Teleretinal Diabetic Retinopathy Screening Program Successfully Implemented

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Implementation of TDRS program reduces median time to screening from 158 to 17 days.
Implementation of TDRS program reduces median time to screening from 158 to 17 days.

HealthDay News - A primary-care-based teleretinal diabetic retinopathy screening (TDRS) program can reduce wait times for DR screening and increase overall screening rates, according to a study published in JAMA Internal Medicine.

Lauren P. Daskivich, MD, from the Department of Health Services in Los Angeles County, and colleagues conducted a pretest-posttest evaluation of exposure to primary-care-based TDRS at five of 15 safety net clinics. 

They examined annual rates of DR screening before and after implementation of the TDRS program as well as time to screening.

The researchers found that for the 21,222 patients who underwent screening, the median time to DR screening decreased significantly from 158 days before the intervention to 17 days after implementation of the program.

 There was an increase in overall annual screening rates for DR, from 40.6%of 14,633 patients before implementation to 56.9% of 13,133 patients after implementation (odds ratio, 1.9) at all 15 targeted clinics.

 Overall, 68.8%, 19.6%, and 11.6%  of those screened did not require referral to an eye care professional, were referred for DR treatment or monitoring, and were referred for other ophthalmologic conditions, respectively.

"A digital TDRS program was successfully implemented for the largest publicly operated county safety net population in the United States, resulting in the elimination of the need for more than 14 000 visits to specialty care professionals, a 16.3% increase in annual rates of screening for DR, and an 89.2% reduction in wait times for screening."

"Teleretinal DR screening programs have the potential to maximize access and efficiency in the safety net, where the need for such programs is most critical," the authors write.

Reference

Daskivich LP, Vasquez C, Martinez C, Tseng CH, Mangione CM. Implementation and evaluation of a large-scale teleretinal diabetic retinopathy screening program in the Los Angeles County Department of Health Services [published online March 27, 2017] JAMA Intern Med. doi: 10.1001/jamainternmed.2017.0204

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