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Next generation telemedicine platforms to screen and triage
  1. Daniel S Ting1,2,
  2. Dinesh V Gunasekeran1,
  3. Louisa Wickham2,
  4. Tien Yin Wong1
  1. 1 Singapore Eye Research Institute, Singapore National Eye Center, Singapore, Singapore
  2. 2 Moorfields Eye Hospital NHS Foundation Trust, London, UK
  1. Correspondence to Dr Daniel S Ting, Vitreo-retinal Department, Singapore National Eye Center, Singapore 168751, Singapore; daniel.ting.s.w{at}

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Visual impairment is a growing problem worldwide.1 By 2040, it is estimated that 288 million patients will have some forms of AMD,2 119 million with glaucoma cases,3 and 422 millions with DR.4 With ageing populations globally, most eye health services will struggle to manage these eye diseases with existing manpower and infrastructure, and face significant financial constraints.5

In this setting, new models of care with digital health technologies and platforms are urgently needed.5 Conventionally, eye care service delivery can be conducted via routine, mobile and teleophthalmology settings. With the advancement in technology and telecommunication networks, numerous novel digital health solutions and service models can streamline and automate critical aspects of the screening and monitoring processes,6 including secure telemedicine platforms that can be coupled with automated algorithms using artificial intelligence and big data analytics.6 These measures not only help screen and triage patients with new eye diseases, but can also monitor stable patients who do not require management in tertiary eye care settings.

Telemedicine can be broadly divided into two types—synchronous and asynchronous models. The synchronous model usually requires good internet connectivity that enables real-time consultations between patients and physicians via a telemedicine platform. This model is useful for emergency rooms consultations in rural hospital settings where ophthalmology services are limited. Local emergency physicians could use telemedicine platforms to present their patients’ history and ocular examination, enabling ophthalmologists or specialists to help triage the urgency of referrals or …

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  • Contributors Drs DST and DVG contributed to the drafting. DST, DVG, LW and TYW contributed to critical review and final approval for this editorial letter.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests Drs DST and TYW report that they are coinventors on a patent for a deep learning system for automated retinal screening; potential conflicts of interests are managed according to institutional policies of the Singapore Health System (SingHealth) and the National University of Singapore (NUS). Dr DVG reports investment in digital healthcare solutions Doctorbell, VISRE, AskDr and Shyfts.

  • Provenance and peer review Commissioned; internally peer reviewed.

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