Telemedicine Program Significantly Improves Diabetic Retinopathy Screening Rates

Primary care-based telemedicine programs could significantly increase diabetic retinopathy (DR) screening rates, cut screening wait times, and reduce unnecessary referrals, according to the results of a recent study.  

In order to determine whether a primary care-based telemedicine DR screening program could be implemented to reduce wait times and improve timelines, researchers conducted a quasi-experimental, pretest-posttest evaluation of exposure to teleretinal DR screening in 5 Los Angeles-area safety-net primary care clinics from September 1, 2013 to December 31, 2015. A subgroup analysis of random samples of 600 patients before and after the intervention was also conducted.
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Medical assistants and nurses, trained and certified as fundus photographers, uploaded all images to a web-based screening software where it was analyzed by optometrists, who then transmitted the results to the patient’s primary care providers.

Overall, the median screen time decreased from 158 days to 17 days among the 21,222 patients who underwent screening. Annual screening rates increased from 5942 of 14,633 patients (40.6%) before the program to 7470 of 13,133 (56.9%) after initiation of the program. Of the 21,222 patients screened, 14,595 did not require referral, 4160 were referred for treatment or monitoring of DR, and 2461 were referred for other ophthalmologic conditions.

“With standardization and oversight, primary care–based teleretinal DR screening programs have the potential to maximize access and efficiency in the safety net, where the need for such programs is most critical,” the researchers concluded.

—Michael Potts

Reference:

Daskivich LP, Vasquez C, Martinez C, et al. Implementation and evaluation of a large-scale teleretinal diabetic retinopathy screening program in the Los Angeles county department of health services [published online March 27, 2017]. JAMA Intern Med. doi:10.1001/jamainternmed.2017.0204.