- •Foreword
- •Preface
- •Contents
- •1.1 Introduction
- •1.2 Method
- •1.2.1 Databases
- •1.2.2 Dates
- •1.2.3 Keywords
- •1.2.4 Criteria for Inclusion
- •1.2.5 Criteria for Exclusion
- •1.2.6 Selection of Papers
- •1.3 Results
- •1.3.1 Subspecialty
- •1.3.2 Type of Telemedicine
- •1.3.3 Study Design
- •1.3.4 Final Conclusions of Papers
- •1.4 Discussion
- •References
- •2.1 Introduction
- •2.2 The Need for Diabetic Retinopathy Screening Programs
- •2.4 Guidelines for Referring Patients
- •2.7 Program Models for Diabetic Retinopathy Screening
- •2.9 Program Personnel and Operations
- •2.9.1 Primary Care Providers
- •2.9.2 Photographers
- •2.9.3 Clinical Consultants
- •2.9.4 Administrators
- •2.9.5 A Note to CEOs, Operations Directors, and Clinic Managers
- •2.10 Policies and Procedures
- •2.10.1 Sample Protocol 1
- •2.10.1.1 Diabetic Retinopathy Screening Services
- •Policy
- •Background
- •Procedure
- •2.10.2 Sample Protocol 2
- •2.10.2.1 Pupil Dilation Before Diabetic Retinopathy Photography
- •Policy
- •Background
- •Procedure
- •2.10.3 Sample Protocol 3
- •2.10.3.1 Diabetic Retinopathy Photography Review
- •Policy
- •Background
- •Procedure
- •2.11 Technical Requirements
- •2.11.1 Connectivity
- •2.11.2 Resolution
- •2.11.3 Color
- •2.11.4 Stereopsis
- •2.11.5 Compression
- •2.11.6 Enhancement
- •2.11.7 Pupil Dilation
- •2.11.8 Early California Telemedicine Initiatives Diabetic Retinopathy Screening
- •2.11.9 The American Indian Diabetes Teleophthalmology Grant Program
- •2.11.10 Central Valley EyePACS Diabetic Retinopathy Screening Project
- •2.12.1 Diabetic Retinopathy
- •2.12.1.1 ADA Guidelines Terms
- •2.12.1.2 Vitrectomy
- •References
- •3: Stereopsis and Teleophthalmology
- •3.1 Introduction
- •3.2 History of Stereopsis and Stereopsis in Ophthalmology
- •3.3 Technology and Photography
- •3.3.3 Imaging Fields
- •3.3.4 Image Viewing Techniques
- •3.3.5 Image Compression
- •3.4 Stereoscopic Teleophthalmology Systems
- •3.4.1 University of Alberta
- •3.4.4 Joslin Vision Network
- •3.5 Conclusion
- •References
- •4.1 Introduction
- •4.2 Methods
- •4.2.1 Main Outcome Measures
- •4.3 Results
- •4.3.1 Retinal Video Recording Versus Retinal Still Photography
- •4.3.2 Video Compression Analysis
- •4.4 Discussion
- •References
- •5.1 Introduction
- •5.1.1 Automated, Remote Image Analysis of Retinal Diseases
- •5.1.2 Telehealth
- •5.2 Design Requirements
- •5.2.1 Telehealth Network Architecture
- •5.2.2 Work Flow
- •5.2.3 Performance Evaluation of the Network
- •5.3 Automated Image Analysis Overview
- •5.3.1 Quality Assessment Module
- •5.3.2 Vascular Tree Segmentation
- •5.3.3 Quality Evaluation
- •5.4 Anatomic Structure Segmentation
- •5.4.1 Optic Nerve Detection
- •5.4.2 Macula
- •5.4.3 Lesion Segmentation
- •5.4.4 Lesion Population Description
- •5.4.5 Image Query
- •5.5 Summary
- •References
- •6.1 Introduction
- •6.3 Optical Coherence Tomography to Detect Leakage
- •References
- •7.1 Introduction
- •7.2 Patients and Methods
- •7.2.1 Participants
- •7.2.2 Methods
- •7.2.3 Statistics
- •7.3 Results
- •7.3.1 Reliability of Image Evaluation
