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Page 683 – Stanford Medicine X

Mobile technologies as a conduit for specialist care

Doug Foster doug.foster@digisight.net


In the United States, there are less than 19,000 ophthalmologists to care for a population of over 300 million people. This shortage of ophthalmic providers is even more acute in developing economies; there are less than four ophthalmologists per million population in 53 countries around the world. Clearly, there are not enough ophthalmologists to meet the needs of the patient population.

Given this shortage, a cost and time efficient method is needed to quickly assess the care needs of ophthalmic patients. Connected mobile technologies enable non-specialists at the point-of-care to collaborate with remote specialists. Mobile devices are a compelling platform given their high prevalence – there are over two billion smartphones in use worldwide – and their rapidly advancing technological capabilities. Further, mobile technology is already a primary conduit for communication across the globe.

Enter Paxos, an integrated mobile solution that amplifies ophthalmic coverage by enabling non-specialist providers to complete eye exams at the point-of-care and remotely collaborate with ophthalmologists. A non-specialist uses Paxos to capture high-resolution photos of the front of the eye and retina with a smartphone adapter, complete a visual acuity test, and enter additional patient data and history. All of this information is transmitted to the HIPAA-compliant Paxos Cloud and shared with a specialist through a push notification. The HCP and specialist can then use the Paxos app to securely discuss next steps for patient care in real-time and guarantee that high-need patients receive immediate care.

In the United States, this method of triaging ophthalmic patients is particularly helpful in emergency rooms, especially for hospitals that do not have an ophthalmologist on staff. With Paxos, the ER is able to capture patient information and collaborate with ophthalmic specialists in real time. Internationally, Paxos is being used to support telemedicine programs and connect specialists with remote care providers. For example, in Nepal, ophthalmic technicians situated across the country’s rugged terrain have been armed with Paxos. These technicians capture patient information and send it to Nepal’s center of ophthalmic excellence, Tilganga, where a specialist reviews the information. Patients that require direct attention from a specialist are referred to Tilganga, while others are able to receive care remotely without traveling days for specialist attention.

The model of care that Paxos facilitates for ophthalmology can be applied to other medical disciplines where there is limited access to specialist care. Mobile technologies like Paxos can amplify a specialist’s reach and impact while reducing the cost and time patients need to invest in their own wellbeing, especially those patients in remote or rural settings.
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