Innovation Exchange
Diabetes Retinopathy Screening using Telehealth
Arjun Dirghangi
University of Virginia Department of Ophthalmology
Organization type
Health System
App(s), device(s), or platform(s) used

Remidio NM-FOP (nonmydriatic fundus on phone) and related iPhone app and web portal.

Topcon Synergy (soon to be Topcon Harmony) web-based image management software.

Topcon Optiflow (web-based diabetic retinopathy screening image review software).

Canon CR-2 cameras; WelchAllyn RetinaVue tabletop cameras (at CVHS).

Program description
We have a diabetic retinopathy screening (DRS) program at UVA Ophthalmology, which UVA Telehealth has administered for the past several years. I'm the lead on that DRS program for two grant-funded projects (with major funding from Virginia Department of Health as well as the National Association of Chronic Disease Directors, both with funding via the CDC), which extends the department's reach into multiple sites (free clinics, FQHC networks, other partnered primary care clinics including UVA off-ground sites) with a variety of program partners throughout Virginia including Appalachia and Eastern Shore, plus multiple sites in central Virginia. We are also currently planning a pilot program at UVA and some partners to expand to "e-Consults" which will be a virtual consultation program, but this is in its initial planning phases. This program is designed to serve as a scalable, sustainable model for the rest of the country by using established reimbursement models for DRS (diabetic retinopathy screening), a comparatively inexpensive camera, and a mix of virtual CME training modules (via the online Telehealth Village portal) and in-person training and support via our technology implementation partners. Additionally, we seek to address some of the usability roadblocks preventing use of telehealth in DRS in the past by using very easy-to-use cameras with an integrated secure cloud back end and automated image uploads of images and patient data to a secure cloud-based image interpretation portal.