- •7.3.2 Prevalence of Glaucomatous Optic Nerve Atrophy
- •7.4 Discussion
- •7.5 Perspectives
- •References
- •8.1 Introduction
- •8.1.2 Homology Between Retinal and Systemic Microvasculature
- •8.1.3 Need for More Precise CVD Risk Prediction
- •8.2.1 Retinal Microvascular Signs
- •8.2.2 Retinal Vessel Biometry
- •8.2.3 Newer Retinal Imaging for Morphologic Features of Retinal Vasculature
- •8.3 Associations of Retinal Imaging and CVD Risk
- •8.3.1.1 Risk of Pre-clinical CVD
- •8.3.1.2 Risk of Stroke
- •8.3.1.3 Risk of Coronary Heart Disease
- •8.3.2.1 Risk of Hypertension
- •8.3.2.2 Risk of Stroke
- •8.3.2.3 Risk of Coronary Heart Disease
- •8.3.2.4 Risk of Peripheral Artery Disease
- •8.3.3 Newer Morphologic Features of Retinal Vasculature
- •8.4 Retinal Imaging and Its Potential as a Tool for CVD Risk Prediction
- •References
- •9.1 Alzheimer’s Disease
- •9.2 Treatments
- •9.3 Diagnosis
- •9.6 Conclusions
- •References
- •10.1 Introduction
- •10.1.1 Stroke
- •10.1.2 Heart Disease
- •10.1.3 Arteriovenous Ratio
- •10.2 Purpose
- •10.3 Method
- •10.3.1 Medical Approach
- •10.3.2 Technical Approach
- •10.3.3 Output of Medical Data
- •10.4 Patients
- •10.5 Results
- •10.5.1 Medical History
- •10.5.2 Telemedical Evaluation of Retinal Vessels
- •10.5.2.1 Prevalence of Retinal Microangiopathy
- •10.5.2.2 Arteriovenous Ratio
- •10.5.2.3 PROCAM-Index
- •10.6 Discussion and Perceptive
- •10.6.1 Estimation of “Stroke Risk” Estimated by the Stage of Retinal Microangiopathy
- •References
- •11.1 Introduction
- •11.2 System Requirements
- •11.3 Fundus Camera
- •11.4 Imaging Procedure
- •11.4.1 Reading Center Procedure
- •11.5 Detection of Macular Edema
- •11.6 Implementation
- •11.7 Unreadable Images
- •11.7.1 Impact on Overall Diabetic Retinopathy Assessment Rates
- •11.7.2 Compliance with Recommendations
- •11.7.3 Challenges
- •11.7.4 Summary
- •References
- •12.1 Screening
- •12.2 Background
- •12.3 Historical Perspective in England
- •12.4 Methodology
- •12.4.1 The Aim of the Programme
- •12.5 Systematic DR Screening
- •12.6 Cameras for Use in the English Screening Programme
- •12.7 Software for Use in the English Screening Programme
- •12.9 Implementation in England
- •12.11 Quality Assurance
- •12.12 The Development of External Quality Assurance in the English Screening Programme
- •12.13 Information Technology (IT) Developments for the English Screening Programme
- •12.14 Dataset Development
- •12.15 The Development of External Quality Assurance Test Set for the English Screening Programme
- •12.16 Failsafe
- •12.17 The Epidemic of Diabetes
- •References
- •13.1 Introduction
- •13.2 Burden of Diabetes and Diabetic Retinopathy in India
- •13.3 Diabetic Retinopathy Screening Models
- •13.4 Need for Telescreening
- •13.5 Guidelines for Telescreening
- •13.6 ATA Categories of DR Telescreening Validation
- •13.7 Yield of Diabetic Retinopathy in a Telescreening Model
- •13.8 How Are Images Transferred
- •13.10 How Many Fields Are Enough for Diabetic Retinopathy Screening
- •13.11 Is Mydriasis Needed While Using Nonmydriatic Camera?
