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 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.[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]