Shorye Payne, MD, MPH Medical Retinal Specialist VHA Louisville, KY
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1 Shorye Payne, MD, MPH Medical Retinal Specialist VHA Louisville, KY
2 DIABETIC RETINOPATHY IS THE LEADING CAUSE OF BLINDNESS IN THE U.S. IN ADULTS AGE THE INCREASING PREVELANCE OF DIABETES CHALLENGES THE CURRENT DR SCREENING RECOMMENDATIONS. Currently ~ 20,000 ophthalmologists Currently ~ 35,000 optometrists Currently ~ 26 million diabetics
3 VHA is the largest U.S. integrated health care system. Serves > 5.5 million veterans More than 97 million outpatient visits 2000, U.S. Congress recognized the importance of preventing blindness from diabetes. Recommended VHA to collaborate with Joslin Vision Network (Boston, MA) to implement a technology based platform that uses non-mydriatic retinal imaging and remote image interpretation. (TELERETINAL IMAGING)
4 2006, VHA established its teleretinal screening program More than 1 million patients have been screened. VHA has developed a care management pathway (CMP) for patients with diabetes. Highly successful gold standard teleretinal program.
5 "The wider application of care and case management principles to the delivery of health care services using health informatics, disease management, and telehealth technologies to facilitate access to care and improve the health of designated individuals and populations with the intent of providing the right care in the right place at the right time VHA definition
6 3 Telehealth Focus Areas 1. Clinical Video Telehealth 2. Home Telehealth 3. Store & Forward Telehealth
7 1. CAN SUCH A PROGRAM BE BROADLY APPLIED TO THE SCREENING AND RISK ASSESSMENTS OF PATIENTS WITH DIABETES OUTSIDE VHA? 2. SHOULD OPHTHALMOLOGISTS PLAY MORE OF A ROLE IN TELERETINAL SCREENING? 3. IS THERE A ROLE FOR RETINAL SPECIALISTS IN TELERETINAL SCREENING?
8 OUT-PATIENT BASED CLINIC SITES (CBOCS) 1. Newburg 4 yrs ~1100 images/yr 2. New Albany 4 yrs ~1250 images/yr 3. Shively 4 yrs ~900 images/yr 4. Dupont 5. Ft. Knox 6. Grayson 7. Scott 8. Carrolton
9 OPTOMETRIST OR OPHTHALMOLOGIST TO INTERPRET TELERETINAL SCREENING EYE PHOTOGRAPHER/MEDICAL ASSISTANT TO PERFORM TELERETINAL IMAGING TELERETINAL COORDINATOR TO ACT AS ADMINISTRATIVE LIAISON AND/OR DIABETIC EDUCATOR DIABETIC EDUCATOR TO HELP IN PATIENT EDUCATION AND METABOLIC MANAGEMENT TRIAGE
10 TELEHEALTH PRECEPTOR TELERETINAL IMAGER TELERETINAL READER TELERETINAL IMAGE PROVIDER
11 Equipment Cost: ~ $25,000 - $30,000 Monthly Revenue: Fundus photography (92250) x $ 80 per pt = $ /mth Patient Charged Screenings x $30 per pt = $ /mth Total Monthly Revenue $ Total Monthly Payment $ Monthly Net Profit $ x 12 = A CPT is defined as bilateral so reimbursement is for both eyes. The first quarter 2015 national Medicare Physician Fee Schedule allowable is $ Of this amount, $55.06 is assigned to the technical component and $24.31 is the value of the professional component (i.e., interpretation). These amounts are adjusted in each area by local wage indices.
12 92250 FUNDUS PHOTOGRAPHY WITH INTERPRETATION PATIENT IMAGING SITE REMOTE IMAGING DETECTION OF RETINAL DISEASE PROVIDER READING SITE REMOTE IMAGING MONITORING & MGMT OF ACIVE RETINAL DISEASE PROVIDER READING SITE Teleretinal diabetic screening is preventative medicine. Diabetes is considered a clinical indictor for preventative eye care for potential retinopathy.
13 1. IN A THIS FAST PACE, GADGET DEPENDENT IMAGING WORLD, the LEADING EYE CARE SPECIALISTs IN DIABETIC SURVEILLANCE AND MANAGEMENT, OPHTHALMOGISTs and RETINAL SPECIALISTs, ARE MISSING OUT on THE FUTURE IMPACT OF TELERETINAL IMAGING on diagnostic surveillance of diabetic eye disease AND other chronic retinal eye diseases AND its FUTURE BROAD SPECTRUM USE in atypical settings, like pharmacies, grocery stores, weight mgmt ctrs, emergency depts, home settings, etc.
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15 TRC-NW 400 HIGH QUALITY IMAGING MEETS EASE OF USE 1. True Color Fundus Images 2. Easy to Use & to Navigate 3. Space Saving 4. Versatile and Simple Operation. TRC-NW400 Non-Myd System Topcon Medical Systems, Inc.
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19 Impact Diabetic Screening with Telehealth Invigorate Community Outreach/Marketing with Teleretinal Outreach U OF L Dept. of Ophthalmology Involve Telehealth in Residency Core Competencies Initiate a Teleretinal Technology Testing Site
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