- •13.12 Validation Studies on Telescreening
- •13.12.1 Accuracy of Telescreening
- •13.12.2 Patient Satisfaction in Telescreening
- •13.12.3 Cost Effectivity
- •13.12.4 Telescreening for Diabetic Retinopathy: Our Experience
- •13.13 Future of Diabetic Retinopathy Screening
- •References
- •14.1 Introduction
- •14.2 Methods
- •14.3 Discussion
- •14.4 Conclusion
- •References
- •15.1 Introduction
- •15.1.1 Description of the EADRSI
- •15.5 State Support of Screening in the Safety Net
- •15.7 Screening Economics for Providers
- •15.8 Patient Sensitivity to Fees
- •15.9 Conclusion
- •References
- •16.1 Introduction
- •16.2 Setting Up the New Screening Model
- •16.2.1 Phase 1: Training
- •16.2.2 Phase 2: Evaluation of Agreement
- •16.2.3 Phase 3: Implementation of the Screening Model
- •16.3 Technologic Requirements
- •16.3.1 Data Management
- •16.3.2 Data Models
- •16.3.2.1 Data Scheme for Patient-Related Information
- •16.3.2.2 Data Scheme for Images
- •Fundus Camera VISUCAM Pro NM
- •PACS Server
- •ClearCanvas DICOM Visualizer
- •16.4 Results
- •16.4.1 Phase 2: Agreement Evaluation
- •16.4.2 Phase 3: Implementation of the Screening Model
- •16.5 Discussion
- •16.5.1 Evaluation of the Screening Model
- •16.5.2 Prevalence of DR
- •16.5.3 Quality Evaluation
- •16.6 Conclusion
- •References
- •17.1.3 Examination and Treatment
- •17.1.4 Limitations of Current Care
- •17.2 Telemedicine and ROP
- •17.2.2 Accuracy and Reliability of Telemedicine for ROP Diagnosis
- •17.2.3 Operational ROP Telemedicine Systems
- •17.2.4 Potential Barriers
- •17.3 Closing Remarks
- •17.3.1 Future Directions
- •References
- •18.1 Introduction
- •18.2 Neonatal Stress and Pain
- •18.3 ROP Screening Technique
- •18.4 Effect of Different Examination Techniques on Stress
- •18.5 Future of Retinal Imaging in Babies
- •References
- •19.1 Introduction
- •19.2 History of the Program
- •19.3 Telehealth Technologies
- •19.4 Impact of the Program
- •Selected References
- •Preamble
- •Introduction
- •Background
- •The Diabetic Retinopathy Study (DRS)
- •Mission
- •Vision
- •Goals
- •Guiding Principles
- •Ethics
- •Clinical Validation
- •Category 1
- •Category 2
- •Category 3
- •Category 4
- •Communication
- •Medical Care Supervision
- •Patient Care Coordinator
- •Image Acquisition
- •Image Review and Evaluation
- •Information Systems
- •Interoperability
- •Image Acquisition
- •Compression
- •Data Communication and Transmission
- •Computer Display
- •Archiving and Retrieval
- •Security
- •Reliability and Redundancy
- •Documentation
- •Image Analysis
- •Legal Requirements
- •Facility Accreditation
- •Privileging and Credentialing
- •Stark Act and Self-referrals
- •State Medical Practice Acts/Licensure
- •Tort Liability
- •Duty
- •Standards of Care
- •Consent
- •Quality Control
- •Operations
- •Customer Support
- •Originating Site
- •Transmission
- •Distant Site
- •Financial Factors
- •Reimbursement
- •Grants
- •Federal Programs
- •Other Financial Factors
- •Equipment Cost
- •Summary
- •Abbreviations
- •Appendices
- •Appendix A: Interoperability
- •Appendix B: DICOM Metadata
- •Appendix C: Computer-Aided Detection
- •Appendix D: Health Insurance Portability and Accountability Act (HIPAA)
- •Appendix F: Quality Control
- •Appendix H: Customer Support
- •Level 1
- •Level 2
- •Level 3
- •Appendix I: Reimbursement
- •Medicare
- •Medicaid
- •Commercial Insurance Carrier Reimbursement
- •Other Financial Factors
