A pilot teleconsultation network for retinal diseases in ophthalmology.

A store-and-forward teleconsultation network was developed as a web application in order to provide second opinions on retinal diseases. The system provided automatic notification messages to the referring doctor and the consulted ophthalmologist by mobile phone message (SMS) and email. Images in the electronic medical record (EMR) could be examined in detail using special magnification software. Of the 19 ophthalmologists who agreed to participate, 17 used the teleconsultation network during the pilot trial (89%). During the four-week study period, a total of 52 EMRs containing 82 images were uploaded by the participating ophthalmologists. In 46 cases (89%), a second opinion was provided by the consulted ophthalmologist. Thirty-three of the cases (72%) were related to macular diseases and anti-VEGF (vascular endothelial growth factor) ophthalmology drugs. At the end of the study period, 18 of the participating ophthalmologists evaluated the cases, using a three-point score (poor, good, very good) for Access, Acceptability, Image Quality and Medical Efficacy. Most cases were rated as very good or good for all four variables. Successful use of the network in future will depend on various technical, policy and human factors. The latter is particularly important and appropriate motivations need to be found in order to promote teleconsultations.