604-P: Automated Diabetic Retinopathy Screening in the Primary Care Setting Improves Compliance with Follow-Up Ophthalmic Care

Diabetes ◽  
2019 ◽  
Vol 68 (Supplement 1) ◽  
pp. 604-P
Author(s):  
JAMES C. LIU ◽  
SHAWN RAMCHAL ◽  
ELLA GIBSON ◽  
JESSICA KUO ◽  
KAUSHAL SOLANKI ◽  
...  
Keyword(s):  
Primary Care ◽  
Diabetic Retinopathy ◽  
Care Setting ◽  
Primary Care Setting ◽  
Diabetic Retinopathy Screening ◽  
Retinopathy Screening

scholarly journals Correction to: Diabetic retinopathy screening in urban primary care setting with a handheld smartphone-based retinal camera

2020 ◽  
Author(s):  
Márcia Silva Queiroz ◽  
Jacira Xavier de Carvalho ◽  
Silvia Ferreira Bortoto ◽  
Mozania Reis de Matos ◽  
Cristiane das Graças Dias Cavalcante ◽  
...  
Keyword(s):  
Primary Care ◽  
Diabetic Retinopathy ◽  
Care Setting ◽  
Primary Care Setting ◽  
Diabetic Retinopathy Screening ◽  
Retinopathy Screening

Improving Access to Diabetic Retinopathy Screening through Telemedicine (Preprint)

2020 ◽  
Author(s):  
Shuja Rayaz ◽  
Tiffany Wandy ◽  
Jenna Brager ◽  
Michael Kiritsy ◽  
Daniel Durand
Keyword(s):  
Primary Care ◽  
Diabetic Retinopathy ◽  
Care Setting ◽  
Vision Loss ◽  
Primary Care Setting ◽  
Adult Population ◽  
Descriptive Study ◽  
Pilot Program ◽  
Diabetic Retinopathy Screening ◽  
Retinopathy Screening

BACKGROUND Screening for diabetic retinopathy is important for the prevention of blindness among the adult population. Currently, patients with diabetes require a referral from their primary care physician to see an ophthalmologist for their annual eye exam, which can be an added inconvenience. As such, there is a need for alternative screening strategies within an outpatient network. The use of a telemedicine platform in a primary care network serves as a novel strategy to increase diabetic retinopathy screening rates. LifeBridge Health operates two Track 1 Accountable Care Organizations with a combined attribution of approximately 28,000 patients. Many value-based care and pay for performance programs use diabetic retinopathy screening rate as a quality measure. In order to provide better access to diabetic retinopathy screening for our patients, three specialized cameras were placed in three primary care practices in October 2017 as part of a pilot program. The online Intelligent Retinal Imaging Systems (IRIS) platform was utilized as a secure data warehouse of images that could be interpreted remotely by an ophthalmologist within the LifeBridge Health network for the diagnosis of diabetic retinopathy or detecting other types of pathology (e.g. macular edema). OBJECTIVE The aim of this retrospective descriptive study was to examine if a telemedicine platform can be used to increase diabetic retinopathy screening rates in the primary care setting. METHODS Three distinct datasets corresponding with three time periods were examined for this study. Pre-post comparison examined screening rates from all practices from January 2018 – December 2018 to those of January 2017 – December 2017. The pilot program dataset examined screening rates in the practices before and after the implementation of the IRIS cameras in October 2017. Aggregate diagnostic data from the IRIS online dashboard from October 2017- December 2019 was also examined to determine the benefit of the IRIS platform since the initial implementation. RESULTS Pre-post comparison screening rates showed mean screening rates of 38.5% and 47.2%, respectively, indicating an 8.7% improvement in screening. The pilot program showed improved screening rates at each outpatient practice with the implementation of the IRIS cameras. Aggregate data since the implementation of the IRIS cameras showed that, of the 1213 patients who were screened, approximately 17.1% (n=207 patients) were diagnosed with diabetic retinopathy and an additional17.7% (n=215 patients) were suspected of having some form of other pathology. 10.1% (n=123 patients) were also suspected to be at risk for imminent vision loss. CONCLUSIONS This retrospective descriptive study suggests that a telemedicine platform can be used to improve diabetic retinopathy screening rates in the primary care setting within a large healthcare system.

scholarly journals Development and Validation of an Automated Diabetic Retinopathy Screening Tool for Primary Care Setting

Diabetes Care ◽  
2020 ◽  
Vol 43 (10) ◽  
pp. e147-e148
Author(s):  
Alauddin Bhuiyan ◽  
Arun Govindaiah ◽  
Avnish Deobhakta ◽  
Meenakashi Gupta ◽  
Richard Rosen ◽  
...  
Keyword(s):  
Primary Care ◽  
Diabetic Retinopathy ◽  
Care Setting ◽  
Screening Tool ◽  
Primary Care Setting ◽  
Diabetic Retinopathy Screening ◽  
Development And Validation ◽  
Retinopathy Screening

scholarly journals Diabetic retinopathy screening in urban primary care setting with a handheld smartphone-based retinal camera

2020 ◽  
Vol 57 (12) ◽  
pp. 1493-1499
Author(s):  
Márcia Silva Queiroz ◽  
Jacira Xavier de Carvalho ◽  
Silvia Ferreira Bortoto ◽  
Mozania Reis de Matos ◽  
Cristiane das Graças Dias Cavalcante ◽  
...  
Keyword(s):  
Primary Care ◽  
Diabetic Retinopathy ◽  
Care Setting ◽  
Primary Care Setting ◽  
Diabetic Retinopathy Screening ◽  
Retinopathy Screening