- •Disease Prevention
- •Resource Utilization
- •American Telemedicine Association’s Telehealth Practice Recommendations for Diabetic Retinopathy
- •Conclusion
- •References
- •Contributors
- •Second Edition
- •First Edition
- •Index
Appendix |
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and cotton-wool spots in digital color fundus photographs for diabetic retinopathy diagnosis. Invest Ophthalmol Vis Sci 48:2260Ð2267
141. Philip S, Fleming AD, Goatman KA et al (2007) The efÞcacy of automated Òdisease/no diseaseÓ grading for diabetic retinopathy in a systematic screening programme. Br J Ophthalmol 91:1512Ð1517
142.Abramoff MD, Niemeijer M, Russell SR (2010) Automated detection of diabetic retinopathy: barriers to translation into clinical practice. Expert Rev Med Devices 7:287Ð296
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144.Tobin KW, Abdelrahman M, Chaum E, Govindasamy V, Karnowski TP (2007) A probabilistic framework for content-based diagnosis of retinal disease. Conf Proc IEEE Eng Med Biol Soc 2007:6744Ð6747
145.Chaum E, Karnowski TP, Govindasamy VP, Abdelrahman M, Tobin KW (2008) Automated diagnosis of retinopathy by content-based image retrieval. Retina 28:1463Ð1477
146.LeBlanc K, SafÞotti A (2009) Multirobot object localization: a fuzzy fusion approach. IEEE Trans Syst Man Cybern B Cybern 39:1259Ð1276
147.Nguyen TT, Wong TY (2009) Retinal vascular changes and diabetic retinopathy. Curr Diab Rep 9:277Ð283
148.Bayu Sasongko M, Wang JJ, Donaghue KC et al (2010) Alterations in retinal microvascular geometry in young type 1 diabetes. Diabetes Care 33(6):1331Ð1336
149.Grauslund J, Green A, Kawasaki R, Hodgson L, Sjolie AK, Wong TY (2010) Retinal vascular fractals and microvascular and macrovascular complications in type 1 diabetes. Ophthalmology 117(7):1400Ð 1405, Epub 2010 Feb 21
150.Covered Entity Charts. Centers for Medicare and Medicaid Services. Accessed at http://www.cms.hhs. gov/HIPAAGenInfo/06_AreYouaCoveredEntity.asp
151.http://edocket.access.gpo.gov/2010/pdf/201012647.pdf
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158.Centers for Medicare and Medicaid Services, Department of Health and Human Services (2011) Medicare Program; Payment Policies Under the Physician Fee Schedule and Other Revisions to Part B for CY. http://www.regulations.gov/#!document Detail:D=CMS-2010-0205-1982. Accessed on 2 June 2011
159.OcularSpecialInterestGroup,AmericanTelemedicine Association. American Telemedicine Association comments on Diabetic Retinopathy Codes. http://hub. americantelemed.org/AMERICANTELEMED/ AMERICANTELEMED/Resources/ViewDocument/ Default.aspx?DocumentKey=8fd1a5c2-9158-46a5- a0a4-e2843fd0cd96&MessageKey=dae865a4-f48c-
4cee-87ce-c815c7e06bc1. Accessed on 2 June 2011 160. Whited JD, Datta SK, Aiello LM et al (2005) A
modeled economic analysis of a digital tele-ophthal- mology system as used by three federal health care agencies for detecting proliferative diabetic retinopathy. Telemed J E Health 11:641Ð651
Contributors
Second Edition
Editorial Committee: Helen K. Li, M.D. (Chair), Mark Horton, OD, M.D. (Co-chair), Sven-Erik Bursell, Ph.D., Jerry Cavallerano, OD, Ph.D., Ingrid Zimmer-Galler, M.D., Mathew Tennant, M.D.
Writing Committees
Clinical: Jerry Cavallerano, OD, Ph.D. (Chair), Ingrid Zimmer-Galler, M.D.
Technology: Sven-Erik Bursell, Ph.D. (Chair), Michael Abramoff, M.D., Ph.D., Edward Chaum, M.D., Ph.D., Debra Cabrera DeBuc, Ph.D..
