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Office of Rural Health

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Enterprise-Wide Initiative (EWI) - Specialty Care

Technology-based Eye Care Services (TECS)

Background

  • Technology-based Eye Care Services (TECS) is a telehealth program that provides eyeglasses and eye health exams to rural Veterans. 
  • TECS began in March 2015 and became an Office of Rural Health Enterprise-Wide Initiative (EWI) in October 2017.
  • Rural Veterans are examined by a specially trained eye care (ophthalmology) technician. The technician checks the Veteran's vision, their glasses prescription, and take pictures of the Veteran's eyes.
  • Special equipment is used to collect information about the Veterans eyes. A remote eye doctor reviews the information and prescribes glasses and/or medicine, if needed.
  • The eye doctor decides if the Veteran needs to come see them in person.
  • TECS technicians and eye doctors from different VA medical centers and clinics work together so rural Veterans get the care they need.

Goals and Objectives

  • Provide eye care access to rural, highly rural, and homeless Veterans.
  • Improve Veterans access to routine eye exams using telehealth.
  • Reduce how far and how long rural Veterans have to travel for eye care.

Methodolgy

Veterans in both rural and urban areas with limited access to eye care benefit greatly from TECS. The program provides better access to eye care by providing eye care in the Veterans’ primary medical care home.

How does TECS work?

  • Veterans see a trained eye technician in a local VHA facility. These appointments are usually at a VA Community Based Outpatient Clinic.
  • Veterans have the same kind of eye exam they would have at a traditional face-to-face eye clinic visit. This includes a vision check, measuring the power for glasses, eye pressure reading, and taking pictures of the Veteran's eyes (retinal imaging).
  • An eye care doctor looks at the information and pictures from the Veterans exams within 48 hours.
  • The provider contacts the Veteran with eye exam results. They also coordinate follow-up visits.

What is the impact on rural Veterans?

  1. TECS gives Veterans more access to eye care in rural areas.
  2. TECS sites are in VA's community clinics. They are often closer to Veterans than a VA medical center.
  3. TECS reduces wait times for eye care services. Trained eye care technicians help Veterans with exams and glasses, and eye doctors treat Veterans with more serious eye conditions.
There are currently more than 100 TECS sites across the VHA nationally, including a mobile van, with 37 of the 100+ TECS sites having received start-up funding or are currently supported by ORH.

Key Takeaways

  • TECS improves rural Veterans access for eye care.
  • TECS technicians provides Veterans with an eyeglass check and eye (ocular) health exam.
  • TECS eye doctors look at eye exam results. They see Veterans with major eye conditions in person.
  • Veterans are highly satisfied with TECS. They can get their eye exam without waiting too long or driving long distances.

Image of a patient having an eye exam.
Download the Printable PDF for Healthcare Providers and Researchers.

Read About TECS




References

  • US Medicine Article about TECS https://www.usmedicine.com/clinical-topics/glaucoma/technology-based-eye-care-services-offer-quality-comprehensive-care-to-veterans-nationwide/*
  • VA News Article about TECS and Glaucoma Care https://news.va.gov/136093/expanding-access-glaucoma-care-with-telehealth/
  • VA News Article about TECS and Saving Vision https://news.va.gov/134055/va-brings-vision-saving-eye-screening-closer
  • VA Insider Article about TECS https://vaww.insider.va.gov/ophthalmologists-have-a-vision-for-serving-veterans/
  • Maa AY, Wojciechowski B, Hunt K, Dismuke C, Janjua R, Lynch MG. Remote Eye Care Screening for Rural Veterans with Technology-based Eye Care Services (TECS): A Quality Improvement Project. Rural and Remote eHealth, 2017 Jan-Mar; 17(1): 4045.
  • Maa AY, Wojciechowski B, Hunt K, Dismuke C, Shyu J, Janjua R, Lynch MG. Early Experience with Technology-based Eye Care Services (TECS): A Novel Ophthalmologic Remote Care Initiative. Ophthalmology. 2017 Apr;124(4):539-54
  • Medert C, Lynch MG, Maa AY. Detection of Idiopathic Intracranial Hypertension, enabled by Tele-ophthalmology. Can J Ophthalmol. 2017 Jun;52(3):e117-e120. doi: 10.1016/j.jcjo.2016.11.009. Epub 2017 Jan 12
  • McCord S, Lynch MG, Maa AY. Diagnosis of Retinal Detachments by a Tele-Ophthalmology Screening Program. J Telemed Telecare. 2019 Apr;25(3):190-192. doi: 10.1177/1357633X18760418. Epub 2018 Feb 28.
  • Maa AY, Medert CM, Lu X, Janjua R, Howell AV, Hunt KJ, McCord S, Giangiacomo A, Lynch MG. Diagnostic Accuracy of Technology-based Eye Care Services: The Technology-based Eye Care Services Compare Trial Part I. Ophthalmology. 2020 Jan;127(1):38-44. doi: 10.1016/j.ophtha.2019.07.026. Epub 2019 Aug 13.PMID: 31522900
  • Maa AY, McCord S, Lu X, Janjua R, Howell AV, Hunt KJ, Medert CM, Giangiacomo A, Lynch MG. The Impact of OCT on Diagnostic Accuracy of the Technology-Based Eye Care Services Protocol: Part II of the Technology-Based Eye Care Services Compare Trial. Ophthalmology. 2020 Apr;127(4):544-549. doi: 10.1016/j.ophtha.2019.10.025. Epub 2019 Oct 31.PMID: 31791664
  • 11. Simon LS, Davis ML, Medunjanin D, Fanning L, Damonte JC, Hunt K, Maa AY. National Experience of Technology-based Eye Care Services: A Comprehensive Ophthalmology Telemedicine Initiative. Ophthalmology. 2024 Oct 4:S0161-6420(24)00602-X. doi: 10.1016/j.ophtha.2024.09.032. Online ahead of print. PMID: 39368749

Contact

April Maa, MD, TECS EWI Program Lead. Director, National Subspeciality Ophthalmology Network (NSON) Virtual Eye Care Services. April.Maa2@va.gov

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