In­te­grat­ing di­a­betic eye screen­ings with pri­mary care

Modern Healthcare - - INNOVATIONS - By Erica Te­ichert

Di­a­betic retinopa­thy is the lead­ing cause of blind­ness in the U.S., and 4.5 mil­lion peo­ple suf­fer from some stage of the dis­ease.

Early de­tec­tion and treat­ment can re­duce the risk of de­vel­op­ing blind­ness by 95%, ac­cord­ing to the Na­tional In­sti­tutes of Health, which rec­om­mends di­a­bet­ics get an­nual di­lated eye ex­ams be­cause the early symp­toms aren’t oth­er­wise no­tice­able.

While many of the more than 29 mil­lion Amer­i­cans with di­a­betes du­ti­fully visit their pri­mary-care provider to man­age their illness, about half forgo yearly eye ex­ams, po­ten­tially al­low­ing ir­re­versible eye dam­age to go un­de­tected.

A com­pany called In­tel­li­gent Reti­nal Imag­ing Sys­tems, or IRIS, de­vel­oped a cloud-based plat­form and im­ageen­hance­ment tech­nol­ogy that con­nects pri­mary-care physi­cians with op­tometrists and oph­thal­mol­o­gists who can read eye exam im­ages taken dur­ing a nor­mal doc­tor visit. The com­pany’s goal is to cre­ate a work­flow that makes it easy for doc­tors to or­der and ad­min­is­ter the tests and have them an­a­lyzed.

“What we’ve found is the cur­rent process is very bur­den­some. There are a lot of oner­ous steps,” said IRIS CEO Ja­son Craw­ford. “We look at it as a com­pre­hen­sive so­lu­tion from in­take to re­im­burse­ment.”

Rather than try­ing to sell physi­cians a cam­era for the ex­ams, Pen­sacola, Fla.based IRIS fo­cuses on its tech­nol­ogy, which in­te­grates the ex­ams with elec­tronic health records and ei­ther con­nects doc­tors with eye spe­cial­ists in their area or the ex­ams are read by spe­cial­ists at an IRIS-con­tracted cen­ter. The com­pany has a con­tract with Johns Hop­kins Hos­pi­tal’s oph­thal­mol­ogy in­sti­tute for those read­ings, as well as med­i­cal director lead­er­ship.

IRIS, which is pri­vately held, in­tro­duced its tech­nol­ogy in 2011 and in 2015 re­ceived ap­proval for the plat­form from the U.S. Food and Drug Ad­min­is­tra­tion. So far, the com­pany has scored clients in 26 states and busi­ness is boom­ing thanks in part to the CMS’ fo­cus on qual­ity mea­sures for physi­cians. As doc­tors be­come ac­count­able for their pa­tients’ over­all care, it be­comes more im­por­tant to make sure they are tak­ing ad­van­tage of pre­ven- tive health tests like eye ex­ams.

“Now we’re giv­ing them the abil­ity to do it,” Craw­ford said. “That’s re­ally driv­ing adop­tion.”

And providers are see­ing tan­gi­ble re­sults from mak­ing eye ex­ams more ac­ces­si­ble. The CoxHealth sys­tem based in Spring­field, Mo., started us­ing IRIS’ tech­nol­ogy in 15 of its 80 of­fices in mid-June, and it has di­ag­nosed 291 pa­tients with di­a­betic retinopa­thy so far. Be­fore CoxHealth in­tro­duced eye ex­ams into its pri­mary-care vis­its, only 32% to 38% of its di­a­betic pa­tients were go­ing to spe­cial­ists to get the test.

“There’s a rea­son Medi­care and in­sur­ance com­pa­nies are plac­ing a pre­mium on this,” said Dr. Mark Cost­ley, med­i­cal director for CoxHealth’s re­gional ser­vices. “If you can catch (di­a­betic retinopa­thy) at low lev­els and get con­trol of the di­a­betes, you can pre­vent re­ally ex­pen­sive treat­ment that comes with se­vere dis­ease.”

The tests have also un­cov­ered other is­sues in di­a­betic pa­tients, in­clud­ing cataracts, mac­u­lar edema, mac­u­lar de­gen­er­a­tion and even strokes in the eye. CoxHealth is plan­ning to ex­pand use of the tests in its clinic and out­pa­tient set­tings.

Brock Shamel, CoxHealth’s ad­min­is­tra­tive director of re­gional ser­vices, said it’s par­tic­u­larly re­ward­ing to see the buy-in and re­sults of the tech­nol­ogy from pa­tients and physi­cians. “A lot of times we send pa­tients away with a plan, and we don’t get to see the re­sults of it,” Shamel said. “You get to see the re­sults of this. That’s a pow­er­ful thing when it comes to pro­vid­ing health­care.”

Now, Craw­ford and IRIS are con­tin­u­ing to work with pay­ers and states to break down bar­ri­ers and make eye ex­ams more ac­ces­si­ble in pri­mary care, with the sup­port of groups such as the Amer­i­can Academy of Oph­thal­mol­ogy and Amer­i­can Di­a­betes As­so­ci­a­tion.

Craw­ford said he finds joy in pro­vid­ing pa­tients with ac­cess to care at the right time be­cause pru­dent med­i­cal care saved his life in 2003 when he was in­jured in com­bat in Iraq while serv­ing in the U.S. Army.

“At the end of the day for us, how many di­a­betic pa­tients were we able to ex­am­ine this week and how many of them have sight-threat­en­ing dis­ease?” he said. “Those are the met­rics that gauge our suc­cess.”

Newspapers in English

Newspapers from USA

© PressReader. All rights reserved.