Teleretinal Imaging Enhances Equity in Diabetic Eye Screening at Urban Community Health Clinics

Area of Science:

• Ophthalmology
• Public Health
• Health Services Research

Background:

• Diabetic eye screening is crucial for preventing vision loss in diabetic patients.
• Urban community health centers face challenges in providing consistent diabetic eye care.
• Teleretinal screening offers a potential solution to increase access to eye care services.

Purpose of the Study:

• To evaluate the impact of a teleretinal screening program on diabetic eye screening rates.
• To identify factors associated with screening receipt in an urban community health center setting.
• To assess the effect of teleophthalmology on screening equity across different demographic and insurance groups.

Main Methods:

• A retrospective, cross-sectional study was conducted comparing baseline and teleophthalmology periods (2020-2024).
• Teleretinal imaging for diabetic eye screening was implemented in two urban clinics.
• Logistic regression analysis was used to identify factors associated with screening receipt.

Main Results:

• Diabetic eye screening increased from 14.4% to 40.3% after implementing teleophthalmology (p < 0.001).
• The largest screening increases were observed among Hispanic/Latino patients (+32.1%) and uninsured patients (+33.6%).
• Teleophthalmology improved screening equity for men and uninsured patients, making them as likely to be screened as women and Medicare patients, respectively.

Conclusions:

• Teleophthalmology effectively increased diabetic eye screening rates and improved equity based on sex and insurance status.
• Strategies focusing on patient outreach, staff engagement, and resource allocation are vital for advancing telemedicine screening equity.
• The study highlights the potential of teleophthalmology to address disparities in diabetic eye care within underserved populations.