The article by Daskivich et al1 in this issue of JAMA Internal Medicine evaluates a large-scale telemedicine diabetic retinopathy (DR) screening program in the Los Angeles County Department of Health Services, one of the largest safety net health care systems in the United States. This widespread screening program used existing primary care workflows to train medical assistants and licensed vocational nurses to be the certified fundus photographers and then sent the digital images to staff optometrists to grade levels of DR and determine timing of follow-up appointments for appropriate specialty care.
Lyles C, Sarkar U. Seeing the Effect of Health Care Delivery Innovation in the Safety Net. JAMA Intern Med. 2017;177(5):649-650. doi:10.1001/jamainternmed.2017.0220