Can digital photography enhance health care delivery?

4626755785_77eae4d421_bAs the number of people developing diabetes continues to grow, the health care challenges and costs of managing this chronic condition also grow. 23 million American’s have the disease, and globally an estimated 7.8% of the world’s population is afflicted, that’s 439 million people. The total economic burden in 2010 is estimated by International Diabetes Federation to total $376 billion.

Being a chronic condition, there are special challenges. “Whenever you are talking about chronic disease management, it’s about continuous comprehensive care,” says Frank Opelka, MD, President and CEO of the LSU Health Care Network, and a professor of surgery. “The minute you drop continuous out of the equation, you lose a patient.”

Diabetes is an especially insidious disease not only because it messes with your endocrine system, but also because it increases your risk of other serous conditions, including heart disease, amputation, and blindness. It’s because of that last possibility that diabetics are supposed to have annual eye exams, though health care research estimates that only about 50% actually undergo the screening. Now a new paper in the journal Ophthalmology suggests a relatively simple way for digital technology to increase that screening rate.

Researchers at the University of Iowa involved over 16,000 diabetics in a trial of an innovative new application of digital photography to health care. They took digital photographs of patient’s retinas, then utilized a computer program to scan the image looking for signs of retinal bleeding that are hallmarks of impending vision lose. Without this technology, screening requires that an ophthalmologist take the time to exam each patient’s eyes. Examining 100 patients generally nets about 10 cases with vision troubles. But researchers found that their computerized process flagged about 20 out of 100 patients as possibly having vision problems. The rationale is that the technology could be used to narrow the number of potential cases so that an ophthalmologist would only have to screen 20 patients to locate those 10 cases of concern.

The higher sensitivity of a screening test (increasing chances of false-positives) can often lead to all kinds of issues, especially in conditions like cancer where biopsies, potentially harm-inducing treatment, and worry quickly cascade from a positive result. But in this case it seems that the higher sensitivity works well: Narrowing the number of candidates that will receive the gold-standard of diagnoses, namely an exam by an ophthalmologist. Best of all, using this type of health care technology to streamline the manner in which care is delivered has the potential to increase eye exams, reducing future cost and vision loss.

Photo credit: The author.

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