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Utilization of Remote Diabetic Retinal Screening in a Suburban Healthcare System
Kristen H Kuo1,2, Sidrah Anjum1, Brian Nguyen1,3,4
1Department of Ophthalmology, Lahey Hospital & Medical Center, Peabody, MA, USA.
Clinical Ophthalmology (Auckland, N.Z.)
|September 29, 2021
Summary
Tele-ophthalmology screening effectively identifies diabetic retinopathy (DR) in diabetic patients, offering significant cost savings. This remote screening method is particularly beneficial for patients who have had recent eye exams, improving access to care.
Area of Science:
- Ophthalmology
- Diabetology
- Health Services Research
Background:
- Diabetic retinopathy (DR) is a leading cause of vision loss in diabetic patients.
- Regular screening is crucial for early detection and management of DR.
- Tele-ophthalmology offers a potential solution for improving screening accessibility and efficiency.
Purpose of the Study:
- To evaluate the utilization of a tele-ophthalmology screening program for diabetic patients in a low-risk, suburban population.
- To compare the characteristics of patients who participated in tele-ophthalmology screening versus those who did not.
- To analyze the cost-effectiveness of tele-ophthalmology screening compared to traditional in-person eye examinations.
Main Methods:
- A cross-sectional study involving 214 diabetic patients without prior DR diagnosis.
- Point-of-care non-mydriatic fundus photography utilized through primary care providers.
- Comparison of patient demographics and clinical factors between screened and eligible non-screened groups.
- Time-driven activity-based costing (TDABC) applied for cost analysis.
Main Results:
- Tele-ophthalmology screening was more common in younger, obese patients with HbA1c > 8.0%, and those with recent eye exams.
- Newly diagnosed DR was associated with a higher likelihood of diabetic nephropathy.
- Tele-ophthalmology screening resulted in cost savings of $8-$29 per patient compared to in-person exams.
Conclusions:
- Tele-ophthalmology is a viable and cost-effective method for screening diabetic patients for DR, particularly those without prior evidence of the condition.
- The program shows promise in reducing healthcare costs associated with DR screening.
- Further implementation could enhance screening rates and early detection, especially in populations with recent eye examination history.
