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Identification of barriers, facilitators and system-based implementation strategies to increase teleophthalmology use for diabetic eye screening in a rural US primary care clinic: a qualitative study
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  • Published on:
    Pushing teleophthalmology in Brazil
    • Erno Harzheim, Professor of Primary Care Universidade Federal do Rio Grande do Sul
    • Other Contributors:
      • Juliana N Pfeil, Family Physician
      • Natan Katz, Family Physician
      • Aline L de Araujo, Ophthalmologist
      • Roberto N Umpierre, Professor of Primary Care

    Diabetes is the 7th leading cause of death in Brazil (1), with a self-reported prevalence of 5.6% (1). Despite the great need for diabetic retinopathy screening, access to ophthalmological consultations in the public health care system is limited, with a long waiting list. Because of that, in the southern Brazilian state of Rio Grande do Sul – where about 12 million people live (3) – a teleconsulting service for Teleophthalmology was implemented in June 2017 at in seven municipalities (4). It should be noted that telemedicine is not full regulated medical practice in Brazil. Until nowadays, Teleconsultation between physician and patient is not allowed (5). Because of this, teleophthalmology is only accessible to patients referred for evaluation by primary care physicians. After an ophthalmologist's remote assessment, an opinion is issued and the PHC physician prescribes the treatment (including glasses) based on this technical report.

    Teleophthalmology consultations are available all the week, during working hours. A nurse and a physician are available locally for contact with the remote ophthalmologist if needed. Presently, the median waiting time is 170 days for teleophthalmology consultations in the state capital Porto Alegre and approximately 150 days in other cities. Although this may seem like a long wait, it is still less than the wait for face-to-face consultations – currently median of 423 days. Differently from what is described by Liu et al. (6), du...

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    Conflict of Interest:
    None declared.