Operations: Mark Horton, OD, M.D. (Chair), Helen K. Li, M.D., Tom Leonard-Martin, Ph.D.,
153.The Joint Commission on the Accreditation of MPH, Mathew Tennant, M.D., Marc Winchester, Healthcare Organizations (2004) Comprehensive B.A.
accreditation manual for hospitals: the ofÞcial handbook. EC6.10. MS.5.10
154.Scanlon PH (2008) The English national screening programme for sight-threatening diabetic retinopathy. J Med Screen 15:1Ð4
155.Garvican L, Clowes J, Gillow T (2000) Preservation of sight in diabetes: developing a national risk reduc-
tion programme. Diabet Med 17:627Ð634
156. Arun CS, Young D, Batey D et al (2006) Establishing ongoing quality assurance in a retinal screening programme. Diabet Med 23:629Ð634
157. Schneider S, Aldington SJ, Kohner EM et al (2005) Quality assurance for diabetic retinopathy telescreening. Diabet Med 22:794Ð802
Other Contributors
Reviewers [R], ATA Standard and Guidelines
Committee Members [SG], ATA Staff [S]
Nina Antoniotti, RN, M.B.A., Ph.D. [Chair, SG]
Jordana Bernard, M.B.A [S]
David Brennan, MSBE [SG]
Anne Burdick, M.D., MPH [SG]
Jerry Cavallerano, OD, Ph.D. [SG]
Brian Grady, M.D. [SG]
Tom Hirota, DO [SG]
Elizabeth Krupinski, Ph.D. [Vice Chair, SG]
224 |
Appendix |
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Cindy K. Leenknecht, M.S., APRN-CS, CCRP [SG]
Jonathan Linkous, MPA [S] Lou Theurer [SG]
Jill Winters, Ph.D., RN [SG]
First Edition
American Telemedicine Association, Ocular
Telehealth Special Interest Group, and the
National Institute of Standards and Technology
Working Group
American Telemedicine Association Executive
Committee:
Jonathan D. Linkous, Richard Bakalar, M.D.,
Adam Darkins, M.D., Col. Ronald K. Poropatich
M.D.
American Telemedicine Association Ocular
Telehealth Special Interest Group:
Jerry Cavallerano, OD, Ph.D. (Chair), Mary
G.Lawrence, M.D., MPH (Vice Chair) Editorial Committee:
Helen K. Li, M.D. (Co-chair), Mathew
Tennant, M.D. (Co-chair), Sven Bursell, Ph.D.,
Jerry Cavallerano, OD, Ph.D., Mark Horton, OD,
M.D., Richard Bakalar, M.D.
Writing Committees:
Clinical: Jerry Cavallerano, OD, Ph.D. (Chair), Mary G. Lawrence, M.D., MPH, Ingrid ZimmerGaller, M.D., COL Wendall Bauman, M.D.
Technology: Sven Bursell, Ph.D. (Chair), W. Kelly Gardner
Operations: Mark Horton, OD, M.D. (Chair), Lloyd Hildebrand, M.D., Jay Federman, M.D.
National Institute of Standards and Technology:
Lisa Carnahan
Veterans Administration:
Peter Kuzmak, John M. Peters, Adam Darkins, M.D.
At Large Group Participants:
Jehanara Ahmed, M.D., Lloyd M. Aiello, M.D., Lloyd P. Aiello, M.D., Ph.D., Gary Buck, Ying Ling Chen, Ph.D., Denise Cunningham, CRA, RBP, M.Ed., Eric Goodall, Ned Hope, Eugene Huang, Ph.D., Larry Hubbard, MAT, Mark Janczewski, M.D., J.W.L. Lewis, Ph.D., Hiro Matsuzaki, COL Francis L. McVeigh, OD, Jordana Bernard, Diane Parker-Taillon, Robert Read, Peter Soliz, Ph.D., Bernard Szirth, Ph.D., COL Robert A. Vigersky, M.D., COL Thomas Ward, M.D.
American Telemedicine Association Administrative Contributor:
Catherine Diver
