Project Retisalud which at present has been implemented in 28 “Zonas Básicas de Salud” and 8 Hospitals in the Canary Islands, is going to be extended to the entirety of the archipelago.

The Canary health care plan places Diabetes as a health problem by itself due to its elevated prevalence in the Canary Islands. The consequences it has on quality of life relate to the chronic nature of the illness, the gravity of its micro-vascular and macro-vascular complications, its elevated morbidity… It is the most common cause of blindness in developed countries.

Diabetic retinopathy is a vascular complication of diabetes, its prevalence its strongly related to the lenght of the illness and the glycemic control. Nearly 100% of type 1 diabetics develop retinopathy within 20 years, as well as 60% of type 2 diabetics. 25% of type 2 diabetics are already suffering from retinopathy the moment they are diagnosed.

In order to find a solution to this problem, the Canary health care service has chosen C2C to develop and implement a system to capture, store and view diagnostic images based on MIO™, as well as a collaborative environment for medical images. The RETISALUD project will be the first project where the aforementioned system is used.

Retinographies in MIO Viewer™

RETISALUD is a Telemedicine project whose goals are the early detection and treatment of diabetic retinopathy on the 112.000 diabetics within the Canary Islands, as well as the reduction in the occurrence of blindness due to this pathology.

The new health care process consists of:

• Retinography at the health care center. MIO LT™ is used here to capture, transform into DICOM, and deliver to a central repository (PACS) the images generated by the retinographs.
• Primary care physicians evaluate all the retinographies. MIO Viewer™ is used at this stage as a web visualization tool to view the images stored in the PACS.
• Diagnostic evaluation by an ophthalmologist of any images considered dubious or pathological by the primary care physician. It is estimated that these images will amount to 20-30% of the total number of retinographies. MIO WADO™ is used in a fully transparent way on this phase, to access the patient images via web independently of which hospital where they taken, and of they physical location.
• If needed (approximately 8% of the aforementioned patients) an appointment will be made with an ophthalmologist.

The patient only needs to be present for the retinography and for the appointment with the ophthalmologist. During the rest of the process it is the image (retinography), the one that is seen in an asynchronous way by the different professionals who intervene during the health care process.

The solution implanted at the SCS is based on MIO™ technology and makes possible:

• Incorporating retinographies to a patient’s history
• Access patients who have a health care card (services portfolio) and their medical history.
• Create a patient’s follow-up report.
• Data mining, thus allowing the evaluation of diagnostics, efficiency…
• Integration with clinical management software and binding with administrative management.

The use of MIO™ in the RETISALUD project offers some clear advantages to patients (early detection of retinopathy, rapid exploration without secondary effects, better accessibility to tests, greater information regarding their health as well as a reduction in transportation costs…).

Medical professionals will also benefit from the use of MIO™ technology in the RETISALUD project (availability of more medical information, patient’s follow-up, better coordination between primary and specialized care, improved training…).

Lastly the health care system itself will benefit (full integration of the early detection process, reduction of avoidable complications, improvement in the quality and efficiency of service, availability of assistance information for management…).

To this moment the Canary health care service has installed a total of 32 non-mydriatic retinographs within the Retisalud project, which cover 60 of the archipelago’s “zonas básicas”, although the goal is to extend this program to the seven islands. The implantation and expansion of the Retisalud project has reached a total of 61.117 people with diabetes in the Archipelago since last year.

In order to operate this retinographs the health department has trained more than 200 general practitioners during the last year. There are currently 708 certified doctors, which amounts 66% of the total number of medical practitioners within the Canary islands.

(Source: Canary health care service Web; Newspaper “La Opinión”, Santa Cruz de Tenerife, 23 Sept. 2009, Health care section and in-house contributions).