Strategies to help overcome barriers to the implementation of screening

Strategies to help overcome barriers to the implementation of screening

There are a several strategies that could potentially help overcome some of the barriers to the implementation of screening outline above.

Telemedicine

Telemedicine is the use of electronic telecommunications that allows a patient’s medical problems to be evaluated and monitored by a physician located in a remote location.[22] In telemedicine for DR screening (also referred to as ‘telescreening’ or ‘teleretinal screening’), digital retinal images are obtained at the patients’ local clinic or at a mobile screening unit, using a fundus camera. These are then sent electronically for assessment by retinal imaging experts at a centralized reading centre who can then determine if DR is present, and potentially make recommendations for further follow-up and treatment, if required.

The major advantage of telescreening is that it allows DR screening to be performed in people living in rural areas for whom screening would otherwise not be available. Telescreening programs for DR have been implemented in several countries, including France, United States, United Kingdom, Netherlands and Canada.[23] There is evidence that this approach increases access to care and screening rates [24], and is also more cost-effective than conventional screening, where the patient would have to visit a retinal specialist (e.g. ophthalmologist) for assessment.[25]