Telehealth solutions have been rapidly evolving since COVID-19 struck. Remote consults enable patients to seek care from within their homes, and a research team wondered how a similar telehealth application may fare in a combat zone. In a recent study, researchers tested a secure teleophthalmology mobile app at 16 military treatment facilities in Afghanistan, with 30 point-of-care medics and medical professionals.

Users downloaded the app to their mobile phones and rated the app on a one-to-five scale based on their satisfaction, with five being very satisfied. An expeditionary ophthalmologist stationed at a military hospital responded to the mobile consults.

The researchers evaluated the app based on doctor response time, agreement between the teleophthalmology diagnosis and final diagnosis, treatment and management, prevention of the need for aeromedical evacuation, user satisfaction and HIPAA compliance.

In total, 18 different users requested 28 consults over a period of six weeks. The users (aged 30.3±9.8 years) were mainly male (93%) and active-duty US military (78%). Typical response time was about four minutes, and the teleophthalmology consult and final diagnosis agreed 86% of the time. They found that teleophthalmology consults prevented the need for aeromedical evacuation in in consults (14%) and the patient was able to return to duty in 15 consults (54%). Overall, users were very satisfied with the mobile app, and all interactions were HIPAA-compliant.

Though the study included only a small number of consults, the researchers suggest teleophthalmology mobile apps have the potential to improve and extend ophthalmic care in combat zones.

Gensheimer WG, Miller KE, Stowe J, et al. Military teleophthalmology in Afghanistan using mobile phone application. JAMA Ophthalmology. August 27, 2020. [Epub ahead of print].