Today’s doctors can now diagnose, treat, and communicate with patients and other health care providers electronically. 

Thanks in part to the introduction of electronic medical records (EMR), more doctors are using telemedicine as a component of their eye-care practices.

With telemedicine, doctors access patient information electronically and communicate with them, and with colleagues, through online technology. This saves patients and doctors the time involved in in-person visits when face-to-face consultations aren’t practical or necessary. This expanding category of the medical profession is already being applied to a number of ophthalmic areas.

This form of telemedicine has grown in popularity among eye-care practices since the American Recovery and Reinvestment Act of 2009. This federal economic stimulus package mandated that, as of January 1, 2014, all public and private healthcare providers must have adopted and demonstrated “meaningful use” of EMRs in order to maintain their existing Medicaid and Medicare reimbursement levels.


With the advent of EMR, patients can share one physician’s findings
and test results with another, such as their eyecare professionals (ECPs). They do this using a secure email program within the EMR system. In its simplest form, this might mean patients can ask straightforward questions regarding their eyeglass prescriptions, eye medications, or test results without coming in for a visit. The ECP can simply type a response into the record or reply to the email without much to-do. Patients can have lab test results automatically sent to themselves and the ECP through the EMR.


Doctors are also using telemedicine to connect with consultants from outside their practices. In this scenario, one ECP consults with another who may be several streets, states, or even countries away. ECPs can use the technology to share patients’ test results and images, as necessary. The consulting doctor then has all the information needed to provide advice, insights, and opinions. Done well, this technique can be a huge advantage for the patient, who gets more medical input without leaving home, and the referring doctor, who can receive a specialist’s input without hassle. The system is convenient and can, in fact, speed up a consultation dramatically since the patient doesn’t have to make an appointment with, and travel to, the second doctor.


Telemedicine can be a sight saver. For example, diabetic retinopathy affects millions of Americans, and vision loss can be minimized with early detection and regular monitoring. Primary care physicians (PCPs) can use non-mydriatric cameras to take pictures of the diabetic patient’s retina without dilation. They can then send the images for remote evaluation by ophthalmologists, who could watch for worsening over time. In fact, a recent industry study found positive results when PCPs used telemedicine to screen for diabetic retinopathy.

The option of telemedicine increases access greatly in rural areas that have few eyecare specialists. It also can reach patients who may not schedule a yearly eye exam.


Telemedicine is being used across the globe. Providers in developing countries have found it useful for screening, diagnosing, and managing strabismus, external disease, oculo-plastics, glaucoma, and pediatric cataract consults. In most cases, retinal cameras, digital cameras, and slit lamp biomicroscopes equipped with a digital camera are used. Providers can send the images through protected email so a mentor can recommend a diagnosis and treatment plan. Video conferencing between providers and patients is likely to become more widely used, as well.

The use of EMR and telemedicine together are making an impact worldwide. The pairing provides access to high-quality eyecare, lower costs, and convenience for patients in the United States and around the world.

Kim Pickett is a certified ophthalmic medical technologist and ophthalmic writer in Minneapolis, MN.


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