The JVN consists of an image acquisition system (IAS) that uses a non-mydriatic fundus camera managed by a specially equipped computer. The system utilizes a computerized medical record that is interactive with the Indian Health Service (IHS) Resource & Patient Management System/Electronic Health Record (RPMS/EHR) system, but is able to operate effectively without RPMS/EHR connectivity if required. An imager captures external eye and retinal images and transmits them via the IHS wide area network (WAN) along with relevant patient clinical information to the IHS-JVN National Reading Center in Arizona. In the reading center eye doctors interpret each image set using computer assistance to produce a diagnosis and management plan that is in standardized alignment with the Early Treatment Diabetic Retinopathy Study (ETDRS). A report is automatically generated to document the diagnosis and recommended management recommendations, and made available to the patient's referring primary care provider. If the imager feels that a "stat" interpretation is required, the Reading Center is notified directly and the images are evaluated and reported immediately. All images remain securely archived on IHS equipment on IHS property.