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Teleretinal diabetic retinopathy screening program decreases need for referrals
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Screening rates were increased and both the need for referral and wait time for screening were reduced for patients who participated in a large-scale urban teleretinal diabetic retinopathy screening program.
The quasi-experimental pretest-posttest evaluation was implemented in 15 of the largest Los Angeles County Department of Health Services-operating primary care clinics, where staff were certified to perform fundus photography and to upload the digital images to a reading center via EyePACS software.
Of 21,222 patients screened, only 31% were deemed to need referral, thus eliminating the need for more than 14,000 visits (69%) to specialty care professionals, according to the study. The median time to DR screening decreased from 158 days before the start of the program to 17 days after the program was initiated (P < .001).
“A key to the sustainability of our program is the integration of DR screening into primary care practices, treating it as a diagnostic test to establish a need for referral to specialty eye care. By eliminating the need for a separate visit to a specialist, we are able to increase the number of patients screened for DR without increasing demand on specialty care, which is critical in a system in which more than 3,000 people are currently waiting for eye care appointments. Most patients do not need to see an eye care professional, and removing them from the queue decreases the backlog of patients waiting for eye care appointments,” the study authors wrote. – by Robert Linnehan
Disclosure: The authors report no relevant financial disclosures.
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Daskivich LP, et al. JAMA Intern Med. 2017;doi:10.1001/jamainternmed.2017.0204.
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