Digital Healthcare and Diabetic Retinopathy: Patient Experience Innovation and Support for Diabetes Care

Diabetic retinopathy (DR) remains a leading cause of visual loss among working-age adults. However, DR screening adherence is suboptimal due to inconvenient care pathways and fragmented information flow between internal medicine and ophthalmology. To address these challenges, we describe the design, implementation, and early experience of AfterNOON, a patient-centered digital platform that coordinates DR screening across internal medicine in general hospitals and local eye clinics. Design principles included patient-experience optimization, minimal clinician workload, and closed-loop care coordination using standardized reports, electric medical record system integration, and a messengerbased patient channel. Since AfterNOON service launch in March 2024 with 11 clinics, the network expanded to over 230 local ophthalmology clinics and multiple tertiary/general hospitals nationwide. Patients can book screening without application installation; ophthalmologists submit standardized reports that are returned to patients and referring physicians; internal medicine teams can track outcomes through a dashboard. Early feedback indicates shorter referral-to-test intervals and higher visibility of results. These outcomes demonstrates that a lightweight, interoperable digital pathway centered on patient experience and care coordination can enhance DR screening adherence and information return to internal medicine. Wider evaluation using effectiveness–acceptability–sustainability metrics and policy alignment is warranted.