To say that the digital age has changed the way we do nearly everything would be an understatement. And while some aspects of the Internet’s impact on our lives are cause for concern, others are nothing short of a miracle.

That is certainly the case for the digitization of medicine, which is exactly why Fort Wayne is taking a bold and digital approach to improve diabetes care for those who are uninsured and underinsured. It’s called the Virtual Medicine iTeam. Its goal is to provide diabetic patients who may have possible retinal problems with real-time diagnosis through the use of Internet-connected retinal cameras.

Patients who receive care at Matthew 25 (a free clinic sponsored in part by the city-based Lutheran Foundation) and other local free clinics will now know their diagnosis before they leave the clinic. Not only is this resulting in patients getting more timely treatment, but thanks to Fort Wayne’s Healthcare Access Program (HAP), it’s allowing the city’s network of clinics to create online patient histories. (Nationwide, HAPs link community organizations with health care providers.)
 

Faster Diagnosis, Surer Treatment

The combination of digital access to patient histories and digital online diagnosis is changing the lives and literally saving the sight of hundreds of clinic patients each year in my city.

This iTeam project is a natural fit for Fort Wayne, one of the most “wired” cities in the country, thanks to the fiber optic connectivity throughout the city. Fort Wayne has launched several such iTeams to promote digital innovation and investment in the city.           

This iTeam’s goal is to diagnose and treat diabetes-related retinopathy through the use of remote digital retinal cameras. Diabetic retinopathy is the leading cause of blindness for people under the age of 65. The only way to control blindness caused by diabetes is to identify and treat the earliest signs of damage in the eye.

Diabetic retinopathy is the leading cause of blindness for people under the age of 65. The only way to control blindness caused by diabetes is to identify and treat the earliest signs of damage in the eye.

While the participating clinics have retinal cameras, doctors who provide their services pro bono do so on a limited basis, so the opportunities to get retinal images read for diagnosis are limited. Combine this with the fact that some patients at the free clinics do not have phones and some are even homeless, making it difficult, if not impossible, to reach them to alert them to the diagnosis and begin treatment.

Enter real-time remote digital diagnosis and HAP, which allow physicians to view retinal images immediately from any Internet-connected computer and update patient records and histories with the same immediacy.

Thanks to the city’s wide-ranging fiber-optic broadband connectivity, area ophthalmologists and retinal surgeons are able to view the retinal images taken at clinics like Matthew 25 in real time from any location. As a result, doctors who might have had monthly opportunities to see patients can now do so daily. This means volunteer physicians now can see and treat hundreds of patients each year without overtaxing their already difficult schedules. And difficult-to-reach patients can be diagnosed on the spot and scheduled for immediate treatment if needed.
 

Cutting Costs, Improving Care

In addition to the hundreds of patients each year who are able to maintain their vision thanks to this technology, the economic impact of the project is far reaching. For instance, all diabetics need to be examined at least annually for retinopathy. A patient without insurance would have to pay at least $60, and often much more, for even the simplest screening exam at optometrists’ offices located at malls and other retail venues. Accessibility and cost is preventing many Fort Wayne residents from getting the screenings that they need.

On a larger scale, patients kept free of vision loss save society hundreds of thousands of dollars in terms of medical care, disability and loss of productivity. Most importantly, there is no way to put a price on the amount of personal suffering that can be avoided by stopping even one patient from going blind. This technology has an exponential return because it saves the cost of the exam, allows access to needed treatment and saves society the cost of caring for patients who should never have been allowed to go blind in the first place.

Finally, while diabetic patients have been the greatest beneficiaries of this initiative, it is by no means limited to the diagnosis of diabetic retinopathy. It also is being used by the regular eye clinic at Matthew 25 to photograph patients with non-diabetic problems, such as glaucoma or retinal scarring. This allows the volunteer ophthalmologists to better follow patients’ progress as they do not need to depend on the drawings and notes of multiple examiners. And HAP is assuring that all clinic patient records and histories are up-to-date and available to physicians throughout the system.

The Virtual Medicine iTeam, which is made up of a partnership between the city, Matthew 25 (free) Clinic, the Allen County Retinal Surgeons group and the Lutheran Foundation, is one of many such projects in our city that are using the bridge we’ve built over the digital divide to put cutting-edge technologies to use for all of our residents. With fiber optic connectivity available at nearly all levels in our community – from city offices, hospitals and businesses to 100,000 homes – the possibilities are nearly limitless for the improvements we can make in the lives of all our citizens.

About the Author

Graham Richard is mayor of Fort Wayne, a city of 252,000 in northeastern Indiana. The city attracted Verizon for an early FiOS build.