The Promise of Telemedicine

Telemedicine, which allows patients to communicate with a doctor via videoconference and share test results electronically in real time, has entered the mainstream.

Studies show that telemedicine can provide care comparable to in-person visits in fields such as mental health, substance abuse, dermatology, diabetes management, and yes, eye care. Telemedicine can also significantly reduce costs for both patients and healthcare providers.

Telemedicine is lately becoming a game-changer in providing eye care to some American Indian communities, where there is a stark unmet need for specialized care. One driver of this need is diabetes, which is twice as prevalent among American Indians as among the general U.S. population. Diabetic eye disease eventually affects almost all people with diabetes and is the most common cause of blindness among working-age adults. The good news is that timely diagnosis and treatment can nearly eliminate serious vision loss from this disease. Unfortunately, due to geographic isolation and a severe shortage of eye doctors in Indian country, only half of American Indians with diabetes currently receive an annual eye exam.

The Kewa Pueblo Health Corporation (KPHC) in New Mexico, in partnership with Seva, is addressing this disparity and is revolutionizing eye care for tribal members in the process. KPHC is using telemedicine to diagnose and prescribe treatment for eye health issues, including diabetic eye disease. Many Native Americans live in rural areas and simply don't have in-person access to healthcare specialists. But most of them can get to a local health clinic. There, community health workers connect patients to off-site eye care providers who might be hundreds of miles away.

Seva's American Indian Sight Initiative (AISI) recently sent representatives from KPHC, led by optometrist Dr. Lindsey Marvel, to India to learn telemedicine best practices from experts at Aravind Eye Care System. Dr. Marvel and her team, in turn, became mentors to the healthcare team serving the neighboring San Felipe Pueblo community. With Seva's input, Dr. Marvel designed and ran a telemedicine training for healthcare workers in Kewa and San Felipe. Additionally, San Felipe can now refer patients in need of follow-up care to the Kewa eye clinic. This leadership practice, of receiving training and mentorship and passing it on to others, exemplifies Seva's capacity building model.

The AISI telemedicine project is an exciting opportunity for American Indian communities to help one another address eye health challenges. In the broader picture, American Indian communities are using telemedicine to leverage scarce resources to address significant unmet healthcare needs. These innovative tools and programs, which continue to evolve, hold great promise in addressing eye care and other healthcare challenges into the future.

Above: Dr. Lindsey Marvel, Optometrist at Kewa Pueblo Health Corporation, visits an outreach camp in rural India during her visit to the Aravind Eye Care System.