically examined provider satisfaction and attitudes. Purpose: To determine the acceptability and perceived impact on primary care providers ' (PCP) practices of a randomized clinical trial of the use of telemedicine to electronically deliver health care services to Medicare patients with diabetes in federally designated medically underserved areas of upstate New York, primarily those in rural areas and small towns with limited access to primary care. Methods: A longitudinal phone survey was completed by 116 PCPs with patients with diabetes in the treatment arm of the trial, and conducted 12 and 24 months after a PCP ' s fi rst patient was randomized to the home telemedicine arm of the trial. The 36-item survey included measures of acceptability (to PCPs, time required), impact (on patient knowledge, confi dence, perceived health outcomes), and communication. Six open-ended questions were analyzed qualitatively. Results: The quantitative data indicated positive responses in terms of acceptability of the telemedicine intervention to the PCPs and of the impact on the PCPs ' patients. This was most evident in issues critical to good control of diabetes: patient knowledge, ability to manage diabetes, confi dence, and compliance in managing diabetes. Key qualitative themes, on the positive end, were more patient control and motivation, helpfulness of having extra patient data, and involvement of nurses and dieticians. Negative themes were excessive paperwork and duplication taking more PCP time, and confl icting advice and management decisions from the telemedicine team, some without informing the PCP but none involving medications. Conclusions: Telemedicine was reported to be a positive experience for predominantly rural PCPs and their Medicare-eligible patients from medically underserved areas; several ineffi ciencies need to be refi ned.
JAMA ophthalmology, 2015
Minimal information exists regarding the long-term comparative effectiveness of telemedicine to provide diabetic retinopathy screening examinations. To compare telemedicine to traditional eye examinations in their ability to provide diabetic retinopathy screening examinations. From August 1, 2006, through September 31, 2009, 567 participants with diabetes were randomized and followed up to 5 years of follow-up (last date of patient follow-up occurred on August 6, 2012) as part of a multicenter randomized clinical trial with an intent to treat analysis. We assigned participants to telemedicine with a nonmydriatic camera in a primary care medical clinic (n = 296) or traditional surveillance with an eye care professional (n = 271). Two years after enrollment, we offered telemedicine to all participants. Percentage of participants receiving annual diabetic retinopathy screening examinations, percentage of eyes with worsening diabetic retinopathy during the follow-up period using a valid...
International Journal of E-Health and Medical Communications
Research on the attitude of diabetes retinopathy's (DR) patients towards teleophthalmology as a branch of telemedicine has not been examined in developing countries. This article examines the receptiveness attitude of the patients with DR towards the use of teleophthalmology using 400 questionnaires to examine patients in Calabar DR screening center in Cross River State, Nigeria. The hypotheses were tested using multiple indicators multiple causes (MIMIC) as a special case of the structural equation modeling (SEM). The findings in this study indicated high cost and excess time negatively affects patient attitude, information, knowledge, and experience significantly and positively predict patients attitude towards teleophthalmology. Furthermore, the result of the paper shows that convenience and knowledge for 35.7 percent of the receptiveness of patients towards teleophthalmology. This study contributes by identifying that among other factors positive factors to enhance patient&#...
Telemedicine and Diabetic Retinopathy: Review of Published Screening Programs
Journal of Endocrinology and Diabetes, 2015
Fortunately, when identified early and treated, the risk of vision loss is cut in half [2]. However, according to the National Committee for Quality Assurance, our current health care system meets guidelines for diabetic screening only by 40-60% of the time [3,4]. With a growing population of diabetics [5] and with work shortages projected for ophthalmologists [6], innovative approaches to diabetic retinopathy assessments could prevent needless vision loss. One approach is to use tele-ophthalmology to aid in the evaluation process by: 1) increasing local access to screening for diabetic retinopathy and 2) risk stratifying patients with diabetic eye disease so that those who require treatment can be scheduled more efficiently [7-9]. The American Telemedicine Association (ATA) has described four categories which classify telemedicine programs [10]. In this review, our aim was to provide a narrative review of the literature surrounding the four different categories of DR screening programs in the US and around the world. Methods Initial articles were identified by performing a PubMed search using the following key words: "diabetic retinopathy" or "diabetes and eye disease" and at least one of the following "telemedicine", "telepathology", "remote consultation", "mobile health units", "telemed", "teleimage", "teleEye", "telesurveillance", "teleophthalmology", "tele-consultation", or "tele-retina". Additional inclusion criteria were articles published in English, human studies, and publication after the year 2000. The final search was conducted on December 4, 2014. With this search, 168 articles were identified. For inclusion in this narrative review, a program had to have published data on at least 150 patients and describe the process of ATA validation for their telemedicine program. The purpose of this review was to focus on telemedicine programs that have been implemented. By limiting our review to programs that had evaluated at least 150 patients, we excluded programs that were in the pilot testing-phase. All abstracts were reviewed and 30 articles were identified that directly discussed validation or design of an included diabetic screening program. The bibliographies of articles that were read were then reviewed