Impact of Hiring a Patient Care Navigator on Follow-Up Metrics of a Telemedicine Screening Program

Abstract

Purpose : We aim to evaluate the impact of hiring a patient care navigator on patient follow-up in the diabetic retinopathy (DR) screening program via Temple Health System. Previously, we demonstrated that the hiring of a patient care navigator significantly improved the rate of follow-up scheduling, time elapsed to scheduling and time to completing the follow-up exam. However, the increased rate of completing follow-up after the hiring of a patient care navigator was not statistically significant. In this study, with larger patient cohorts, we compared the rate of scheduling and completing follow-up in patients with referable screening diagnoses before and after the navigator.

Methods : A retrospective chart review of patients 18 years or older with diabetes who were screened for DR using digital fundus photography at primary care clinics between 03/2016 and 12/2022 was performed. Before 01/2022, patients were responsible for calling the office and scheduling their own follow-up appointments. After 01/2022, a study navigator was hired to contact all referable patients for follow-up. Follow-up outcomes were collected before and after the navigator and compared. Chi-square analyses were performed.

Results : 2014 patients were screened between 03/2016-12/2022. 380 patients in the pre-navigator phase and 610 patients in the post-navigator phase received referable diagnoses. Of the pre-navigator referable group, 68/380 (18%) patients scheduled a follow-up, and 39/380 (10%) patients completed the follow-up. Of the post-navigator referable group, 404/610 (66%) patients scheduled a follow-up (p<0.001) (Figure 1), and 261/610 (43%) patients completed the follow-up (p<0.001) (Figure 2).

Conclusions : Hiring a patient care navigator significantly improved the rate of patients scheduling and completing follow-up appointments.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.

 

Figure 1. Rate of scheduling follow-up exam pre- and post-navigator.

 

Figure 2. Rate of completing follow-up exam pre- and post-navigator.