Diabetic retinopathy screening using tele-ophthalmology in a primary care setting

2010 ◽  
Vol 16 (8) ◽  
pp. 429-432 ◽  
Author(s):  
José Andonegui ◽  
Luis Serrano ◽  
Aitor Eguzkiza ◽  
Lara Berástegui ◽  
Laura Jiménez-Lasanta ◽  
...  
Keyword(s):  
Primary Care ◽  
Diabetic Retinopathy ◽  
Care Setting ◽  
Primary Care Setting ◽  
Diabetic Retinopathy Screening ◽  
Retinopathy Screening

scholarly journals Adherence to ophthalmology referral, treatment and follow-up after diabetic retinopathy screening in the primary care setting

2020 ◽  
Vol 8 (1) ◽  
pp. e001154
Author(s):  
George Bresnick ◽  
Jorge A Cuadros ◽  
Mahbuba Khan ◽  
Sybille Fleischmann ◽  
Gregory Wolff ◽  
...  
Keyword(s):  
Primary Care ◽  
Diabetic Retinopathy ◽  
Complete Information ◽  
Persistent Problem ◽  
Diabetic Retinopathy Screening ◽  
Patients With Diabetes ◽  
The Usa ◽  
Adherence Monitoring ◽  
Retinopathy Screening

IntroductionTelemedicine-based diabetic retinopathy screening (DRS) in primary care settings has increased the screening rates of patients with diabetes. However, blindness from vision-threatening diabetic retinopathy (VTDR) is a persistent problem. This study examined the extent of patients’ adherence to postscreening recommendations.Research design/methodsA retrospective record review was conducted in primary care clinics of a large county hospital in the USA. All patients with diabetes detected with VTDR in two time periods, differing in record type used, were included in the study: 2012–2014, paper charts only; 2015–2017, combined paper charts/electronic medical records (EMRs), or EMRs only. Adherence rates for keeping initial ophthalmology appointments, starting recommended treatments, and keeping follow-up appointments were determined.ResultsAdequate records were available for 6046 patients; 408 (7%) were detected with VTDR and recommended for referral to ophthalmology. Only 5% completed a first ophthalmology appointment within recommended referral interval, 15% within twice the recommended interval, and 51% within 1 year of DRS. Patients screened in 2015–2017 were more likely to complete a first ophthalmology appointment than those in 2012–2014. Ophthalmic treatment was recommended in half of the patients, of whom 94% initiated treatment. A smaller percentage (41%) adhered completely to post-treatment follow-up. Overall, 28% of referred patients: (1) kept a first ophthalmology appointment; (2) were recommended for treatment; and (3) initiated the treatment. Most patients failing to keep first ophthalmology appointments continued non-ophthalmic medical care at the institution. EMRs provided more complete information than paper charts.ConclusionsReducing vision impairment from VTDR requires greater emphasis on timely adherence to ophthalmology referral and follow-up. Prevention of visual loss from VTDR starts with retinopathy screening, but must include patient engagement, adherence monitoring, and streamlining ophthalmic referral and management. Revision of these processes has already been implemented at the study site, incorporating lessons from this investigation.

Mailed letter versus phone call to increase diabetic retinopathy screening engagement by patients in a team-based primary care practice: a prospective, single-masked, randomized trial.

2021 ◽  
Author(s):  
Vess Stamenova ◽  
Megan Nguyen ◽  
Nike Onabajo ◽  
Rebecca Merritt ◽  
Olivera Sutakovic ◽  
...  
Keyword(s):  
Primary Care ◽  
Diabetic Retinopathy ◽  
Usual Care ◽  
Patient Engagement ◽  
Primary Care Practice ◽  
Phone Call ◽  
Care Practice ◽  
Diabetic Retinopathy Screening ◽  
Engagement Strategies ◽  
Retinopathy Screening

Abstract Background: Diabetic retinopathy is the leading cause of blindness among adults, but vision loss is preventable through regular screening. Urban areas in Canada have large numbers of unscreened individuals and teleophthalmology programs have been used to improve access and uptake of screening. The purpose of this study was to test different patient engagement approaches to expand teleophthalmology program to team-based primary care clinic in the city of Toronto, Canada.Methods: A teleophthalmology program was set up in a large urban academic team-based primary care practice. Patients over 18 years of age, with type 1 or type 2 diabetes were randomized to one of four engagement strategies: a phone call, a letter, a letter plus phone call, or usual care. Outreach was conducted by administrative staff within the clinic. The primary outcome was booking an appointment for diabetic retinopathy screening through a teleophthalmology program at the time of the call or within one week for the mail intervention. Results: A total of 23 patients in the phone, 28 in the mail, 32 in the mail and phone, and 27 in the control (usual care) were included in the analysis. After the intervention, 88% of patients in the phone intervention, 11% of patients in the mail group, and 100% in the mail and phone group booked an appointment with the teleophthalmology program compared to 0% in the control group. Phoning patients positively predicted patients booking a teleophthalmology appointment (p< .0001), while sending a letter had no effect. Conclusions: Patient engagement to book diabetic retinopathy screening via teleophthalmology in an urban academic team-based primary care practice using telephone calls was much more effective than letters or usual care. Practices that have access to a local DR screening programs and have the required resources to undertake such engagement strategies should consider using them as a means in improving their DR screening rates.

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