PDF(Pubmed)
Abstract：
This study explored the potential of telemedicine integration into the eye health ecosystem with an aim of scaling effective refractive error coverage in Kenya. This exploratory study was conducted telephonically and through online interviews with key opinion leaders, ophthalmologists, optometrists, ophthalmic clinical officers, optical technicians and beneficiaries of the optical technician\'s services in rural areas. A telemedicine workflow was developed and validated based on the comments from the key opinion leaders using the Delphi technique. Quantitative and qualitative data were analysed using SPSS and NVivo Software respectively. All of the key opinion leaders agreed that telemedicine is relevant in the eye health ecosystem and recognition of primary vision technicians is critical for effective telemedicine integration. The reasons for the need of telemedicine integration were categorized into; good relationship, organized refractive error service delivery, convenience and availability and cost reduction. The possible factors influencing integration of telemedicine identified were categorized into cost, unwillingness, dominance, perception, lack of technical team, policies and network coverage. The limited human resources in the eye health ecosystem in developing countries cannot effectively deliver refractive error services to the growing population. Hence, integration of telemedicine and establishment of policies recognizing telemedicine are desirable to strengthen task shifting and scale effective refractive error coverage.
摘要：
这项研究探索了远程医疗整合到眼睛健康生态系统中的潜力，目的是扩大肯尼亚的有效屈光不正覆盖率。这项探索性研究是通过电话和在线采访主要意见领袖进行的，眼科医生,验光师,眼科临床人员,光学技术人员和农村地区光学技术人员服务的受益者。使用Delphi技术，根据关键意见领袖的评论，开发并验证了远程医疗工作流程。分别使用SPSS和NVivo软件对定量和定性数据进行分析。所有主要意见领袖都同意，远程医疗与眼健康生态系统相关，对初级视力技术人员的认可对于有效的远程医疗整合至关重要。需要远程医疗整合的原因分为：良好的关系，有组织的屈光不正服务提供，方便，可用性和成本降低。确定的影响远程医疗整合的可能因素分为成本、不愿意,支配地位,感知，缺乏技术团队,政策和网络覆盖。发展中国家眼健康生态系统中有限的人力资源无法有效地为不断增长的人口提供屈光不正服务。因此，需要整合远程医疗和建立识别远程医疗的政策，以加强任务转移和扩大有效的屈光不正覆盖范围。
