Teleophthalmology reduces rates of vision loss and improves access to care

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Teleophthalmology not only improves access to care and reduces the cost of care, but it can also reduce rates of vision loss in patients with type 2 diabetes, said Parisa Emami-Naeni, MD, MPH, professor assistant ophthalmologist at the University of California, Davis, and vitreoretinal surgeon and uveitis specialist at the UC Davis Eye Center.

Teleophthalmology not only improves access to care and reduces the cost of care, but it can also reduce rates of vision loss in patients with type 2 diabetes, said Parisa Emami-Naeni, MD, MPH, professor assistant ophthalmologist at the University of California, Davis, and vitreoretinal surgeon and uveitis specialist at the UC Davis Eye Center.

Transcription

Your research revealed that the use of remote retinal imaging increased from 2011 to 2020, but payments for remote imaging decreased. Why is there this disconnect?

We have seen that over the past 10 years, the number of teleophthalmology claims has more than tripled. However, as you mentioned, refunds have been declining over time. The loss of insurance coverage and the bundling of various services play a role. A previous study by my co-author and collaborator, Dr. Glenn Yiu, showed that less than half of teleophthalmology costs at a single university are paid for by insurance. And most of the denials indicated that remote eye screening was not a covered benefit. In addition, there are 3 different CPTs [Current Procedural Terminology] commonly used codes for teleophthalmology services, and some of these codes are declined more often than others, showing the confusing landscape of these codes and reimbursements.

What is the importance of extending the coverage of remote retinal imaging?

We know that guidelines from the American Academy of Ophthalmology and the American Diabetes Association recommend that anyone with type 2 diabetes should have an eye exam – a dilation eye exam – soon after the diagnosed with diabetes and every year thereafter. However, we know that only less than 50% of people with diabetes have an eye exam within a year of being diagnosed with diabetes. This would increase their risk of serious diabetes complications and vision loss in these people.

Teleophthalmology has [been] have been shown to reduce the cost of care and increase access to eye exams in remote or rural areas. People with diabetes can undergo retinal imaging during their primary care visits or endocrinologist’s office without even having to go to an ophthalmologist’s office. This will eliminate access issues and improve eye exam rates for these people and reduce complications for these people. Moreover, in our study, we showed that individuals [who] undergoing remote eye imaging can access these services upon diagnosis of diabetes, resulting in timely access to eye care. Thus, these services are very important in reducing larger complications and reducing rates of vision loss in people with diabetes.

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