Telehealth Practice Recommendations for Diabetic Retinopathy,Second Edition

Abstract

Diabetic Retinopathy Telehealth Practice Recommendations Working Group

Second Edition

Editorial Committee:

Helen K. Li, MD (Chair), Mark Horton, OD, MD (Co-chair), Sven-Erik Bursell, PhD, Jerry Cavallerano, OD, PhD, Ingrid Zimmer-Galler, MD, Mathew Tennant, MD

Writing Committees:

Clinical: Jerry Cavallerano, OD, PhD (Chair), Ingrid Zimmer-Galler, MD

Technology: Sven-Erik Bursell, PhD (Chair), Michael Abramoff, MD, PhD, Edward Chaum, MD, PhD, Debra Cabrera DeBuc, PhD

Operations: Mark Horton, OD, MD (Chair), Helen K. Li, MD, Tom Leonard-Martin, PhD, MPH, Mathew Tennant, MD, Marc Winchester, BA

Other Contributors:

Reviewers [R], ATA Standard and Guidelines Committee Members [SG], ATA Staff [S]

Nina Antoniotti, RN, MBA, PhD [Chair, SG]

Jordana Bernard, MBA [S]

David Brennan, MSBE [SG]

Anne Burdick, MD, MPH [SG]

Jerry Cavallerano, OD, PhD [SG]

Brian Grady, MD [SG]

Tom Hirota, DO [SG]

Elizabeth Krupinski, PhD [Vice Chair, SG]

Cindy K. Leenknecht, MS, APRN-CS, CCRP [SG]

Jonathan Linkous, MPA [S]

Lou Theurer [SG]

Jill Winters, PhD, RN [SG]

First Edition

American Telemedicine Association, Ocular Telehealth Special Interest Group, and the National Institute of Standards and Technology Working Group

American Telemedicine Association Executive Committee:

Jonathan D. Linkous, Richard Bakalar, MD, Adam Darkins, MD, Col. Ronald K. Poropatich, MD

American Telemedicine Association Ocular Telehealth Special Interest Group:

Jerry Cavallerano, OD, PhD (Chair), Mary G. Lawrence, MD, M.P.H. (Vice Chair)

Editorial Committee:

Helen K. Li, MD (Co-chair), Mathew Tennant, MD (Co-chair), Sven Bursell, PhD, Jerry Cavallerano, OD, PhD, Mark Horton, OD, MD, Richard Bakalar, MD

Writing Committees:

Clinical: Jerry Cavallerano, OD, PhD (Chair), Mary G. Lawrence, MD, MPH, Ingrid Zimmer-Galler, MD, COL Wendall Bauman, MD

Technology: Sven Bursell, PhD (Chair), W. Kelly Gardner

Operations: Mark Horton, OD, MD (Chair), Lloyd Hildebrand, MD, Jay Federman, MD

National Institute of Standards and Technology:

Lisa Carnahan

Veterans Administration:

Peter Kuzmak, John M. Peters, Adam Darkins, MD

At Large Group Participants:

Jehanara Ahmed, MD, Lloyd M. Aiello, MD, Lloyd P. Aiello, MD, PhD, Gary Buck, Ying Ling Chen, PhD, Denise Cunningham, CRA, RBP, M.Ed., Eric Goodall, Ned Hope, Eugene Huang, PhD, Larry Hubbard, MAT, Mark Janczewski, MD, J.W.L. Lewis, PhD, Hiro Matsuzaki, COL Francis L. McVeigh, OD, Jordana Motzno, Diane Parker-Taillon, Robert Read, Peter Soliz, PhD, Bernard Szirth, PhD, COL Robert A. Vigersky, MD, COL Thomas Ward, MD

American Telemedicine Association Administrative Contributor:

Catherine Diver

Table of Contents

1. PREAMBLE

2. INTRODUCTION

3. BACKGROUND

• a. The Diabetic Retinopathy Study

• b. Early Treatment Diabetic Retinopathy Study

• c. Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications

• d. The United Kingdom Prospective Diabetes Study

• e. The Diabetic Retinopathy Clinical Research Network

4. PRINCIPLES OF A TELEHEALTH DR PROGRAM

• a. Mission

• b. Vision

• c. Goals

• d. Guiding Principles

5. ETHICS

6. CLINICAL VALIDATION

• a. Category 1

• b. Category 2

• c. Category 3

• d. Category 4

7. COMMUNICATION

8. PERSONNEL QUALIFICATIONS

• a. Medical Care Supervision

• b. Patient Care Coordinator

• c. Image Acquisition

• d. Image Review and Evaluation

• e. Information Systems

9. EQUIPMENT SPECIFICATIONS

• a. Interoperability

• b. Image Acquisition

• c. Compression

• d. Data Communication and Transmission

• e. Computer Display

• f. Archiving and Retrieval

• g. Security

• h. Reliability and Redundancy

• i. Documentation

• j. Image Analysis

10. LEGAL REQUIREMENTS

• a. Health Insurance Portability and Accountability Act

• b. Privileging and Credentialing

• c. Stark Act and Self-Referrals

• d. State Medical Practice Acts/Licensure

• e. Tort Liability

• f. Duty

• g. Standards of Care

• h. Consent

11. QUALITY CONTROL

12. OPERATIONS

13. CUSTOMER SUPPORT

• a. Originating Site

• b. Transmission

• c. Distant Site

14. FINANCIAL FACTORS

• a. Reimbursement

• b. Grants

• c. Federal Programs

• d. Other Financial Factors

• e. Equipment Cost

15. SUMMARY

• REFERENCES

• APPENDIX

• 1. Interoperability

• 2. Digital Imaging and Communications in Medicine (DICOM) Metadata

• 3. Computer-Aided Detection

• 4. Health Insurance Portability and Accountability Act

• 5. Privileging and Credentialing

• 6. Quality Control

• 7. Operational Specifications

• 8. Customer Support

• 9. Reimbursement

• ABBREVIATIONS

• GLOSSARY