5099 Capturing the Patient Voice for Diabetes Eye Exams

Abstract Disclosure: S. Du: None. S. Lambrechts: None. M. Freeby: None. M. Han: None. Background: Diabetic retinopathy (DR) is a leading cause of blindness among adults 20-74 years old. Ophthalmic exams are recommended every 1-2 years for type 2 diabetes patients with minimal to no DR. The 50th percentile Integrated Healthcare Association benchmark for DR screening is 49%, but at our academic medical center, the completion rate is 30%. Potential barriers to screening noted in the literature include lower levels of education, lack of knowledge about DR, and financial barriers. Objective: To understand motivating factors and barriers to DR screening among patients in our health system. Methods: We utilized the Patient Voice qualitative research method to uncover themes and identify interventions to improve care delivery. The literature was synthesized to develop a structured interview guide. From our urban academic health system, 15 patients were randomly selected for interview, six of whom had completed the “Diabetes Eye Exam” care gap and nine that had not. Interviews were transcribed and coded for thematic analysis. Results: Six opportunity areas were identified. 1) There are currently only six retinal cameras located across primary and specialty care clinics serving more than 38,000 diabetes patients. 67% of patients felt the current clinic locations were inconvenient, with distant locations and long travel times. 2) 20% of patients expressed that they would like increased flexibility of appointments offered, such as evening, weekend, and same day appointments. 3) Patients were motivated by automated diabetes eye exam specific reminder messages and appreciated the ability to self-schedule within the patient portal. 47% of patients wanted yearly reminder messages, while 40% had no preference. 4) 53% of patients expressed that they did not fully understand DR or were confused about the difference between an optometrist exam and diabetes eye exam. 5) 40% of patients completed their eye exam with their local optometrist and found this to be a more convenient option. One patient expressed that she wished her doctor had informed her that she could complete her diabetes eye exam at a local optometry clinic. 6) If patients do choose to complete their exam with their local optometrist, they would like reminders to send their records to their primary care physician or endocrinologist. A more streamlined processes to upload outside records through the patient portal would decrease this barrier. Conclusion: It is important to engage patient stakeholders and understand their needs to improve overall experience and close care gaps. Through the Patient Voice, we learned that factors such as driving distance, traffic, scheduling, and issues with uploading records are major barriers to care gap completion. Convenient clinic locations, education, and reminder messages are motivating factors. Future work will focus on developing and implementing solutions in each opportunity area. Presentation: 6/1/2024