Impact of Telemedicine on Retinopathy of Prematurity Screening at a Level II Neonatal Intensive Care Unit in Southwest Oklahoma: A 6-Year Experience

Abstract

Background:

In 2013, Comanche County Memorial Hospital in Lawton, OK, in collaboration with the University of Oklahoma Medical Center, established a satellite level II neonatal intensive care unit (NICU) in southwest Oklahoma by utilizing a hybrid telemedicine model. The satellite level II NICU began offering telemedicine for retinal imaging (Tele-ROP) in July 2017. The availability of the Tele-ROP program has expanded access to retinopathy of prematurity (ROP) screening, allowing lower-risk premature infants to receive timely evaluations and continued intensive care closer to home. The objective was to evaluate the impact of the Tele-ROP program at a level II NICU with a hybrid telemedicine model.

Methods:

This retrospective study evaluated the use of the Tele-ROP program between July 2017 and December 2023. The inclusion criteria were infants transferred to a satellite level II NICU and “without severe ROP.” Infants with major congenital anomalies, or “severe ROP,” were excluded. Demographic data, image quality, and cost analysis were collected and analyzed.

Results:

Over a 6-year period, 83 patients were able to be transferred to the satellite level II NICU, due to the availability of the Tele-ROP program. A total of 68 Tele-ROP examinations were performed, with telemedicine-based retinal image evaluation conducted in 55 patients, resulting in the capture of 816 images; 98.2% of the images were graded as good. No patients required referral for ROP treatment, and no complications were reported related to the imaging procedure. Cost analysis showed a reduction in travel-related expenses for families.

Conclusions:

Telemedicine for ROP screening in a hybrid level II NICU is safe and feasible and enhances health care affordability and access in underserved areas.