|Description||Purpose: The purpose of this project is to increase the rate of screening for diabetic retinopathy in one academic primary care practice. Prior to the project, the rate of screening was 18%, which was below the benchmark for the ACO-41 metric as established by the Center of Medicaid and Medicare. Diabetic retinopathy is the leading cause of blindness in diabetics. Annual screening for the complication is an effective step in preventing blindness related to diabetes. The goal for the project was a screening rate of 29.9% or the 30th percentile for the ACO-41 metric.
Methodology: Patients without an annual eye examination within the past year were offered retinopathy screening during a routine primary care visit. The screening was completed using a non-mydriatic digital photograph machine. Appropriate referrals and follow-up examinations were based on results of the screening. This project took place between September 2018 and December 2018. The pre- and post-implementation screening rates were compared.
Results: A total sixty-nine patients were offered screening. Fifty-three (N=53) patients elected to have retinopathy screening at the point-of-care. Nine patients screened positive for diabetic retinopathy. Six of the positive results were mild/moderate non-proliferated retinopathy, one was severe non-proliferated retinopathy, and two were proliferated retinopathy. The rate of retinopathy screening increased from 18% to 28% during the 3-month implementation period.
Implications for Practice: Using a non-mydriatic digital photograph machine to screen for diabetic retinopathy is a viable option for primary care practices. Integrating this process into routine care for diabetes patients may increase screening rates, reduce proliferative eye disease and blindness, reduce the patient burden of multiple provider visits, reduce costs of care, and increase reimbursement rates from Medicaid and Medicare.||en_US