Public healthcare institutions in Montenegro: Connected diagnostics for diabetic retinopathy screening

Results

EHS successfully integrated and operationalized a teleophthalmology screening workflow within Montenegro’s national radiology and diagnostic platform, demonstrating the flexibility and scalability of the enterprise imaging infrastructure.
By connecting patient data, fundus imaging devices, PACS, and diagnostic workflows, the platform enabled healthcare providers to perform diabetic retinopathy screening through a fully digital process spanning primary care and specialist review.
Within the first month of implementation:

• • 790 screenings were performed
  • 710 assessments were completed
  • More than 200 patients were identified with diabetes-related retinal changes requiring monitoring or further evaluation

The project demonstrated that the national diagnostic platform can support new clinical workflows beyond radiology, creating a foundation for future telemedicine and screening initiatives.

The challenge

Healthcare providers needed a scalable way to screen patients with diabetes for early signs of eye disease, without overloading specialist services.
Key challenges included:

• • • Identifying and reaching patients with diabetes across multiple locations
    • Lack of structured workflow for remote diagnostics
    • Manual coordination between technicians, doctors, and patient communication
    • Limited integration between imaging equipment and diagnostic systems

The solution

EHS supported the implementation of a teleophthalmology screening workflow through Montenegro’s national radiology and diagnostic platform, built on RIS and PACS technologies and designed to support enterprise imaging workflows across healthcare institutions.
Rather than introducing a standalone solution, the project leveraged the existing national imaging infrastructure to integrate diabetic retinopathy screening into a connected diagnostic ecosystem.
The platform enabled seamless coordination between primary care providers, medical technicians, and ophthalmologists by connecting:

• • • Patient data and screening lists
    • Fundus imaging devices
    • Centralized image storage and review through PACS
    • Diagnostic reporting and workflow management through RIS

This implementation demonstrated how the national enterprise imaging platform can support new clinical use cases beyond radiology, creating a foundation for future telemedicine and screening initiatives.

How it works

The process was designed to be simple, scalable, and efficient:

• • 1. Patient identification
       Patients with diabetes were identified and imported into the system based on structured data.
    2. Scheduling & outreach
       Technicians access patient lists in RIS and schedule appointments directly.
    3. Imaging
       Fundus images are captured and automatically sent to PACS.
    4. Remote diagnosis
       Doctors review images in PACS and record findings in RIS.
    5. Patient communication
       Results are shared with patients and further steps are coordinated.

Key improvements

• • Structured and scalable screening process for diabetic patients
  • Faster and more efficient diagnostic workflows
  • Reduced need for in-person specialist visits
  • Improved coordination between primary care and specialists
  • Foundation for future telemedicine expansion