Diabetic retinopathy is the leading cause of blindness among working-age adults, yet early detection and treatment can reduce vision loss by 90%. California's rural areas are some of the hardest hit by diabetes. Many poor and uninsured patients lack access to regular care and specialists. A CHCF-funded pilot project in California's Central Valley incorporated diabetic retinopathy screening into primary care visits, with results interpreted remotely by optometrists. The pilot was so successful that it expanded to reach over 80 community clinic sites across California.
The program provided clinics with digital retinal cameras, EyePACS (license-free, web-based software for capturing and delivering retinal images), and technical support by a team from the UC Berkeley School of Optometry. UC Berkeley also offered the clinics screening services by certified readers across the state. Participating clinics ranged from federally qualified health centers to public hospital clinics to Indian health centers.
In the first three years, the program screened over 53,000 patients and discovered over 4,500 cases with some level of sight-threatening retinopathy. While the grant period is coming to an end, the program is continuing to provide telehealth services for participating safety-net clinics across the state at a low cost of $15 per screen.
To hear more about the beneficial impact of diabetic retinopathy screening for patients, providers, and specialists, watch the video and see the External Links below.
Cost-Effectiveness of Store and Forward Technology
The store and forward teleophthalmology screening method has the potential both to reduce costs and to improve access to health care services. According to a May 2009 analysis by Blue Sky Consulting Group, for each patient examined for retinopathy with store and forward telemedicine, state cost savings will total nearly $2,500 over the patient's lifetime. Read the complete report, Fiscal Impact of AB 175: Analysis of the Cost Effectiveness of Store and Forward Teleophthalmology, available as a Document Download.
Independent Project Evaluation
An independent evaluation of the diabetic retinopathy screening initiative, produced by Quade & Associates in January 2011, was developed around five questions addressing the effect on health, cost effectiveness, impact on clinic operations, provider satisfaction, and reimbursement experiences. The complete evaluation is available as a Document Download.
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