Utilization of Remote Diabetic Retinal Screening in a Suburban Healthcare System

Kristen H Kuo,1,2 Sidrah Anjum,1 Brian Nguyen,1,3,4 Jeffrey L Marx,1,2 Shiyoung Roh,1,2 David J Ramsey1,2 1Department of Ophthalmology, Lahey Hospital & Medical Center, Peabody, MA, USA; 2Department of Ophthalmology, Tufts University School of Medicine, Boston, MA, USA; 3Tufts University School...

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Autores principales:	Kuo KH, Anjum S, Nguyen B, Marx JL, Roh S, Ramsey DJ
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	telemedicine tele-ophthalmology diabetes diabetic retinopathy screening non-mydriatic fundus photography Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/ed89d978345340c9a8d06e5412c5d3df
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spelling	oai:doaj.org-article:ed89d978345340c9a8d06e5412c5d3df2021-12-02T17:44:34ZUtilization of Remote Diabetic Retinal Screening in a Suburban Healthcare System1177-5483https://doaj.org/article/ed89d978345340c9a8d06e5412c5d3df2021-09-01T00:00:00Zhttps://www.dovepress.com/utilization-of-remote-diabetic-retinal-screening-in-a-suburban-healthc-peer-reviewed-fulltext-article-OPTHhttps://doaj.org/toc/1177-5483Kristen H Kuo,1,2 Sidrah Anjum,1 Brian Nguyen,1,3,4 Jeffrey L Marx,1,2 Shiyoung Roh,1,2 David J Ramsey1,2 1Department of Ophthalmology, Lahey Hospital & Medical Center, Peabody, MA, USA; 2Department of Ophthalmology, Tufts University School of Medicine, Boston, MA, USA; 3Tufts University School of Dental Medicine, Boston, MA, USA; 4Heller School for Social Policy and Management, Brandeis University, Waltham, MA, USACorrespondence: David J RamseyDepartment of Ophthalmology, Lahey Hospital & Medical Center, Beth Israel Lahey Health, 1 Essex Center Drive, Peabody, MA, 01960, USAEmail David.J.Ramsey@lahey.orgPurpose: We conducted a cross-sectional study to assess the utilization of a tele-ophthalmology screening program in a low-risk, suburban population of patients with diabetes.Methods: A total of 214 diabetic patients without previously documented diabetic retinopathy (DR) underwent point-of-care non-mydriatic fundus photography through their primary care providers at five Beth Israel Lahey Health locations. The characteristics of the patients who received remote screening were compared with those patients who were eligible for screening but did not take part in the program. Time-driven activity-based costing (TDABC) was implemented to examine the cost of screening by tele-ophthalmology compared with in-person examinations.Results: Tele-ophthalmology screening was more likely to be provided for patients who were younger (OR 0.985; 95% CI 0.973– 0.997, p=0.016), who were obese (OR 2.04; 95% CI: 1.47– 2.84, p=0.008), who had an HbA1c above 8.0% (OR 1.60; 95% CI: 1.13– 2.26, p=0.031), or who had an eye examination in the past year (OR 5.55; 95% CI: 3.89– 7.92, p< 0.001). Those patients newly diagnosed with DR because of the program were more likely to have diabetic nephropathy (OR 7.79; 95% CI: 1.73– 35.05, p=0.007). TDABC identified a health system cost-savings of between $8 and $29 per patient screened by tele-ophthalmology compared with the cost of in-person eye examinations.Conclusion: Tele-ophthalmology presents an opportunity to reduce the costs of screening patients without prior evidence of DR, especially those who have completed a comprehensive eye examination within the prior year.Keywords: telemedicine, tele-ophthalmology, diabetes, diabetic retinopathy, screening, non-mydriatic fundus photographyKuo KHAnjum SNguyen BMarx JLRoh SRamsey DJDove Medical Pressarticletelemedicinetele-ophthalmologydiabetesdiabetic retinopathyscreeningnon-mydriatic fundus photographyOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 15, Pp 3865-3875 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	telemedicine tele-ophthalmology diabetes diabetic retinopathy screening non-mydriatic fundus photography Ophthalmology RE1-994
