LEXINGTON, Ky. (Feb. 17, 2020) — UK HealthCare CECentral and partners were awarded the Outstanding Educational Collaboration Award in 2020 by the Alliance for Continuing Education in the Health Profession (ACEHP). This national award recognized a collaborative initiative to improve provider knowledge on diabetic retinopathy screening and treatment, as well as improving access to and utilization of eye screening technology to positively impact patient screening, treatment and referral outcomes related to diabetic retinopathy.
Diabetic retinopathy (DR) is the leading cause of blindness among working-age people in the United States, affecting more than half of the 18 million adults with diagnosed diabetes. Yearly eye examinations for people with diabetes can reduce blindness by 95%. However, many people with diabetes are not being screened for diabetic eye diseases at the frequency recommended by the American Diabetes Association (ADA). At the University of Kentucky, only 33% of patients with diabetes had documented retinal screens prior to the implementation of a performance improvement project called “Optimizing Disease Management (ODM): A Vision for Eye Screening.”
The ODM project involved partners from interdisciplinary organizations to improve knowledge and clinical care for diabetic retinopathy screenings in 23 primary care clinics across Kentucky. Collaborating partners included UK HealthCare CECentral, UK Department of Ophthalmology, UK Family and Internal Medicine Clinics, UK Telemedicine, Family Health Centers Clinics, Primary Care Centers of Eastern Kentucky Clinics, Park DuValle Community Health Center Clinics, Volk Optical and DKBmed, RealCME, Post Graduate Institute of Medicine. The program was supported by an educational grant from Regeneron Pharmaceuticals.
“The University of Kentucky is a land-grant institution with a strong sense of responsibility for the Commonwealth,” said Dr. Kimberly Northrip, director of UKHC CECentral. “We at CECentral apply this philosophy to providing professional development to healthcare providers to support their work in making Kentucky healthy. That’s why we reached out to community clinics across the state beyond those managed by the University of Kentucky.”
This initiative required feedback and collaboration among the partners in three main areas:
- Deployment of technology to allow screening within the primary care clinic, as well as to bridge the distance between the rural clinics and access to ophthalmology services,
- Development and dissemination of high-quality education for community providers and their patients, and
- Performance improvement and academic detailing to facilitate implementation of knowledge and technology.
"By offering these screening tests in a more accessible venue, we are reducing the barriers of time and access to care, which will likely lead to more patients with diabetes receiving the recommended yearly eye testing," said Dr. Ana Bastos de Carvalho, assistant professor in the UK Department of Ophthalmology and Visual Sciences, and co-director of the ODM performance improvement program. "We expect to detect more pathology and also to detect it earlier on and therefore allow for better visual prognosis."
“Improving patient outcomes is always the goal of the education and performance improvement programs that we create with our partners,” said Dean Beals, president of DKBmed, a medical education company. “After our successful program with Lancaster General Health, we were excited to team up with UKHC CECentral and the University of Kentucky to expand this important program. All of the partners were enthusiastic to bring education to primary care providers and recommended eye screening to vulnerable patients who may not otherwise have access to ophthalmologists.”
Staff at participating clinics received education about the importance of regular screening for diabetic retinopathy and current treatments. They were also trained to use specialized handheld cameras to complete screenings on-site. Linking education to clinic processes and technology access created a feedback loop: the performance improvement initiative generated data that guided the manufacturer, Volk Optical, to incorporate improvements in screening technology and software based on real-world clinical need. The technical improvements then facilitated better workflow and, therefore, improved screening rates and documentation at clinic sites.
Preliminary results indicate the greatest increase in screening rates occurred within rural clinics, where access to eye care is most limited. Screening rates increased in all participating clinic groups, with UK Family Medicine clinics having a participant increase of 105%, Family Health Centers Iroquois Clinic increasing by 20.5%, and the Primary Care Centers of Eastern Kentucky group increasing by 95% over the implementation period.
“We worked very hard to facilitate great partnerships by utilizing feedback, working with clinical staff to identify barriers, and prioritizing the needs of the clinic providers and their patients,” said Jasleen Chahal, grants program manager at UKHC CECentral. “This collaboration highlights the importance that continuing education and evidence-based practices can have on reducing health disparities. We are excited about future opportunities to partner with clinics and educational partners in order to continue addressing the needs of both patients and providers across our state.”
The results of the ODM project emphasizes the opportunity for future education and performance improvement programs to provide tailored interventions to address clinical care gaps based on differing geographic limitations and workflow barriers. UKHC CECentral attributes the success of the program to the many UK and community-based clinical staff, as well as the continuing education partners for enriching the work of the ODM study and emphasizing the value that continuing medical education can have on improving clinical care and patient outcomes.
As the state’s flagship, land-grant institution, the University of Kentucky exists to advance the Commonwealth. We do that by preparing the next generation of leaders — placing students at the heart of everything we do — and transforming the lives of Kentuckians through education, research and creative work, service and health care. We pride ourselves on being a catalyst for breakthroughs and a force for healing, a place where ingenuity unfolds. It's all made possible by our people — visionaries, disruptors and pioneers — who make up 200 academic programs, a $501 million research and development enterprise and a world-class medical center, all on one campus.
In 2022, UK was ranked by Forbes as one of the “Best Employers for New Grads” and named a “Diversity Champion” by INSIGHT into Diversity, a testament to our commitment to advance Kentucky and create a community of belonging for everyone. While our mission looks different in many ways than it did in 1865, the vision of service to our Commonwealth and the world remains the same. We are the University for Kentucky.