Journal of Health Care for the Poor and Underserved

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.