spellingShingle	telemedicine tele-ophthalmology diabetes diabetic retinopathy screening non-mydriatic fundus photography Ophthalmology RE1-994 Kuo KH Anjum S Nguyen B Marx JL Roh S Ramsey DJ Utilization of Remote Diabetic Retinal Screening in a Suburban Healthcare System
description	Kristen H Kuo,1,2 Sidrah Anjum,1 Brian Nguyen,1,3,4 Jeffrey L Marx,1,2 Shiyoung Roh,1,2 David J Ramsey1,2 1Department of Ophthalmology, Lahey Hospital & Medical Center, Peabody, MA, USA; 2Department of Ophthalmology, Tufts University School of Medicine, Boston, MA, USA; 3Tufts University School of Dental Medicine, Boston, MA, USA; 4Heller School for Social Policy and Management, Brandeis University, Waltham, MA, USACorrespondence: David J RamseyDepartment of Ophthalmology, Lahey Hospital & Medical Center, Beth Israel Lahey Health, 1 Essex Center Drive, Peabody, MA, 01960, USAEmail David.J.Ramsey@lahey.orgPurpose: We conducted a cross-sectional study to assess the utilization of a tele-ophthalmology screening program in a low-risk, suburban population of patients with diabetes.Methods: A total of 214 diabetic patients without previously documented diabetic retinopathy (DR) underwent point-of-care non-mydriatic fundus photography through their primary care providers at five Beth Israel Lahey Health locations. The characteristics of the patients who received remote screening were compared with those patients who were eligible for screening but did not take part in the program. Time-driven activity-based costing (TDABC) was implemented to examine the cost of screening by tele-ophthalmology compared with in-person examinations.Results: Tele-ophthalmology screening was more likely to be provided for patients who were younger (OR 0.985; 95% CI 0.973– 0.997, p=0.016), who were obese (OR 2.04; 95% CI: 1.47– 2.84, p=0.008), who had an HbA1c above 8.0% (OR 1.60; 95% CI: 1.13– 2.26, p=0.031), or who had an eye examination in the past year (OR 5.55; 95% CI: 3.89– 7.92, p< 0.001). Those patients newly diagnosed with DR because of the program were more likely to have diabetic nephropathy (OR 7.79; 95% CI: 1.73– 35.05, p=0.007). TDABC identified a health system cost-savings of between $8 and $29 per patient screened by tele-ophthalmology compared with the cost of in-person eye examinations.Conclusion: Tele-ophthalmology presents an opportunity to reduce the costs of screening patients without prior evidence of DR, especially those who have completed a comprehensive eye examination within the prior year.Keywords: telemedicine, tele-ophthalmology, diabetes, diabetic retinopathy, screening, non-mydriatic fundus photography
format	article
author	Kuo KH Anjum S Nguyen B Marx JL Roh S Ramsey DJ
author_facet	Kuo KH Anjum S Nguyen B Marx JL Roh S Ramsey DJ
author_sort	Kuo KH
title	Utilization of Remote Diabetic Retinal Screening in a Suburban Healthcare System
title_short	Utilization of Remote Diabetic Retinal Screening in a Suburban Healthcare System
title_full	Utilization of Remote Diabetic Retinal Screening in a Suburban Healthcare System
title_fullStr	Utilization of Remote Diabetic Retinal Screening in a Suburban Healthcare System
title_full_unstemmed	Utilization of Remote Diabetic Retinal Screening in a Suburban Healthcare System
title_sort	utilization of remote diabetic retinal screening in a suburban healthcare system
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/ed89d978345340c9a8d06e5412c5d3df
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Utilization of Remote Diabetic Retinal Screening in a Suburban Healthcare System

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