American Academy of Optometry
American Academy of Optometry
January 03, 2019
2 min read

Telemedicine improves access for patients, clinicians

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Tony Cavallerano
Anthony Cavallerano

SAN ANTONIO – “Telemedicine will change the way health care is delivered globally,” Anthony Cavallerano, OD, FAAO, said here at the American Academy of Optometry’s annual meeting.

During the plenary session on the future of health care delivery, which Primary Care Optometry News cosponsored, Cavallerano said telemedicine is about access and education.

He is executive director of clinical training and patient care and an adjunct professor at New England College of Optometry, as well as a former PCON Editorial Board member

“Patients demand convenience and efficiency, and they demand the best care,” he said. “If you believe technology can improve access and improve what you do for your patients, they will embrace it. Patients are far more devoted to the convenience aspect of care than any of us ever imagined.”

Because nearly everything in an eye care exam is visual, Cavallerano said this area of medicine is well suited to telemedicine.

“The problem is we spend eight or nine times longer gathering the data than analyzing the data,” he said. “That’s not very efficient.”

Cavallerano said there are three major components to a telemedicine program: the technical aspect (DICOM was developed as a standard for images), the business aspect (HIPAA, practicing health care over state lines, telehealth parity) and the clinical aspect (much of which takes place behind the scenes).

The three general modalities of telehealth include home, clinic-based and store-and-forward, Cavallerano said.

Home telehealth lends itself to patients with chronic disease, those who need regular monitoring and care but do not need to come into the office for it. “There are so many devices to allow an individual to capture information at home and send it to a central location where it’s evaluated,” he said.

More than 2,000 studies have been conducted on telemonitoring in the home, Cavallerano said. “We know it reduces hospital readmissions by 83%, decreases home nursing visits by 86% and lowers overall costs by more than 30%. Patients and care givers report increased satisfaction.”

Clinic-based or real-time telehealth is an important option to patients who need specialty or primary care, allowing them to interact with a clinician in a real-time consultation, he said.

Store-and-forward is where an image, data or video is captured at one site and reviewed at another, usually by an expert. This is often used in screening for diabetic retinopathy, Cavallerano said.

“This pathway frightens a lot of people, especially in eye care,” he said.

He noted that several artificial intelligence and virtual reality systems have been licensed by the FDA for detecting diabetic retinopathy.

“We have to decide what telemedicine means to us,” Cavallerano said. “It will mean something different to everybody. There is no universal approach to using technology in practice. Think of telemedicine as something that not only improves access for your patients, but improves your access.” – by Nancy Hemphill, ELS, FAAO


Cavallerano A. The future of health care delivery. Presented at: American Academy of Optometry annual meeting; San Antonio; November 6-10, 2018.

Disclosure: Cavallerano reported no relevant financial disclosures.