Teleophthalmology: An Essential Tool in the Era of the Novel Coronavirus 2019

Meghana Kalavar; Hong-Uyen Hua; Jayanth Sridhar

Disclosures

Curr Opin Ophthalmol. 2020;31(5):366-373. 

In This Article

Limitations of Teleophthalmology

The dramatic expansion of telemedicine access to millions of Americans also puts immense stress on a system that is potentially unprepared for such large volumes. Although many health systems had started to lay the groundwork for telehealth adoption prior to COVID, many of these programs were still in nascent stages.[9] Healthcare institutions have been overwhelmed by the surge of virtual visits, as this sudden high demand requires having detailed plans for telemedicine expansion, trained physicians, established workflows, and sufficient hardware.[30] Second, the implementation and expansion of telemedicine programs require significant monetary investment in the short term. This presents an acute problem, especially considering many hospitals are in financial stress from the pandemic,[68] although studies have shown that teleophthalmology is cost-effective in the long-term.[69] Next, as the ophthalmology examination relies so heavily on visualization, high-quality images and video resolution are essential to performing an adequate exam. Images that are uninterpretable because of low quality are not reimbursed, thus resulting in lack of clinical utility as well as financial loss. However, the advent of new imaging options provides promise that this will improve in the future.[70,71] Lastly, telemedicine creates security concerns in data storage, particularly vulnerable to cyberattacks. In the COVID-19 era with relaxed HIPAA regulations, we must be cautious about data security and assure the implementation of safeguards to ensure that patient information is protected. Growing pains can be expected, especially considering the exponential demand for telemedicine in such a short time. Indisputably, the benefits of telemedicine outweigh the risks in the context of this pandemic, but we must still consider the barriers and limitations.

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