Seed Grant Profile
Evaluation and Design of Telemedicine For Screening of Diabetic Retinopathy
In the United States, there are 15 million blind or visually impaired people, with an additional person going blind every seven minutes. Diabetic retinopathy is one of the leading causes of blindness, particularly in adults of working age, and this public health problem is expected to increase with the rise in diabetes. Yet, the disease (including diabetic macular edema) can be treated or the progression slowed if it is detected early. Recent advances in technology have led to the use of telemedicine in rural clinics to screen for the disease, where photographs are transmitted to a central service for reading by specialists; however, they have not fully been evaluated for their potential in reducing vision loss. In this research, we propose to evaluate this cutting edge mode of health delivery, which has been implemented in the VA system in the last few years. We will analyze the electronic health records and eye clinic records to estimate the number of cases of retinopathy detected, at which stage, and with what outcomes. We will develop statistical techniques and stochastic models to estimate the actual prevalence of the eye disease in the VA population determined by its coprogression with diabetes, and we will compare the results to determine how effective the program has been. In addition, we will look for regions in the network where additional opportunities exist to prevent or slow further vision loss, and we will develop an optimization model that will help to promote positive vision outcomes and reduce health equities in the network given a limited budget. Outcomes include estimations of the vision loss prevented by actual telemedicine programs and recommendations on how to improve its effectiveness for the future. Future funding is possible from several NIH agencies, VA Health Services R&D, and others, and the seed grant will promote the collaboration as well as lay the groundwork for larger-scale proposals for various eye diseases.
Investigators: Julie Swann (GT, Stewart School of Industrial & Systems Engineering), Claire Barnes (VA Rehabilitation R&D Center, Department of Opthalmology, Emory University School of Medicine), Eser Kirkizlar (State University of New York-Binghamton, School of Management), Nicoleta Serban (GT, Stewart School of Industrial & Systems Engineering)