FOXTROT Changes Consult Requests for Ophthalmology
March 31, 2021 | Download PDF
TATRC continues its growing partnership with fellow collaborator’s at the U.S. Air Force’s 59th Medical Wing, furthering the secure mobile application known as ‘FOXTROT’ and its accompanying web portal. The Forward Operating Base Expert Telemedicine Resource Utilizing Mobile Application for Trauma (FOXTROT) application provides a secure, HIPPA-compliant tool that connects the providers at the point of injury in deployed locations to an ophthalmologic specialist at a higher level of care. The FOXTROT application leverages TATRC’s Mobile Health Care Environment - Research (MHCE-R) and its accompanying mobile app, mCare, as a solution to treat ocular trauma. As previously reported, FOXTROT was deployed to Afghanistan in 2019, and in August 2020, the findings of that project were published in JAMA Ophthalmology. During the Afghanistan performance improvement project, 18 different FOXTROT users directed a total of 28 consults to one expeditionary ophthalmologist over a six week period. The teleophthalmology services provided via the FOXTROT application helped prevent the need for aeromedical evacuation in four of the 28 consults placed, and downgraded the category of aeromedical evacuation in four more. Moreover, users really liked utilizing the app. Application users’ median rating was a 5 on a 5 point satisfaction survey scale.
Since October of 2020, FOXTROT is revolutionizing virtual consults for two ophthalmology specialists at Joint Base Andrews and their Emergent Care Center (ECC), replacing traditional consult methods. On average, the specialists receive 3-5 consults per week, with a maximum of three consults received in one day. To date, providers at the Joint Base Andrews ECC have requested a total of 33 consults. Ophthalmology specialists receive a complete picture of the patients in question using FOXTROT, and can respond to consults with a thorough treatment plan at all hours of the day. The FOXTROT application transmits patient demographic data, historical information as well as injury information and assessment. Additionally, providers at the ECC can send numerous images and directly communicate using FOXTROT’s secure messaging function.
According to the FOXTROT research coordinator Michelle Moccia,” the FOXTROT application saves the ophthalmologists from being pulled from an exam room to answer an urgent consult. It allows them to provide better care for consult patients and scheduled exam patients as well.”
The immediate future plans for FOXTROT include bringing the additional approved sites at Brooke Army Medical Center in San Antonio, TX and Portsmouth Naval Hospital in Portsmouth, Virginia online. Providers at these two sites completed training on the platform in January 2021. Furthermore, efforts are underway to expand FOXTROT to include a secure video web-conferencing feature using Web RTC as part of a push for a global “ocular suite” of a la cart ophthalmological assessment options. The development and project management staff at TATRC’s Digital Health Innovation Center continue to work hand in hand with the FOXTROT team to make this project a success. This technology has the potential to change the way specialty consults are communicated in a deployed setting and here at home as well.
For more information on this project, please contact Ms. Jeanette Little, jeanette.r.little.civ@mail.mil.
Team TATRC extends a warm welcome to Sunday as he fills this long overdue position!
This article was published in the July 2021 issue of the TATRC Times.