Utilising technology to prevent vision loss: the PEHET project

  • Allied health worker Taylah Baird at Mallee District Aboriginal Services, screening patients for diabetic eye disease.

Allied health worker Taylah Baird at Mallee District Aboriginal Services, screening patients for diabetic eye disease.

As 2021 draws to a close, so too will the Provision of Eye Health Equipment and Training (PEHET) project. It comes time to reflect on the success of the program and, importantly, its sustainability into the future. 

The PEHET project was established in 2017 to supplement the introduction of new Medicare items aimed at bolstering screening rates of diabetic retinopathy in regional and remote communities. A national rollout of 167 retinal cameras to various Aboriginal community-controlled health services, mainstream Aboriginal medical services and some hospitals, brought with it the challenge of coordinating and delivering training to close to 1000 staff across these 167 recipient sites. 

The project’s sustainability beyond December 2021 has been a major focus of our work in the second half of this year. There have been several challenges to this given the COVID-19 pandemic, including significant travel restrictions to remote communities. 

Making available self-guided digital training resources that can be accessed remotely from any device, without too much technical knowledge, was important to ensuring ongoing training and use of the equipment in these sites. Our team developed several online courses to provide training for all eye equipment provided to these sites, as well as digital (and physical) resource toolkits that contained our A-Z of instructions, information sheets, case studies and troubleshooting tips. 

We’ve made this easily accessible by taking advantage of a little invention that has become wildly popular lately – the QR code. QR codes have been stuck to the cameras nationwide, with a prompt for new staff to scan them to access training for the camera. 

A key project aim is to empower Aboriginal Health Workers and Practitioners and other clinic staff with the skills and knowledge to perform in-house, no-cost retinal screening for their clients with diabetes. They can then review the images with those clients to provide visually meaningful and personally relevant patient education around diabetic eye complications. The PEHET project has also provided ongoing refresher training and mentoring, as well as additional resources to help embed retinal screening into clinic workflows and chronic disease care management at the local interface.

Empowering local optometry service providers on the ground to continually contribute to the sustainability of this project was also a key goal. Optometrists witness the devastating consequences of diabetic eye disease daily in practice and more so in rural practice. Virtual meeting tools such as Zoom and Teams have complemented online training modules developed especially to ‘train the trainers’ and have given us the ability to provide training to optometrists nationally in a short space of time. In addition to this, collaborative Facebook groups and tools such as Teams have been set up to give opportunities for optometrists to stay connected, ask questions and share discussion on their experiences out in the field. 

Lastly, digital innovation has been employed to aid in the triage and screening of patients with diabetes in rural communities. The Centre for Eye Health (CFEH), based in Sydney, operates a remote screening service whereby clinics can send retinal photos to be reviewed by qualified eye health practitioners. Photos are promptly assessed and reports are sent back for appropriate patient referral and care management to be decided and actioned. 

With advances in technology, healthcare providers have an opportunity to provide services to an increasing number of patients, more than at any time in history. We have an opportunity to reach areas previously unserved and provide unique services that have typically been limited by a lack of practitioners and coverage. It is incumbent on us, as service providers and organisations, to take an active role in the planning and implementation of technology in our respective industries. 

If you would like to access the Brien Holden Foundation’s trove of resources, including our retinal camera, diabetic retinopathy and slit lamp training courses, head to brienholdenfoundation.org/australia-program/pehet


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