CommUnityCare Case Study: Delivering High-Quality Preventative Care to Underserved Patients
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New eye exams in 2 years Exams safely performed since COVID-19 New cases of sight-threatening illness detected
As a healthcare provider located in a region where diabetes is a leading health concern, CommUnityCare is continually looking for ways to improve its quality of care and prevent serious illness for its diabetic patients. As an FQHC, the healthcare system’s patient population is largely uninsured or publicly insured. Delivering effective preventive care to these underserved patients can be a challenge, especially as many reside in rural areas that are lacking in healthcare. CommUnityCare is committed to finding a solution for these residents, in turn strengthening the health and wellbeing of the community it serves.
To help prevent vision loss and impairment amongst its patients, CommUnityCare implemented the IRIS eye exam solution with tabletop cameras at two clinic locations, and also included a bi-directional orders and results interface with their EMR platform. IRIS is considered an FDA Class II cleared Medical Device that enables healthcare providers to perform diabetic retinal exams (DREs) for their patients in a non-eyecare setting. The images captured during those exams are then sent via IRIS’s cloud-based platform to an interpreting ophthalmologist for review and probable diagnosis of all stages of diabetic retinopathy, potentially before it causes blindness. IRIS relies on automated processes and clearly defined workflows to make it possible for non-eyecare specialists to perform DREs in a variety of settings.
IRIS’ client success team helped CommUnityCare incorporate DREs into their workflows, with a focus on making the new processes as seamless as possible for medical assistants, who perform the screenings. The CommUnityCare team created standing orders within the EMR so medical assistants could automatically see when a patient was due for a screening without needing to put in an order request.
In many instances, screenings are performed at the start of the patient appointment during the check-in process. CommUnityCare also hosts Diabetic Fairs where patients can receive a DRE, in addition to learning about nutrition, medication, and how to properly use their glucometer. Medical assistants also have a panel of appointments set aside just for preventative services and patients can set up a standalone appointment for a screening on its own.
- In just a few years, there were 18,600 exams performed, 3,390 during the pandemic
- 6,427 patients with pathology (34.5%)
- 4,250 patients with diabetic retinopathy (22.8%)
- 2,570 instances of an IRIS exam catching pathology deemed sight-threatening, known as an IRIS Save
Consistent Levels of Quality
Due to a combination of technology and support services from IRIS, including IRIS’ proprietary image enhancement technology, CommUnityCare sees a 95.7% exam gradable rate. The IRIS screenings factor into their Centers for Medicare & Medicaid Services (CMS) quality levels, which determine whether they receive financial benefit for their services. Being able to rely on the IRIS solution for such a high level of gradability supports them in maintaining that vital funding.
The IRIS customized analytics dashboard allows CommUnityCare to quickly address issues. “If we know that a team member is struggling with the quality of their camera, gaining insight into the amount of time it takes them to use the software k is the first indication that we need to open communication with the team member to get a full understanding into the issues they may be facing with their camera reading process” says Yvonne Camarena, Chief Operating Officer of CommUnityCare.
Driving Adoption with Ease of Use
The ease of the exam encourages higher adoption among patients: “Once an individual has had the exam and sees how easy and quick it is, they come back,” says Camarena. And with that higher adoption comes the opportunity to diagnose other eye ailments. “The retinal exam is our launching pad to being able to find other diagnoses that we might find in their eye, not just retinopathy.”
The same goes for clinical providers. Camarena says, “Once your team can see the ease of taking the pictures, it starts to build. Your clinical providers will start to see the value of the screening really quickly and they’ll start referring their patients over as well.”
Expanding to Reach Patients Where They Are
CommUnityCare recently added two additional tabletop cameras and seven mobile handheld cameras to better serve its patients, particularly those in rural areas. The mobile cameras will be shared between multiple centers, with nursing teams moving them around based on need. Because the image is uploaded to a cloud-based system, the team at CommUnityCare can reach patients in a variety of venues, making the DREs more convenient and accessible to a population that is particularly vulnerable to receiving inadequate care.
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