Factors Associated with Utilization of Teleretinal Imaging in a Hospital-Based Primary Care Setting

Area of Science:

• Ophthalmology
• Primary Care Medicine
• Medical Technology

Background:

• Diabetic retinopathy (DR) screening is essential for preventing vision loss in diabetes mellitus (DM) patients.
• Access barriers often hinder regular DR screening adherence.
• Teleretinal imaging (TRI) offers a potential solution by enabling screening in primary care settings.

Purpose of the Study:

• To evaluate the utilization and cost-effectiveness of TRI for DR screening in an outpatient primary care clinic.
• To assess patient characteristics associated with TRI uptake.
• To determine the economic viability of TRI implementation.

Main Methods:

• Point-of-care DR screening using a non-mydriatic handheld fundus camera in a primary care setting.
• Extraction of patient demographics and clinical data from electronic medical records.
• Net present value (NPV) analysis to assess cost-effectiveness and break-even point.

Main Results:

• Patients undergoing TRI were more likely to be male, non-White, and have up-to-date monitoring (HbA1c, microalbumin, LDL).
• TRI demonstrated reduced screening costs compared to traditional in-person eye examinations.
• NPV analysis indicated a one-year break-even point for screening sites averaging two patients daily.

Conclusions:

• TRI is an effective strategy to improve DR screening adherence in primary care.
• This approach is cost-effective and economically viable for screening sites.
• TRI facilitates timely DR detection and management, potentially preventing vision loss.