311913
Utilization ofTeleophthalmology Enabled Primary Care Based Surveillance for Diabetic Eye Disease in Neighborhood and Hospital Based FQHCs
Methods: Prospective, Observational Cross Sectional Study. Screening for vision and retinopathy was performed by a medical office assistant and a lay health project coordinator using a Zeiss NM pro non-mydriatic retinal camera at one neighborhood family practice clinic (CFH) and 2 hospital based medical clinics (OPD and Twig Clinics) between August 2013 and January 2014.
Results: 211 diabetic patients were screened. Baseline annual eye exam rates for diabetic patients were 38% and 20% respectively at CFH and at both OPD and Twig and increased to 60-70% at each of the clinics after implementing the screening program. Forty percent of patients had vision impairment, (<20/40). Sixty-eight percent had no significant retinal findings, 22% had non vision threatening diabetic retinopathy, and 4% had vision threatening retinopathy. Thirty percent of patients did not show to their scheduled screening session. Undocumented eye exams occurred seven times more frequently at the hospital based clinics than at the neighborhood clinic.
Conclusions: Primary care based vision screening and education using non-mydriatic retinal cameras can substantially increase rates of annual screening for retinopathy among underserved patients with diabetes relatively equally at both neighborhood and hospital based ambulatory settings. Although the prevalence of vision threatening retinopathy was minimal, a sizable portion of diabetic patients have impaired vision.
Learning Areas:
Administer health education strategies, interventions and programsChronic disease management and prevention
Clinical medicine applied in public health
Implementation of health education strategies, interventions and programs
Provision of health care to the public
Learning Objectives:
Compare the utilization and level of ocular impairment between a community and hospital based federally qualified health clinic for diabetic patients enrolled in a teleophthalmology enabled primary care based diabetic eye disease surveillance and education program
Keyword(s): Vision Care, Diabetes
Qualified on the content I am responsible for because: I am a practicing vireoretinal surgeon with expertise in diabetic eye disease. I am funded by the Greater Rochester Health Foundation to conduct a feasibility study for implementing teleophthalmology as part of a diabetic retinopathy detection and treatment program in primary care clinics that target disadvantaged populations in inner city Rochester, NY. Among my scientific interests is to implement and evaluate new eye care delivery models to improve population eye health.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.