April 2014
Volume 55, Issue 13
Free
ARVO Annual Meeting Abstract  |   April 2014
Follow-up Care After Teleophthalmology Screening for Diabetic Retinopathy Through the Tele-I-CARE Program
Author Affiliations & Notes
  • Lauryn Chris
    University of Rochester, Rochester, NY
  • Vanessa Desmore
    Ophthalmology, University of Rochester, Rochester, NY
  • Gwen Sterns
    Ophthalmology, Rochester General Hospital, Rochester, NY
  • Rajeev S Ramchandran
    Ophthalmology, University of Rochester, Rochester, NY
  • Footnotes
    Commercial Relationships Lauryn Chris, None; Vanessa Desmore, None; Gwen Sterns, None; Rajeev Ramchandran, None
  • Footnotes
    Support None
Investigative Ophthalmology & Visual Science April 2014, Vol.55, 2286. doi:
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      Lauryn Chris, Vanessa Desmore, Gwen Sterns, Rajeev S Ramchandran; Follow-up Care After Teleophthalmology Screening for Diabetic Retinopathy Through the Tele-I-CARE Program. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2286.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose: To determine the compliance with scheduling recommendation for patients screened for diabetic retinopathy (DR) via telemedicine.

Methods: Three urban primary care clinics were designated as sites for the telemedicine DR screening program, Tele-I-CARE, in Rochester, NY. Patients diagnosed with diabetes without a documented eye exam were identified, recruited, and consented into the IRB-approved study. Visual acuity measurements (Snellen eye chart) and nonmydriatic digital retinal photographs (Carl Zeiss Nonmydriatic Visucam) were taken for each patient and electronically sent via a secure server to the retina specialist involved in the study. The images were diagnostically evaluated and follow-up care was advised within 1 month, in 1-2m, 3-4m, 6m, 8m, 9m, or 1 year. The follow-up plan was shared with the patient’s PCP and the chief of ophthalmology at the participating eye center to ensure adequate follow-up. The chief of ophthalmology and her staff used standard protocol (telephone/mail contact) to schedule patients. The date of scheduled follow-up for each patient was extracted from the eRecord system at the participating clinic (CareConnect) and compared to the recommended follow-up.

Results: Between February and August 2013, Tele-I-CARE screened 87 patients for DR (mean age = 57.4, 42 male, 45 female). Ophthalmic disease was found in 46% (n=40) of the study population with 66% (n=31) of this associated with DR. For follow-up care, 9.1% (n=8) of the patients were advised to be seen within 1 month, 10.3% (n=9) in 1-2m, 21.8% (n=19) in 3-4m, 10.3% (n=9) in 6m, 2.3% (n=2) in 8m, 3.4% (n=3) in 9m, and 42.5% (n=37) in 1 year. Compliance with scheduling recommendation was 50% (n=4) for within 1 month, 55.5% (n=5) for 1-2m, and 100% for 3-4m, 6m, 8m, 9m, and 1 year. All 87 patients were scheduled with 90.8% (n=79) actually scheduled during the recommended time period and 9.2% (n=8) scheduled later than advised.

Conclusions: Scheduled follow-up complied with recommended follow-up for the majority of our patients, although there were a small number of patients who were scheduled later than advised. All of the patients with delayed follow-up were recommended to be seen within 1 month or in 1-2m, indicating a more urgent need for eye evaluation and care. This is especially concerning because deferring follow-up care in these patients may be a serious threat to their vision.

Keywords: 499 diabetic retinopathy • 550 imaging/image analysis: clinical  
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