Specifications

14 I About the Program
The EyePACS Handbook: Tools for Program Success
Integrating Screenings into Clinic Workflow
The success of any clinical program depends on how well it is integrated into the
workflow of the care process. One straightforward way to ensure that this happens is to
create a simple set of clinical scenarios and then map out suggestions for a modified
workflow, including alerts and reminders for all the people involved with the patient.
For diabetic retinopathy screening, there are a few basic scenarios:
Clinical Scenarios
- Current diabetic patient visiting the clinic for a regular exam or unrelated
issue. The key is for physicians and case managers to have retinopathy
screening at the front of their minds. They should be making referrals for
retinopathy screening to all diabetic or borderline diabetic patients.
o Tip for Workflow Integration: Use charts and notes as reminders for
referrals. If possible, make retinal screenings available without an
appointment so that a patient who is already in the clinic does not have
to schedule a return trip for the screening. (Many patients do not comply
with scheduled return visits.) If electronic registry systems are available,
set up alerts and reminders for annual eye exams.
- Current diabetic patient who is not scheduled for a clinic visit. Many diabetics
have never had a retinopathy screening and do not know that it is necessary.
Others may have received a retinopathy screening more than a year ago and are
due for another screening. Patient outreach – mailings and phone calls – can
educate these patients and motivate them to schedule a visit. Electronic registry
systems can help simplify identification of patients needing screens and
outreach.
- New diabetic patient who visits the clinic specifically for retinopathy
screening. One result of community outreach is that new patients may come to
the clinic just to have their eyes tested for retinopathy. Since retinopathy
screening is part of a whole program of diabetes management, it is critical to
provide these patients with a more comprehensive care program.
Checks to
see if every
diabetic
patient is up
to date on
screening
Check-In
Provides
referral for
screening
for all
diabetic
patients
Physician
Performs
screening
and
uploads
images
Photo-
grapher
Interprets
images and
creates
report in
EyePACS
UCBOEC
Communicat-
es results to
patient and
makes
referral if
needed
Physician
or Case
Manager
Telemedicine and Diabetic Retinopathy Workflow