Diabetic patients should be screened annually for diabetic retinopathy
There are no early symptoms of diabetic retinopathy (DR), an eye condition that can cause vision loss and blindness in people with diabetes. It’s the most common cause of new cases of blindness in working-age U.S. adults aged 20 to 74, leading to up to 24,000 new cases each year.1
DR affects 7.7 million Americans, and that number is projected to increase to more than 14.6 million people by 2030.2 That’s why it’s so important for diabetic patients to get a comprehensive diabetic retinal exam at least once a year because anyone with any type of diabetes is at risk of developing DR. Finding DR early can help these patients protect their vision.
DR causes retinal tissue to swell, resulting in blurry vision, floating spots in vision and blindness. But symptoms like these don’t occur until DR is in an advanced state. In later stages of the disease, blood vessels in the retina start to bleed into the vitreous – the gel-like fluid that fills the eye – and it’s important to get treatment right away.
“What’s scary is that up to 80% of patients living with diabetes will eventually develop some stage of diabetic retinopathy in their lifetime3,” said John Prior, Senior Marketing Manager for Vision Screening & Diagnostics
and the Welch Allyn® RetinaVue® 700 Imager from Hillrom (now part of Baxter International). “Patients with diabetes should be examined for complications on an annual basis, but only 20%-to-50% of patients comply.4,5,6,7 It’s a serious problem.”
But there is a silver lining. Vision loss from DR is 95% preventable with early diagnosis and treatment.8
More access in primary care
The RetinaVue 700 Imager offers an easy-to-use retina imaging experience, featuring auto-alignment, auto-focus and auto-capture. It’s the latest addition to the RetinaVue care delivery model family and it helps make retinal exams simple and affordable in primary care.
“A paradigm shift is needed to increase access to the DR exam for patients living with diabetes,” Prior said. “Our goal is to increase access to DR exams wherever patients choose to obtain their healthcare.”
The RetinaVue care delivery model is a turnkey solution that consists of three core components, including:
- Welch Allyn® RetinaVue® 700 Imager
- Welch Allyn® RetinaVue® Network Software to securely transmit patient images
- Interpretation by board-certified ophthalmologists and retina specialists through RetinaVue,® P.C.
The RetinaVue 700 Imager’s camera features a 60-degree wide field of view with 2.5 mm small pupil capability (see instructions for use) that requires little to no chemical dilation. It meets ISO 10940 optical standard for ophthalmic instruments. Its small, handheld design is perfect for performing retinal exams in clinics and mobile healthcare applications. Its RetinaVue Network award-winning, HIPAA-compliant software is hosted on the Microsoft® Azure™ cloud.
“When a primary care provider purchases the RetinaVue care delivery model, we provide the services necessary for retinal image interpretation by a team of state-licensed, board-certified ophthalmologists and retinal specialists that can cover every state in the U.S.,” Prior said.
Primary care providers can place retinal exam orders and automatically access diagnostic reports from their EMR. The RetinaVue care delivery model offers wireless connectivity and fully integrated, bi-directional interfaces with over 100 EMR partners including Allscripts®, athenahealth®, Cerner®, Epic®, NextGen® and others to help streamline procedures.
Providers in the growing mobile healthcare space are using the RetinaVue care delivery model to reach patients who are homebound or receive their care in non-traditional settings. And federally qualified health centers, which can represent the first line of defense against health issues that patients face today, are another example where the RetinaVue care delivery model can help improve chronic care management.
“Imagine tomorrow where DR is no longer the leading cause of adult blindness,” Prior said. “We have the power to eradicate diabetic retinopathy as the leading cause of blindness.”
1 CDC: Cost-effectiveness model for Diabetic Retinopathy
2 NIH: People With Diabetes Can Prevent Vision Loss
3 American Academy of Ophthalmology Retina/Vitreous Panel. Preferred Practice Pattern® Guidelines Diabetic Retinopathy, San Francisco, CA. American Academy of Ophthalmology, 2017. www.aao.org/ppp. Accessed Oct. 15, 2019
4 Sloan FA, Brown DS, Carlisle ES, et al. Health Serv Res. 2004; 39(5):1429–1448.
5 Lehigh Valley Health Network. http://scholarlyworks.lvhn.org/cgi/viewcontent.cgi?article=1036&context=select-program. Accessed March 1, 2016.
6 Lee DJ, Kumar N, Feuer WJ, et al. BMJ Open Diabetes Res Care. 2014;2(1):e000031.
7 Rajput Y, Fisher M, Gu T, et al. IOVS. 2015; 56(7):1440.
8 National Eye Institute. People With Diabetes Can Prevent Vision Loss. https://www.nei.nih.gov/learn-about-eye-health/resources-for-health-educators/outreach-materials/people-diabetes-can-prevent-vision-loss. Accessed November 11, 2020.
9 Commercial Coverage Policy data on file. Welch Allyn; 2019.
10 Medicare Program; CY 2021 Payment Policies under the Physician Fee Schedule Proposed Rule [CMS-1734-P], 08/17/2020, https://s3.amazonaws.com/public-inspection.federalregister.gov/2020-17127.pdf
11 Mansberger SL, Gleitsmann K, Gardiner S, Sheppler C, Demirel S, Wooten K, Becker TM; Comparing the Effectiveness of Telemedicine and Traditional Surveillance in Providing Diabetic Retinopathy Screening Examinations: A Randomized Controlled Trial. Telemedicine and e-Health. December 2013, 19(12): 942-948. doi:10.1089/tmj.2012.0313.
12 Enabling diabetic retinal exams at the point of care: A strategy that works for patients and providers, Summit Medical Group case study, Welch Allyn, Inc., 2019
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Sidebar:
“There’s a growing demand for solutions like the RetinaVue care delivery model that can help primary care organizations improve clinical and financial outcomes,” Prior said.
“Most healthcare plans provide coverage for diabetic retinal exams in primary healthcare settings,9” he said. “And as of Jan. 1, 2021, Medicare covers with CPT code 92228, which wasn’t offered before that date.10 That’s great news for providers on the reimbursement front for this important exam.”
“Also, the NCQA [National Committee for Quality Assurance], a HEDIS® quality measure for annual diabetic retinal exams, [NQF [National Quality Forum] #0055 and that’s included in Medicare Advantage Star Ratings as well as CMS Quality Payment Program measures. So, intercepting patients during routine primary care office visits can help our providers achieve up to 90% (5-Star level) documented compliance in 12 months11,12 potentially qualifying them for financial incentives under those programs,” Prior concluded.
Customers using the RetinaVue care delivery model are typically organizations that deliver primary care services for patients living with diabetes and have a need to close their care gaps for the diabetic retinal exam and improve patient outcomes and quality metrics like HEDIS. These organizations range from large IDNs, mobile clinics, retail clinics, nursing homes and small, internal medicine groups.