Cost Analysis of Teleretinal Screening for Diabetic Retinopathy in a County Hospital Population

Compliance to annual diabetic eye examination remains poor: 48–66% nationally and 18% in inner cities (1,2). To improve noncompliance to diabetic eye examination in an inner-city county hospital population with an undersupplied eye clinic, the Wishard-Eskenazi Teleretinal Diabetic Retinopathy Screening (WETDRS) program was implemented in June 2009. Four Topcon digital retinal cameras were purchased by the health system for screening of only patients lacking a documented eye clinic visit within the past year at four primary care clinics. Captured images were remotely interpreted by eye physicians and electronically reported back to primary care clinics. To determine the cost of teleretinal screening for diabetic retinopathy (DR) through primary care, we conducted a retrospective review from program initiation through February 2013 (45-month time period). Institutional review board approval was obtained, and research adhered to tenets of the Declaration of …