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COVER STORY - FIRST NATIONS HEALTH

They have their eye on an even bigger prize

After winning the $5 million Pilbara Challenge, Lions Outback Vision is scaling up its mobile retinal scan technology into clinics across the State in a spinout called Ninox Vision

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Lions Outback Vision won the $5 million prize in the State Government’s global Pilbara Challenge competition, by developing an AI-powered mobile retinal scanner that was better at picking up eye disease than a doctor. The prize money was supposed to enable the winner to continue to develop their solution and help revolutionise healthcare service delivery, especially to Indigenous communities, in the remote north of the State.

But Lions Outback Vision has gone one step further, starting to roll out the technology to clinics in the North-West and other parts of the State, involving GPs in the process.

Professor Angus Turner examines a patient using the AI-assisted retinal scanner.

“The Pilbara Challenge tested the AI technology prospectively in a mobile visiting van, but now it’s ready to base in any GP’s own clinic harnessing the opportunistic screening, since the camera’s always there and the business model stacks up,” Lions Outback Vision Founder and Director Professor Angus Turner explains.

“All diabetic patients have access in WA to at least a nursing post where their diabetes is being checked once a year or more. And in those contexts, the camera technology is suitable. So, we are not losing our mission in Lions Outback Vision, which is for remote settings wherever we go, where it makes the most sense because there are no other opportunities. There’s not even an optometrist resident in those places.

“The real impact of this technology is for all regional towns, and even the cities, because nationally only half the people with diabetes are getting their eyes screened.”

Broome Regional Aboriginal Medical Service and Ord Valley Aboriginal Health Service already have access to the technology, but Prof Turner has also negotiated the supply of the hi-tech cameras to GP clinics in Perth and Albany.

“ The real impact of this technology is for all regional towns, and even the cities, because nationally only half the people with diabetes are getting their eyes screened.

Lions Outback Vision staff examine a patient using OCT (optical coherence tomography) with AI integration.

“I’m hoping to have 25 signed up by June,” he says. “It’s hard to speculate; but if it’s working well, I hope to have another 100 over the course of the following year. The practices will have a one-year free trial. And if it works for their practice, we’ll be offering a lease of the camera over a four-year timeframe so they can make sure it’s sustainable for their business.

“It’s because we have the prize funding that we’re able to do this. It’s created a huge opportunity to provide WA with world-class screening infrastructure.”

The State Government issued the Pilbara Challenge in 2023 for a world-leading medical research and innovation solution to resolve the problem of health service delivery in the region.

From almost 100 entries, 10 shortlisted finalists received a grant of $200,000 to commence work on the ground. They were required to submit a final report at the end of the 12-month “proof of concept” period. Lions Outback Vision was able to show that the use of its mobile technology had produced a 17-fold increase in screening uptake in the Pilbara.

“We’ve been working for a long time in Lions Outback Vision to provide ways of screening for certain conditions, especially for remote settings,” Prof Turner recalls.

“One aspect has been working with optometrists to do telehealth, and that’s been very successful. But in working with the GPs in primary care, we haven’t had much success with screening for diabetes – even though it’s a well-known mode of photographing a diabetic patient’s eye and trying to detect disease, so we can prevent blindness. That has not really worked. So this challenge was to try to dive in and tackle it with some new approaches in a digital health space and see if it made any difference.”

At the outset, Lions Outback Vision identified some barriers to testing using the existing technology: the cameras were clunky and taking the photo required some skill; the operator had to send the photo elsewhere to get it diagnosed, causing delays; and the patient was left out of the loop.

The challengers decided they needed a new type of camera which essentially drives itself, and road-tested three AI models to find the one best suited to the diagnostic task.

Key Facts

  • The retinal camera takes a photo to diagnose diabetic retinopathy, with the digital image immediately transferred to the cloud, where it’s analysed by AI software and integrates seamlessly with the GP’s electronic medical records.
  • Google Health’s advanced diagnostic tool called ARDA (Automated Retinal Disease Assessment) was the clear winner of the three AI models tested.
  • Broome Regional Aboriginal Medical Service and Ord Valley Aboriginal Health Service already have access to the technology.

“Now we’re just testing it in the real world,” says Prof Turner. “Here’s a patient in front of us, here are three different AIs to road-test. How does it go, practically speaking, with this new camera, the new on-the-spot diagnosis, and what difference does it make for that patient on the day?

“It was a research trial. The patient signed a consent form to say they were happy with all this fancy AI stuff. And then we asked them: Do you like this on-the-spot facility? Does it help you? And they said they absolutely loved it. So, the patients were happy with the experience, and the AI was extremely accurate, as good as or better than the doctors.”

In the end, Google Health’s advanced diagnostic tool called ARDA (Automated Retinal Disease Assessment) was the clear winner of the three AI models. This technology has now been handed over to Ninox Vision to provide the service in Australia, so it has no further connection to Google.

The camera takes a photo of the patient’s retina to diagnose diabetic retinopathy at the back of the eye, and then the digital image is immediately transferred to the cloud – where it’s analysed by the fully integrated AI software that provides an instant diagnosis, rather than the patient having to wait perhaps weeks for the results.

“AI is the only reason we can now do that on-the-spot diagnosis,” Prof Turner explains. “The machine securely transfers the photo to the cloud, where AI does its magic to work out whether diabetes is affecting the eye or not. And that’s been validated as being very accurate for Aboriginal people.”

The technology is also easy to master after just a 10-minute training session.

“So, my goal,” Prof Turner says, “is to say to GP practices: if you have a health assistant or a receptionist, they might be able to take the photo on the way in before the patient has even seen anyone because they don’t need any eye drops. And by the time the patient is seeing the doctor, the report is already in the medical record.”

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