Diabetic patients have a higher risk of developing diabetic retinopathy, and regular checkups are required every year to reduce the risk of blindness
According to the Diabetes Atlas report published by the International Diabetes Federation (IDF) at the end of 2019, the number of diabetic patients around the world reached 460 million in 2019 and is expected to rise to 570 million by 2030. According to Taiwan Diabetes Yearbook 2019 published by the National Institutes of Health (NIH) of Taiwan, the aging population, and changes in lifestyles and dietary patterns led to the increase in the number of diabetic patients to over 2.3 million in 2019 with the prevalence rate of over 11%.
Among the many complications caused by diabetes, diabetic retinopathy is the most important cause of blindness. According to a survey conducted by the National Health Promotion Administration (HPA), Ministry of Health and Welfare of Taiwan, the prevalence rate of diabetic retinopathy is about 26.5%. That is, on average, one out of four diabetic patients has developed diabetic retinopathy. Statistically, patients with diabetes are 25 times more likely to become blind than patients without diabetes. If the diagnosis and treatment are not done early, it will affect patients’ daily lives and bring them huge medical bills. Therefore, the HPA of Taiwan has recommended patients with diabetes to undergo fundus photography by an ophthalmologist at least once a year. Early screening and treatment can reduce the chance of blindness by up to 50%.
However, nearly half of Taiwan’s rural areas lack ophthalmology clinics. For example, among 29 administrative districts of New Taipei City, northern Taiwan, as many as 13 districts do not have ophthalmology clinics. People living in areas with no ophthalmology clinics have to drive to downtown hospitals to see an ophthalmologist. Within a limited time, rural patients tend to spend most of their time on high-end treatments for cardiovascular disease and cancer instead of seeing an ophthalmologist. Without proactive fundus photography examination on a regular basis, the HPA of Taiwan shows examination rate is only 45.7% in rural diabetic patients. Therefore, the development of proactive eye examination programs for the elderly and diabetic patients living in rural areas should be one of the top priorities for the government.
The Taiwan government leads the technology industry to develop innovative eye examination services and cooperates with local governments to improve eye examination rates.
As the Taiwan government unit responsible for the development of smart cities island-wide, the Industrial Development Bureau (IDB) of the Ministry of Economic Affairs (MoEA) is assisting a Taiwanese smart healthcare company Leosys to develop AI-assisted ophthalmology patrol services for the elderly and diabetic patients living in rural areas. With the utilization of medical manpower in Universal Eye Center (UEC) and the cooperation with local health units, the company is able to care for eyes of people, especially the elderly, in the rural areas.
Leosys has developed an innovative eye examination kit with portable equipment for fundus photography and diagnostic assistance system. The kit is able to integrate the patient’s personal identification, ophthalmology examination, and archived data into one solution. In cooperation with UEC optometrists, the company is able to provide optometry services and transmit fundus photography images to remote doctors for diagnosis to improve the mobility and convenience of eye examinations in rural areas by connecting patients in the rural areas with remote doctors. This not only has saved commuting time for patients and doctors but also has increased the willingness of patients living in rural areas to conduct eye examinations. In addition, Leosys has collected a large number of fundus photography images, established a database, and developed AI to identify glaucoma, cataracts and macular diseases. It has helped doctors interpret fundus photography more accurately and quickly, and increase the probability of early detection.
Leosys has also worked with the Department of Health of New Taipei City and Tainan City to introduce eye examination patrol services in communities for the elderly, including long-term care institutes, nursing centers, civil sports centers, village offices, diabetes care centers, etc. Thus far, Leosys has 40 sessions of patrol services and the fundus photography examination rate in diabetic patients has increased by 20%. The average satisfaction level of subjects is as high as 98%. The problem of insufficient ophthalmology clinics in rural areas can be solved by the solution and the quality of healthcare in rural areas can be improved significantly. The best news of all is that this solution is ready to be exported to Southeast Asian countries.
The Smart City Taiwan Project of the IBD of MoEA has currently supported nearly 300 Taiwanese manufacturers, including 70 new startups in eight key industries, including health, retail, green energy, new agriculture, tourism, urban governance, transportation, and education. In 22 counties and cities island-wide, Taiwan has incubated more than 220 smart services. Taiwan is committed to using emerging technologies to solve people's daily living problems, promote industrial upgrades, and improve urban governance efficiency. The IDB is poised as a bridge between emerging technology solution providers and city authorities, pointing to the increasing importance of these solutions in matching city needs.