Strategies to help overcome barriers to the implementation of screening

Strategies to help overcome barriers to the implementation of screening

It is critically important that advances in AI technology are included in the screening procedure for DEDs to support our goal of improving access to care for underserved and at-risk populations. Technology can help to improve the accuracy and efficiency of the screening process for all DEDs, especially diabetes-related retinopathy which affects 463 million people worldwide [17]. Improvements in screening technology will also benefit ophthalmologists and retinal specialists by reducing their workload and ensuring patients get quick and reliable diagnoses so as to best manage their condition.

The infographic below [17] represents the huge ratio of people with diabetes-related retinopathy and an ophthalmologist, highlighting an urgent need to improve the current screening strategy. This can be achieved through inclusion of advanced AI technology to help ophthalmologists help their patients.

There are 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.[18] In telemedicine for diabetes-related retinopathy 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 diabetes-related retinopathy is present, and potentially make recommendations for further follow-up and treatment, if required.

The major advantage of telescreening is that it allows Diabetes-related Retinopathy screening to be performed in people living in rural areas for whom screening would otherwise not be available. Telescreening programs for Diabetes-related Retinopathy have been implemented in several countries, including France, United States, United Kingdom, Netherlands and Canada.[19] There is evidence that this approach increases access to care and screening rates [20], and is also more cost-effective than conventional screening, where the patient would have to visit a retinal specialist (e.g. ophthalmologist) for assessment.[21]