11
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Assessment of Annual Diabetic Eye Examination Using Telemedicine Technology Among Underserved Patients in Primary Care Setting

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          CONTEXT:

          Digital retinal imaging with the application of telemedicine technology shows promising results for screening of diabetic retinopathy in the primary care setting without requiring an ophthalmologist on site.

          AIMS:

          We assessed whether the establishment of telemedicine technology was an effective and efficient way to increase completion of annual eye examinations among underserved, low-income (Medicaid) diabetic patients.

          SETTINGS AND DESIGN:

          A cross-sectional study in a primary care setting.

          SUBJECTS AND METHODS:

          Health care claims data were collected before the establishment of telemedicine technology in 2010 and after its implementation in 2012 for Medicaid patients at East Baltimore Medical Center (EBMC), an urban health center that is part of Johns Hopkins Health System.

          STATISTICAL ANALYSIS USED:

          The primary outcome measure was the compliance rate of patients with diabetic eye examinations; calculated as the number of diabetic patients with a completed telemedicine eye examination, divided by the total number of diabetic patients.

          RESULTS:

          In 2010, EBMC treated 213 Medicaid diabetic patients and in 2012 treated 228 Medicaid patients. In 2010, 47.89% of patients completed their annual diabetic eye examination while in 2012 it was 78.07% ( P < 0.001). After adjustment for age, gender, HgBA1C, disease severity, using resource utilization band score as a proxy, and medication possession ratio; telemedicine technology significantly increased the compliance (odds ratio: 4.98, P < 0.001).

          CONCLUSIONS:

          Adherence to annual eye examinations is low in the studied Medicaid diabetic population. Telemedicine technology in a primary care setting can increase compliance with annual eye examinations.

          Related collections

          Most cited references18

          • Record: found
          • Abstract: found
          • Article: not found

          Global data on visual impairment in the year 2002.

          This paper presents estimates of the prevalence of visual impairment and its causes in 2002, based on the best available evidence derived from recent studies. Estimates were determined from data on low vision and blindness as defined in the International statistical classification of diseases, injuries and causes of death, 10th revision. The number of people with visual impairment worldwide in 2002 was in excess of 161 million, of whom about 37 million were blind. The burden of visual impairment is not distributed uniformly throughout the world: the least developed regions carry the largest share. Visual impairment is also unequally distributed across age groups, being largely confined to adults 50 years of age and older. A distribution imbalance is also found with regard to gender throughout the world: females have a significantly higher risk of having visual impairment than males. Notwithstanding the progress in surgical intervention that has been made in many countries over the last few decades, cataract remains the leading cause of visual impairment in all regions of the world, except in the most developed countries. Other major causes of visual impairment are, in order of importance, glaucoma, age-related macular degeneration, diabetic retinopathy and trachoma.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Grading and disease management in national screening for diabetic retinopathy in England and Wales.

            A National Screening Programme for diabetic eye disease in the UK is in development. We propose a grading and early disease management protocol to detect sight-threatening diabetic retinopathy and any retinopathy, which will allow precise quality assurance at all steps while minimizing false-positive referral to the hospital eye service. Expert panel structured discussions between 2000 and 2002 with review of existing evidence and grading classifications. Principles of the protocol include: separate grading of retinopathy and maculopathy, minimum number of steps, compatible with central monitoring, expandable for established more complex systems and for research, no lesion counting, no 'questionable' lesions, attempt to detect focal exudative, diffuse and ischaemic maculopathy and fast track referral from primary or secondary graders. Sight-threatening diabetic retinopathy is defined as: preproliferative retinopathy or worse, sight-threatening maculopathy and/or the presence of photocoagulation. In the centrally reported minimum data set retinopathy is graded into four levels: none (R0), background (R1), preproliferative (R2), proliferative (R3). Maculopathy and photocoagulation are graded as absent (M0, P0) or present (M1, P1). The protocol developed by the Diabetic Retinopathy Grading and Disease Management Working Party represents a new consensus upon which national guidelines can be based leading to the introduction of quality-assured screening for people with diabetes.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Evaluation of telemedicine for screening of diabetic retinopathy in the Veterans Health Administration.

              To explore the cost-effectiveness of telemedicine for the screening of diabetic retinopathy (DR) and identify changes within the demographics of a patient population after telemedicine implementation.
                Bookmark

                Author and article information

                Journal
                Middle East Afr J Ophthalmol
                Middle East Afr J Ophthalmol
                MEAJO
                Middle East African Journal of Ophthalmology
                Medknow Publications & Media Pvt Ltd (India )
                0974-9233
                0975-1599
                Oct-Dec 2017
                : 24
                : 4
                : 207-212
                Affiliations
                [1] Center for Population Health IT, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
                [1 ] Employee Health and Wellness, LifeBridge Health, Baltimore, Maryland, USA
                [2 ] Maryland Physician Care, Linthicum, Maryland, USA
                [3 ] Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medical Institute, Baltimore, Maryland, USA
                [4 ] Chief of Internal Medicine, Johns Hopkins Community Physicians, Odenton, Maryland, USA
                Author notes
                Address for correspondence: Dr. Elham Hatef, Center for Population Health IT, Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA. E-mail: ehatef1@ 123456jhu.edu
                Article
                MEAJO-24-207
                10.4103/meajo.MEAJO_19_16
                5793453
                713fd4a9-421e-490f-b742-a67b649a7742
                Copyright: © 2018 Middle East African Journal of Ophthalmology

                This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

                History
                Categories
                Original Article

                Ophthalmology & Optometry
                diabetic eye examination,medicaid patients,telemedicine technology

                Comments

                Comment on this article