Can You Take the Long View?

Sponsored: Welch Allyn

Primary care doctors can do a lot to preserve the health of their patients with diabetes. Supply chain executives can give them the tools to do so.

Today, healthcare executives must take a “long view” of patient care – one that extends outside the hospital, into the community. The reason is, preventive care contributes to improved health and lower costs for individuals and providers alike.

Given supply chain’s growing responsibilities in non-acute sites of care, you have an opportunity to help your providers take that long view. A good place to start is diabetes management.

Vision loss
“Diabetes is an epidemic,”1 says Edward Chaum, M.D., Ph.D., Margy Ann and J. Donald M. Gass Chair Professor of Ophthalmology, Vanderbilt Eye Institute. Twenty-nine million Americans have it, with 1.7 million new cases per year.2 Absent good preventive care, it is estimated that 80 percent of patients living with diabetes will eventually develop diabetic retinopathy,3 or DR.

The retina detects light and converts it to signals sent through the optic nerve to the brain. Chronically high blood sugar from diabetes is associated with damage to the tiny blood vessels in the retina. Those blood vessels can leak fluid or hemorrhage, distorting vision. In its most advanced stage, new abnormal blood vessels proliferate on the surface of the retina, which can lead to scarring and cell loss in the retina. Severe visual impairment and blindness can result.

To prevent DR from progressing to that point, primary care physicians typically refer patients with diabetes to an eye care specialist for an annual retinal exam. But, half of those patients fail to follow through with the specialist exam.4 They may not comprehend its importance. Geographic and socioeconomic challenges can also prevent patients from complying with referrals.

“Unfortunately, many cases of diabetic retinopathy are advanced by the time I see them,”1 says Chaum, who serves as consulting Chief Medical Officer for the Welch Allyn® RetinaVue® care delivery model.

Early detection in primary care is critical
It doesn’t have to be that way. Ninety-five percent of vision loss due to DR can be prevented with early detection.5 Patients can be successfully managed with close observation and good control of blood glucose, blood pressure and lipids.

And what better place to provide that detection than the primary care practice? A recent survey of 3,200 adults with diabetes showed that nearly 88 percent visited a primary care physician within 12 months.6

The Welch Allyn RetinaVue care delivery model is designed specifically for primary healthcare settings. It includes three main components:

  • Retinal cameras designed to obtain high-quality retinal images in less than five minutes and do not require dilation.
  • HIPAA-compliant, FDA-cleared, RetinaVue Network Software, which transmits encrypted retinal images to the preferred eye specialist or ophthalmologists and retina specialists at RetinaVue, P.C. Includes comprehensive population health management and quality reporting tools to effectively manage retinal exam data and integrates with all of the leading electronic medical records systems.
  • Board-certified, state-licensed ophthalmologists and retina specialists who interpret retinal images and prepare a comprehensive diagnostic report and referral/care plan generally in one business day. Alternatively, the referring providers can transmit the retinal images to the health system’s preferred eye specialist.

As of this month, Welch Allyn is excited to announce the launch of the all new Welch Allyn RetinaVue® 700 Imager from Hillrom, the world’s most advanced handheld retinal camera. Developed from the ground up with data security in mind, and part of a HIPAA-compliant solution to help ensure patient’s health information is protected.

The Welch Allyn RetinaVue 700 Imager is the first and only automated handheld camera, allowing clinicians to capture high-quality images right out of the box, without dedicated training.

Clinicians can conduct fast, comfortable exams using the RetinaVue 700 Imager’s 2.5mm small-pupil capability.

For the first time, a full 60-degree wide field of view, up to 75% larger capture area than other leading cameras, helps clinicians see more pathology in a single image.

An economic story to tell
Most commercial healthcare plans provide coverage for diabetic retinal exams in primary care settings using CPT® Code 92250, and many healthcare providers enjoy a favorable return on investment within their first year. From a quality-of-care standpoint, the RetinaVue care delivery model can help providers achieve up to 90% documented compliance in 12 months,7 potentially qualifying for financial incentives under such programs as the NCQA® HEDIS® quality program and Medicare Advantage Star Ratings.

Acquaint your primary care physicians with the RetinaVue care delivery model. Help your health system achieve that long view of healthcare for which the entire industry is striving today.

To learn more about the RetinaVue care delivery model, please visit www.retinavue.com.

References:

  1. Welch Allyn. Early Detection of Diabetic Retinopathy in Primary Care Settings. 2019. Accessed June 21, 2019.
  2. Centers for Disease Control and Prevention. National Diabetes Statistics Report: Estimates of Diabetes and Its Burden in the United States, 2014. Atlanta, GA: U.S. Department of Health and Human Services; 2014. Available at: https://www.cdc.gov/diabetes. Accessed May 30, 2017
  3. CDC Vision Health Initiative (VHI), Common Eye Disorders. www.cdc.gov/visionhealth/basics/ced/index.html. Accessed July 27, 2018.
  4. Sloan FA, Brown DS, Carlisle ES, Picone GA, Lee PP. Monitoring visual status: why patients do or do not comply with practice guidelines. Health Serv Res. 2004;39(5):1429–1448. doi: 10.1111/j.1475-6773.2004.00297.x
    Rajput Y, Fisher M, Gu T, et al. Patient and provider perspectives: why are patients with diabetes mellitus noncompliant with dilated eye exams? Invest Ophthalmol Vis Sci. June 2015;56:1440.
    Lee DJ, Kumar N, Feuer WJ, et al. Dilated eye examination screening guideline compliance among patients with diabetes without a diabetic retinopathy diagnosis: the role of geographic access. BMJ Open Diabetes Res Care. 2014;2(1):e000031. doi:10.1136/bmjdrc-2014-00031
    Rawi S, Wendling M. Improving population health via a quality measurement analysis: diabetic eye exam. Poster presented at: The Prolog II Presentation Day; July 16, 2015; University of South Florida, Tampa, Fla
  5. National Eye Institute. Facts About Diabetic Eye Disease. Available at: https://nei.nih.gov/health/diabetic/retinopathy. Accessed May 30, 2017.
  6. Gibson, D. Estimates of the percentage of US adults with diabetes who could be screened for diabetic retinopathy in primary care settings. JAMA Ophthalmol. 2019; 137(4):440-4.
  7. Mansberger SL, Gleitsmann K, Gardiner S, et al. Comparing the effectiveness of telemedicine and traditional surveillance in providing diabetic retinopathy examinations: a randomized controlled trial. Telemed J E Health. 2013 Dec; 19(12):942-8.
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