IT‐enabled innovation to prevent infant blindness in rural India: the KIDROP experience

Abstract

PurposeThe purpose of this paper is to share the IT‐based experience of the first tele‐ophthalmology initiative in infant blindness prevention set up to serve rural India.Design/methodology/approachThe paper describes the two‐plus years of experience of the “Karnataka Internet Assisted Diagnosis of Retinopathy of Prematurity (KIDROP) initiative” pioneered by one of the leading private tertiary eye care providers in India, Narayana Nethralaya Postgraduate Institute of Ophthalmology, Bangalore. KIDROP was the first tele‐ophthalmology initiative in the world to use trained non‐physicians (“trained technicians”) to capture images of the retinas of infants a few weeks old for a potentially blinding condition called retinopathy of prematurity (ROP) and validated them to store, process and analyze those images at the rural centre itself. In addition, these images were uploaded to a specially customized software‐hardware platform that allowed remotely situated experts to view these images and report real time either on a PC or on their smart phones. The success of this private initiative paved the way for the first public‐private partnership in infant blindness prevention in India which is poised for a statewide and subsequent nationwide expansion.FindingsIn a country like India, where experts are few and far between and found mostly in the big cities, the human ability of “image processing” allows non‐physicians to quickly gain the expertise to screen seemingly difficult cases by using the medium of digital images and a logical algorithm of triage. With an increasing caseload of these conditions, the standard of care can be delivered to the most underserved of areas with this little IT‐based innovation served with dollops of passion.Practical implicationsThe experience of KIDROP is being used as a cornerstone for similar tele‐ophthalmology programs in India and other developing countries with similar demographics. A case for propagating the innovation as an example of “reverse innovation” for more developed economies to emulate has also been made.Originality/valueThe project described in the paper was the first that used non‐physicians to report images of infants for ROP screening, the first ROP network to cater to rural India and is currently the world's largest single hospital‐managed tele‐ROP network.