A Vision of the Future of Eye Care
I would propose a cooperative program for remote risk assessment for patients with diabetes that can occur anywhere that eye doctors are located and willing to collaborate. With the number of patients with diabetes increasing as the population ages, it will be increasingly difficult to conduct risk assessment of these patients and have time for eye care for those with non-diabetes-related conditions. However, if a group of regionally based eye doctors, including retina specialists, collaborated with primary care providers to have imaging locations with reading done on a rotating basis, risk assessment could be conducted according to primary care provider quality monitors, billing could be accomplished with remote imaging (code 92227 for image management with no retinopathy, 92228 with retinopathy), and referrals could easily be made to a designated retina specialist when needed.
A remote teleretinal imaging network can only work with collaboration between eye care providers and primary care providers. Collaboration must include preferred locations to which patients are sent when necessary for general eye care with the entire network of doctors participating in this care. Imaging staff must be trained in the technical use of the cameras as well as some care management. Most primary care offices have staff to provide patient education and management, and it would be reasonable for the same individuals to be cross-trained as imagers.
Teleretinal imaging programs will flourish most in underserved communities. Healthcare providers tend not to settle in rural areas. In fact, only 1% of providers prefer to practice in communities with populations of 25,000 or less and only 4% in areas with populations of 25,000-50,000. Access to regular eye care on demand is limited by the lack of eye doctors with practices accessible to patients in sparsely populated areas. Furthermore, where these eye doctors exist, the demand for their services can be very high. The access of information by midlevel providers, and interpreted by remote eye doctors, may make access to eye care much easier for all Americans and indeed people located worldwide.
Remote Teleretinal Imaging Networks
I would propose a cooperative program for remote risk assessment for patients with diabetes that can occur anywhere that eye doctors are located and willing to collaborate. With the number of patients with diabetes increasing as the population ages, it will be increasingly difficult to conduct risk assessment of these patients and have time for eye care for those with non-diabetes-related conditions. However, if a group of regionally based eye doctors, including retina specialists, collaborated with primary care providers to have imaging locations with reading done on a rotating basis, risk assessment could be conducted according to primary care provider quality monitors, billing could be accomplished with remote imaging (code 92227 for image management with no retinopathy, 92228 with retinopathy), and referrals could easily be made to a designated retina specialist when needed.
A remote teleretinal imaging network can only work with collaboration between eye care providers and primary care providers. Collaboration must include preferred locations to which patients are sent when necessary for general eye care with the entire network of doctors participating in this care. Imaging staff must be trained in the technical use of the cameras as well as some care management. Most primary care offices have staff to provide patient education and management, and it would be reasonable for the same individuals to be cross-trained as imagers.
Teleretinal imaging programs will flourish most in underserved communities. Healthcare providers tend not to settle in rural areas. In fact, only 1% of providers prefer to practice in communities with populations of 25,000 or less and only 4% in areas with populations of 25,000-50,000. Access to regular eye care on demand is limited by the lack of eye doctors with practices accessible to patients in sparsely populated areas. Furthermore, where these eye doctors exist, the demand for their services can be very high. The access of information by midlevel providers, and interpreted by remote eye doctors, may make access to eye care much easier for all Americans and indeed people located worldwide.
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