Use of digital retinal imaging services to provide on-site eye exams in the Every Diabetic Counts Program

Background: To reduce disparities in diabetes outcomes, CMS initiated the Every Diabetic Counts (EDC) Program in August of 2008. The quality performance measure for annual diabetic retinopathy (DR) assessment stands as one of the lowest performance measures, with nearly one in two patients not receiving this important, annual clinical requirement. Digital imaging technology for retinal exams has been in use for approximately eight years. This presentation will discuss the successful use of onsite digital retinal imaging in the underserved population. Method: DFMC and DFDC investigated the available technologies/companies providing this service and sought CMS approval for the use of the EyeTel Imaging System. EyeTel's digital imaging process had already been approved for payment through CMS, so DFMC's role was to facilitate access to providers and patients who may want to utilize the service. Results: The project was formally initiated in late April, 2010, and the first person was screened on June 28, 2010. . As of Jan 31, 2011, 340 patients have been screened. 56 (16%) of these have required referral to a specialist, and 17 (5% ) required an urgent referral. Thus, approximately 1 in 5 required specialist management of this silent, progressive disease. Discussion: 5% of the screened population required immediate referral to a specialist. This process improves access to care for patients, and increases the efficiency of the specialist's practice by assuring the patient gets the right care at the right time for the right cost.