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I. E. Zimmer-Galler, R. Zeimer, K. Quinn; Impact of an Internet-Based Diabetic Retinopathy Assessment Program on Diabetic Retinopathy Surveillance Rates in a Primary Care Setting. Invest. Ophthalmol. Vis. Sci. 2007;48(13):172.
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To assess the impact of an Internet-based diabetic retinopathy assessment program on overall surveillance rates for diabetic retinopathy in patients with diabetes in a primary care practice.
A semi-automated Internet-based telemedicine diabetic retinopathy assessment system, the DigiScope, was implemented in a primary care practice. Noncompliant patients with diabetes who had not undergone an eye examination in the previous 12 months were imaged with the DigiScope. The images were remotely reviewed to determine whether referral to an ophthalmologist was recommended. Rates of evaluation for diabetic retinopathy by an ophthalmic examination were assessed in the 12 months prior to implementation of the system. Rates of evaluation for detection of diabetic retinopathy, by either an ophthalmic examination or by DigiScope imaging, were again assessed in the 11 months after implementation of the system.
The rate of eye examinations for diabetic retinopathy in a primary care practice was 34% (429 examinations out of 1,256 patients with diabetes) in the 12 months prior to implementation of the diabetic retinopathy assessment system. The rate of eye evaluations for diabetic retinopathy improved to 71% (988 evaluations out of 1,397 patients with diabetes) in eleven months after implementation of the diabetic retinopathy assessment system. This included 357 patients imaged with the telemedicine system. Both the overall surveillance rate and the rate of an examination by an ophthalmologist increased after implementation of the diabetic retinopathy assessment program.
Use of a telemedicine diabetic retinopathy assessment service appears to be an effective method to improve the overall retinopathy surveillance rate of patients with diabetes in the primary care setting. The improvement in the surveillance rate may be a result of both the direct presence of the assessment system and the indirect impact the system had on raising awareness, among patients and providers, of the importance of an annual eye examination in patients with diabetes.
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