Impact of Telemedicine on Retinopathy of Prematurity Screening at a Level II Neonatal Intensive Care Unit in Southwest Oklahoma: A 6-Year Experience.

BACKGROUND

In 2013, Comanche County Memorial Hospital in Lawton, OK, in collaboration with the University of Oklahoma Medical Center, established a satellite level II neonatal intensive care unit (NICU) in southwest Oklahoma by utilizing a hybrid telemedicine model. The satellite level II NICU began offering telemedicine for retinal imaging (Tele-ROP) in July 2017. The availability of the Tele-ROP program has expanded access to retinopathy of prematurity (ROP) screening, allowing lower-risk premature infants to receive timely evaluations and continued intensive care closer to home. The objective was to evaluate the impact of the Tele-ROP program at a level II NICU with a hybrid telemedicine model.

METHODS

This retrospective study evaluated the use of the Tele-ROP program between July 2017 and December 2023. The inclusion criteria were infants transferred to a satellite level II NICU and "without severe ROP." Infants with major congenital anomalies, or "severe ROP," were excluded. Demographic data, image quality, and cost analysis were collected and analyzed.

RESULTS

Over a 6-year period, 83 patients were able to be transferred to the satellite level II NICU, due to the availability of the Tele-ROP program. A total of 68 Tele-ROP examinations were performed, with telemedicine-based retinal image evaluation conducted in 55 patients, resulting in the capture of 816 images; 98.2% of the images were graded as good. No patients required referral for ROP treatment, and no complications were reported related to the imaging procedure. Cost analysis showed a reduction in travel-related expenses for families.

CONCLUSIONS

Telemedicine for ROP screening in a hybrid level II NICU is safe and feasible and enhances health care affordability and access in underserved areas.