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  • Mobile App Improves Eye Care for Military Personnel

    By Lynda Seminara
    Selected and Reviewed By: Neil M. Bressler, MD, and Deputy Editors
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    Journal Highlights

    JAMA Ophthalmology, October 2020

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    Gensheimer et al. conducted a beta test of a secure telehealth mobile app at military treatment facilities in Afghan­istan. They found that app-based oph­thalmology consults prevented some aeromedical evacuations and allowed many patients to continue duty.

    This study was a prospective case series of consults placed in 16 military treatment centers, 15 of which are forward operating bases within Afghani­stan. Thirty point-of-care medics and medical professionals participated in the care. Patients requested teleoph-thalmology consults via their cell phones using the app, and an expeditionary ophthalmologist at a military hospital in Afghanistan responded. The app, known as Foxtrot (Forward Operating Base Expert Telemedicine Resource Uti­lizing Mobile Application for Trauma), has security and reliability features that make it suitable for environments with low or no connectivity.

    The patient-users graded the app on a scale of 1 (very dissatisfied) to 5 (very satisfied). Other outcome measures were response times, concordance of the teleophthalmology diagnosis and fi­nal diagnosis, appropriateness of treat­ment (per clinical practice guidelines of the Joint Trauma System), avoidance of aeromedical evacuation, and security. The latter included HIPAA compliance.

    Overall, 28 consults (by 18 patients) occurred in the six-week study period. Patients’ mean age was 30.3 years, and most were male (93%) and in active duty (78%). The median overall satis­faction score was 5. The mean initial response time from the ophthalmolo­gist was just under four minutes. In 24 consults (86%), the teleophthalmology diagnosis was the same as the final diagnosis. In all cases, treatment and management adhered to the Joint Trau­ma System guidelines. The app consults prevented aeromedical evacuation of four patients. In 54% of consults, patients were able to return to duty. All 28 consults proved to be secure and HIPAA compliant. (Also see related commentary by Kimberly M. Winges, MD, Allison R. Loh, MD, and Michael F. Chiang, MD, in the same issue.)

    The original article can be found here.