Presbyterian Medical Services is a leading Federally Qualified Health Center (FQHC) serving 17 counties in New Mexico. Healthcare professionals strive to deliver comprehensive services to a diverse population of 80,000 patients across 32 sites. Presbyterian Medical Services initially invested in a program to improve diabetic retinopathy exam compliance rates by purchasing Welch Allyn RetinaVue 100 Imagers.
Between 2021 and 2023, Presbyterian Medical Services began replacing the RetinaVue 100 Imagers with Welch Allyn RetinaVue 700 Imagers to further improve the program’s performance. Their staff found the RetinaVue 700 Imager easier to use, and their Quality team felt making the change would help address staff training and competence challenges. Using initial results from the Quality Improvement program and the significant improvement in the Diabetes Eye Exam measure, Presbyterian Medical Services secured funding for an additional eight cameras, which were implemented in 2024. This allowed each site to have a camera, thereby increasing patient access.
Presbyterian Medical Services utilizes the Pre-visit Planning Summary report in the EMR to identify patients with an upcoming appointment who need an annual diabetic retinopathy exam. When these patients arrive for their appointments, staff members can offer to perform the exam during the visit in an effort to close the care gap. To keep the program top of mind, daily huddle meetings are held to review Pre-visit Planning reports, ensuring staff are prepared and aware of which patients need to complete their annual diabetic retinopathy exams.
In addition, staff pull Open Care Gap (GIC) reports from the EMR for patients living with diabetes. They contact these patients to schedule appointments for the diabetic retinopathy exam and other services needed to close care gaps.
“Consistently monitoring data, giving feedback, and promoting the data with clinicians, clinical support staff and leadership are key to long-term success.”
— Catherine Reeves, Director of Quality, Presbyterian Medical Services
Presbyterian Medical Services has instituted a rigorous Quality Improvement Campaign (QIC) for diabetic retinopathy exam compliance, which has significantly contributed to the program’s success. The Quality team monitors 22 metrics in the daily visit summary reports. “When you look at all of the open measures in the reports, it’s hard to focus specifically on diabetic retinopathy compliance rates,” said Catherine Reeves, Director of Quality, Presbyterian Medical Services. “The formal QIC helps keep the focus on closing the diabetes eye exam care gap.”
Staff from all sites meet monthly to review data on performance, utilization and the percentage of billable images. The sessions also discuss strategies to maximize the number of completed exams and compare individual site data. Best practices from high-performing sites and training refreshers address barriers and challenges experienced by sites not meeting monthly goals.
The program includes specialized training for medical assistants (who interact directly with patients and perform the exam) on how to engage patients and overcome barriers to closing care gaps. This includes providing information about wait times for ophthalmologist appointments and encouraging patients to complete the exam during their visit. The training has helped combat staffing and retention challenges that impact Presbyterian Medical Services’ ability to maintain diabetic retinopathy exam compliance rates.
Implementing the RetinaVue care delivery model has led to a significant improvement in diabetic retinopathy exam compliance rates. Between 2020-2024, Presbyterian Medical Services has achieved 7,927 completed eye exams. Additionally, 521 cases of eye disease were detected between 2022 and 2024, with 342 cases being vision-threatening (65.6%).
Presbyterian Medical Services is extremely grateful for its partnership with Baxter and the support provided by their Customer Success Specialists. “The RetinaVue care delivery model has been a valuable addition to our practices,” said Joel A. Martinez, Clinical Affairs Project Manager, Presbyterian Medical Services. “The Baxter team is responsive and easily accessible to review and interpret utilization reports and provide technical and training support.”
“Patient literacy in terms of understanding the importance of completing their annual diabetic retinopathy exam is a challenge,” said Reeves. “We train our staff to think of each patient encounter as the last chance they will have to see the patient that year — that they need to do everything they can to close care gaps during that visit.”
Staff and providers have experienced the impact of the RetinaVue care delivery model firsthand. By sharing data on the number of patients who have completed exams and the percentage of patients identified with vision-threatening diseases, they understand the difference they are making in patients’ lives. “In training, we emphasize how important it is for a patient to know if they have developed diabetic retinopathy, as it can help save their vision. We tell them, ‘If it were you, wouldn’t you want to know?” said Martinez.
“Don’t give up. It takes time to turn the ship, but the results are worth it. We are preserving vision and providing quality of life back to the patient.”
— Joel A. Martinez, Clinical Affairs Project Manager, Presbyterian Medical Services
“Consistently monitoring data, giving feedback, and promoting the data with clinicians, clinical support staff and leadership are key to long-term success,” said Reeves. The Quality team has learned that introducing a new service that adds time to the patient’s visit can be challenging, but having a clearly defined process is essential to ensuring a smooth workflow that staff and providers will support.
Patience is also critical to realizing the benefits of a diabetic retinopathy program. “Don’t give up,” says Martinez. “It takes time to turn the ship, but the results are worth it. We are preserving vision and providing quality of life back to the patient.”
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