June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Engagement of Patients with Diabetic Retinopathy by Telehealth Extenders Improves Follow Up
Author Affiliations & Notes
  • Rachel Munzar
    Tufts University School of Medicine, Boston, Massachusetts, United States
    Lahey Hospital and Medical Center, Burlington, Massachusetts, United States
  • Claudia Lasalle
    Tufts University School of Medicine, Boston, Massachusetts, United States
    Lahey Hospital and Medical Center, Burlington, Massachusetts, United States
  • Shiyoung Roh
    Tufts University School of Medicine, Boston, Massachusetts, United States
    Lahey Hospital and Medical Center, Burlington, Massachusetts, United States
  • David J Ramsey
    Tufts University School of Medicine, Boston, Massachusetts, United States
    Lahey Hospital and Medical Center, Burlington, Massachusetts, United States
  • Footnotes
    Commercial Relationships   Rachel Munzar None; Claudia Lasalle None; Shiyoung Roh None; David Ramsey None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 1153. doi:
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    • Get Citation

      Rachel Munzar, Claudia Lasalle, Shiyoung Roh, David J Ramsey; Engagement of Patients with Diabetic Retinopathy by Telehealth Extenders Improves Follow Up. Invest. Ophthalmol. Vis. Sci. 2022;63(7):1153.

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

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Abstract

Purpose : To determine the effectiveness of telehealth (TH) services delivered by a health extender in promoting patients with diabetic retinopathy (DR) who are overdue for care to schedule and/or return for in-clinic eye examinations.

Methods : Established patients with DR who had not been seen within the last year were identified by a retrospective review of the EMR using a reporting tool. Patients who had not returned for follow-up care were contacted by phone by a TH extender. Each patient was offered screening for acute eye problems by means of a symptom-based screening script. Those patients who raised concerns about vision-related issues were offered transfer to a physician for triage. Finally, patients were offered assistance in scheduling an in-person clinic visit.

Results : 159 patients with DR potentially overdue for care were contacted by phone. 43% of calls reached patients; 52% of calls went to patient voicemail (VM) where instructions were left for appointment-booking; 5.0% of patients were unreachable, and 2.9% of patients contacted were identified to be deceased. Of the 67 patients reached by phone, 39% reported that they had transferred/declined further care. Of the remaining 41 patients, 77% agreed to take the symptom survey, and out of those 91% went on to book a booked an appointment, including one patient who required transfer to physician triage and was brought into the clinic the next day for management of proliferative retinopathy. By contrast, the 3 patients who chose not to book an appointment after the symptom survey all reported no symptoms. A further 3 patients scheduled despite declining the symptom survey. Finally, 5 patients (12%) requested to be called back later and 3 patients (7.3%) to call back themselves. In total, 27% of patients contacted through the program ultimately booked an appointment, including 12% who were left a VM and 1 patient who was called back by a scheduler. This rate of appointment booking was more than twice that of a larger cohort of patients who were overdue for care but not engaged by the program (27% vs. 11%, X2=9.561; P=0.002).

Conclusions : Nearly one-third of patients with DR identified as being overdue for eye care and contacted by a TH extender made follow-up appointments. This study adds to the growing body of research that TH, even when delivered by a non-provider, can help improve the rate at which patients with DR access eye care.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

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