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Morino Institute From Access to Outcomes: Digital Divide Report and Dialogue

    Premise Two
Report Supplement
Using the Report

Premise Two:
Concentrate on Achieving Concrete Outcomes

Efforts to help low-income communities gain the benefits of technology must be directed toward achieving specific outcomes — in other words, tangible improvements in people's standards of living. Many initiatives focus on helping people increase their technological literacy, which can be an important goal. But the application of technology also can contribute to a wide range of health, economic, and educational outcomes, from increased vaccination rates to improved job placement to higher test scores.

Focusing on outcomes is easiest when the application of technology represents just one component of a comprehensive solution to a need. It is much harder to focus on outcomes when launching a stand-alone technology project, such as providing wiring for a school or community center.

Case in Point: A Visionary Approach to Achieving Health Outcomes

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.

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