Improving diabetic retinopathy screening through a statewide telemedicine program at a large federally qualified health center

J Health Care Poor Underserved. 2011 Aug;22(3):804-16. doi: 10.1353/hpu.2011.0066.


Background: Diabetic retinopathy (DR) is the leading cause of acquired blindness in U.S. adults. Early detection prevents progression. Screening rates are only 10% in medically underserved populations.

Methods: A statewide telemedicine-based program within primary care centers was implemented to improve DR screening, detection and referrals for underserved patients.

Study design: Retrospective, descriptive study.

Results: A total of 568 adults were screened during a comprehensive nurse visit from July 2009-June 2010 and had complete data available. Nearly 60% were minorities and 24% were uninsured. A total of 145 cases of DR were identified. The majority were recommended to return in one year for follow-up, while 75 were referred to a specialist.

Conclusions: Telemedicine using digital imaging technology in the primary care office is a strategy that can be used to screen underserved and at-risk patients for DR, increase compliance with screening, and streamline specialist referrals.

MeSH terms

  • Adult
  • Community Health Centers / standards*
  • Diabetic Retinopathy / diagnosis*
  • Female
  • Humans
  • Male
  • Mass Screening / methods*
  • Mass Screening / statistics & numerical data
  • Medically Uninsured / statistics & numerical data
  • Middle Aged
  • Minority Groups / statistics & numerical data
  • Primary Health Care / methods*
  • Program Evaluation
  • Referral and Consultation / statistics & numerical data
  • Retrospective Studies
  • Risk Assessment
  • Telemedicine / methods*
  • United States