Barriers to Implementation of Teleretinal Diabetic Retinal Screening in a Private Practice Setting

According to a new study, implementing teleretinal diabetic retinal screening (TDRS) as an adjunct tool in a private practice can significantly improve diabetic eye care screening rates. The findings were presented by Ramanath Bhandari, MD, at the 37^th ASRS Annual Meeting.

While diabetic screening stands as a cost-effective intervention when compared to the both the social and economic cost of going blind, adherence rates for retinal screening in the US remains low, with most states ranging from 35-60%. As quality billing along with merit-based incentive payment systems have become normalized, it is integral to rectify the problem of having low screening rates, from both a patient and pay for performance perspective. The researchers of this study sought to evaluate a private practice administering DR screening both increase compliance while assessing potential screening barriers.

In this retrospective single-center pre-intervention post-intervention longitudinal study, researchers evaluated 5,058 patients at a private endocrinology practice. All eligible patients in this study were 18 years or older with a diagnosis of diabetes among five endocrinology providers at a large, multispecialty private practice. Active patients were defined as having at least one recorded visit in both 2016 and 2017, and 152 patients were excluded because they did not meet that criteria. Using TDRS as the study’s primary intervention, diabetic screening compliance rates were compared between December 31, 2016 and December 31, 2017.

Retinal screening compliance improved from 41.9% of patients (n=2,098) pre-intervention to 45.9% of patients (n=2,326) post intervention. The McNemar test was implemented for statistical analysis and found the change clinically significant (P<0.001). However, this post intervention rate was still well below previous findings observed in academic centers and community practices.

“Adjunct TDRS can TDRS can increase access to recommended diabetic eye care,” the study authors wrote in abstract. “However, barriers to implementation exist focused on coding and reimbursement within the U.S. healthcare system in a private practice setting where productivity and compensation are linked.”

Echegaray J. Chorioretinal Vascular Side Effects of Intra-Aterial Chemotherapy for Retinoblastoma. Presented at the 37^th ASRS Annual Meeting; July 26-30, 2019; Chicago, IL.

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