In 1996, doctors at Charles R. Drew University, in South Central
Los Angeles, reinvented
the house call.
At the time, there were only seven ophthalmologists in all of
South Central Los Angeles—not nearly enough to treat the area’s
1.4 million residents. Given this shortage, most people with eye
problems waited until their ailment became dangerously acute and
then showed up in area trauma centers.
In partnership with Nortel
Networks, Drew University launched a pilot telemedicine clinic
in the Los Carmelitos housing development and matched a specific
technology with a specific health need.
When a patient arrives at the clinic, a technician and first-year
ophthalmology resident perform an initial screening and take images
of the eye with sophisticated but easy-to-operate equipment. The
images are immediately sent over high-speed digital lines to a
board-certified ophthalmologist at the King/Drew Medical Center, who can
speak to the patient over a real-time video connection, prescribe a
treatment, and schedule a more intensive in-person examination if
necessary. According to the project’s director, Dr. Charles
Flowers, "Most of the examination is completed while the
patient is still at Carmelitos. If something looks suspicious, we
can call for a high-magnification scan immediately."
Evaluations have demonstrated that the tele-ophthalmology program
allows doctors to make highly accurate diagnoses, and patients have
shown a remarkable 90 percent follow-up rate. The model has been
replicated in three additional Los Angeles clinics, which now
monitor more than 2,300 people, many of whom would have experienced
severe visual impairment or blindness if not for the clinic.