Project Ups Diabetic Retinopathy Screening in Primary Care


A quality improvement (QI) project using mobile diabetic retinopathy (DR) screening units in a primary care setting increased DR screening rates, and also increased knowledge and awareness of DR in adults with type 2 diabetes (T2D).


  • The 5-month QI project was implemented at a primary care clinic in a small North Carolina town that encompassed several diverse communities.

  • The clinic partnered with a local accountable care organization (ACO) that contracts with commercial insurers and Medicare to provide patients with standard of care services.

  • Approximately 2000 (13%) of the clinic’s adult patients have T2D and nearly half are insured and contracted with that ACO.

  • A convenience sample of 100 adult patients with T2D met inclusion criteria and 46 participated in DR screening, performed by ACO employees using hand-held cameras.


  • The average DR screening rate increased to 52.1% during the 5-month implementation period, from 45.3% during the prior 3 months (P = .018). 

  • This represented a 15% improvement, achieving the project’s first aim.

  • Of the 46 screened patients, five were found to have DR, including four without a prior DR diagnosis.

  • Mean questionnaire DR knowledge scores improved from 81.5% pre- to 88.6% post-screening (P = .022).

  • In the questionnaire, 83% of patients responded that completing DR screening in their primary care provider’s office was convenient and preferable over other settings.


“This project addressed gaps of care and demonstrated that primary care settings can increase access to DR screening through a patient-centered process and thereby help to prevent irreversible outcomes of DR and improve quality of life.”


Conducted by Katherine K. Clark, RN, of LeBauer Healthcare Stoney Creek, Whitsett, North Carolina. Published October 25, 2023, in Clinical Diabetes.


The unexpected and unavoidable temporary closure of the participating clinic due to urgent building repair need and relocation to two other clinics significantly reduced the sample size; only insured clinic patients were included; and the project had a short duration.



Miriam E. Tucker is a freelance journalist based in the Washington, DC, area. She is a regular contributor to Medscape, with other work appearing in the Washington Post, NPR’s Shots blog, and Diabetes Forecast magazine. She is on Twitter @MiriamETucker.

Source: Read Full Article