Impact of a diabetic retinal exam screening program on quality measure gaps at a family medicine practice.

Background: Diabetic retinopathy is a common complication in people with diabetes and annual screening is recommended by the American Diabetes Association. This annual exam is also a HEDIS quality measure. Barriers such as lack of access to healthcare or cost of specialist visits may impact the number of patients who receive these exams.

Objectives: The objective of this study is to describe the impact of a diabetic retinal exam screening program at a rural family medicine center on the number of quality measure gaps resolved.

Practice Description: This study occurred at a rural family medicine center in southwestern Pennsylvania with a medically underserved patient population. A pharmacist at the site holds boards certifications in Advanced Diabetes Management (BC-ADM) and as a Diabetes Care and Education Specialist (CDCES) and manages diabetes through a collaborative practice agreement.

Practice Innovation: A regional Medicaid plan provided a list of patients with a quality measure gap for an annual DRE and loaned a RetinaVue 700 Imager to take retinal photos. After screening eligible patients via phone, retinal exams were administered by student pharmacists and medical assistants to consenting patients over the course of nine days. Images were then sent to an ophthalmologist to be interpreted.

Evaluation Methods: The rate of quality measure gaps closed and satisfaction survey results are reported using descriptive statistics.

Results: A total of 61 patients were included in the analysis. This program closed quality measure gaps for 11 (18.0%) patients who were able to receive an in-office eye exam.

Conclusion: This pilot project shows that offering in-office diabetic retinal exams may be an effective strategy to close quality measure gaps and provide access to screening among a medically underserved population.