Clinician using RetinaVue Imager on patient ""

3 Keys to a Successful Teleretinal Program

Download our interactive eBook, The Solution is in Sight: The Complete Guide to Successful Teleretinal Programs, to learn more about what teleretinal imaging can do for your patients and primary care practice.

Successful teleretinal programs require capability and proficiency in three core areas:

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Simple and Affordable Hardware

Hillrom offers a flexible portfolio of innovative retinal imaging technology, including the world’s most advanced handheld retinal camera,1 the Welch Allyn® RetinaVue® 700 Imager.

Secure Software Network

Award-winning, HIPAA/HITECH-compliant, SOC-2 Type II certified RetinaVue® Network software with end-to-end encryption of patient data and secure client-server authentication—hosted on the Microsoft® Azure™ cloud. To streamline documentation, fully integrated, bi-directional EMR interfaces for Allscripts®, athenahealth®, Cerner®, Epic®, NextGen® and more are available to you.

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Nationwide Services and Support

The experience and resources necessary to scale and support a patient-centered solution across your organization. Professional medical services are provided by a nationwide team of state-licensed, board-certified ophthalmologists at RetinaVue, P.C. Hillrom consultants will help you customize and optimize your program across your clinic or mobile healthcare locations.

The Solution is in Sight:

The Complete Guide to a Successful Teleretinal Program

Learn more about what teleretinal imaging can do for your patients and primary care practice.

What’s inside the eBook:

  • An overview of diabetic retinopathy and the current standard of care 
  • How to select the right retinal camera for your workflow 
  • The three keys to a successful teleretinal program 
  • CPT® Code coverage for fundus imaging and teleretinal programs 
  • How to improve HEDIS®, STAR and HCC risk factors and close care gaps by offering diabetic retinal exams to patients living with diabetes
cover of an ebook document

  

Frequently Asked Questions:

  • How do artificial intelligence algorithms fit into a successful teleretinal program?

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    • Artificial intelligence (AI) is an exciting development that can provide real-time pass/refer results2,3 for diabetic retinal exams in primary care settings — which is a nice feature — but by itself will not constitute a successful teleretinal program.4
    • Hillrom published a study on the accuracy of the Welch Allyn® AutoDX-DR5 deep learning-based automated algorithm at ARVO 20196 and looks forward to a future release of this feature.
    • However, every successful teleretinal program requires capability and proficiency in three core areas (1) simple and affordable retinal imaging hardware, (2) secure teleretinal software and (3) nationwide medical and technical services and support — and only Hillrom can deliver on all three, today!
  • Are diabetic retinal exams reimbursed? Which CPT Code should I use?

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    • Yes, most commercial healthcare plans provide coverage for diabetic retinal exams in primary care settings7 and Medicare began covering January 1, 2021.8
    • The AMA CPT®Editorial Panel has updated CPT® Code descriptions for retinal imaging codes 92227 and 92228 to specify retinal exams performed in primary care settings with remote interpretation. Both codes can be used to report diagnostic and monitoring services and the distinction is in whom provides the service: physician (CPT® Code 92228) or clinical staff only (CPT® Code 92227).9
    • The description for CPT® Code 92250 remains unchanged, but the AMA has clarified that this code is intended for exams performed in the same place where the interpretation is performed (e.g., in an ophthalmologist’s office).
  • Can remote ophthalmologists detect eye pathologies other than diabetic retinopathy?

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    • While the exam is performed to detect and stratify the severity of diabetic retinopathy at its earliest stages, RetinaVue, P.C. retinal specialists often detect symptoms of other systemic diseases, including papilledema, macular degeneration, age-related macular degeneration, glaucoma and even certain types of cancer and stroke. AI does not currently detect other eye pathologies that ophthalmologists can catch.4 AI algorithms are cleared by the FDA to detect diabetic retinopathy and diabetic macular edema only, while ophthalmologists are typically able to detect more pathologies from fundus images.
  • Does the diabetic retinal exam help improve our quality measures?

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    • The NCQA® HEDIS® quality measure for annual diabetic retinal exams (NQF #0055) is included in Medicare Advantage Star Ratings and CMS Quality Payment Program measures.
  • How easy is it for me to capture a retinal exam? Will it impact workflow?

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    • The retinal camera is arguably the most essential component of an effective teleretinal solution. While there are many teleretinal cameras on the market today, most require clinical staff to undergo substantial hands-on training and technique practice to become proficient. The RetinaVue 700 Imager, on the other hand, is extremely easy to use and requires minimal training to capture high-quality and highly readable images.  A typical exam with the RetinaVue 700 Imager takes less than five minutes to complete.  With the click of a button on the camera’s touchscreen, the images are securely transferred via RetinaVue Network Software to board certified and state licensed eye specialists for review. Once the eye specialist has completed their review, a diagnostic report will be returned to the provider within 24-hours or less. 
  • Teleretinal programs seem complex. How would we implement a solution to ensure a smooth and successful program right from the start?

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    • Teleretinal programs can be complex. However, as a turnkey solution designed from the ground up specifically for the primary care setting, the RetinaVue care delivery model significantly simplifies the implementation process. In addition to the solution itself, Hillrom’s customer consultants will customize and operationalize a teleretinal program that achieves your unique goals. We are your strategic partner to help you close the diabetic retinal exam compliance gap, now and into the future. We bring the experience and nationwide resources to scale and support a patient-centered care delivery model across your organization.
  • Does the RetinaVue care delivery model solution secure important data like patient health information (PHI)?

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    • RetinaVue Imagers and RetinaVue Network software were designed from the ground up with security in mind, including end-to-end AES-256 encryption of data both in transit and at rest. Our controlled, secure software development lifecycle (SSDLC) incorporates cybersecurity risk management at all stages to ensure security is a cornerstone of all products throughout their entire lifecycle. To ensure ongoing deployment of security best practices, the RetinaVue Network software undergoes regular third-party penetration testing and vulnerability scans. The RetinaVue Network is also cleared as a Class II device by the FDA, a designation that requires strict design and risk-mitigation controls. We use an independent third party to perform annual SOC-2 Type II audits to enforce controls that protect security and privacy of customer data. At all times, your hosted data is secure, protected, and resilient in Azure. The RetinaVue Network software is built on Azure, which maintains compliance with more than 90 different standards, including HIPAA (Health Insurance Portability Authorization Act), HITRUST and SOC-2 Type II.
  • Are there any additional economic benefits such as total cost of care?

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    • Teleretinal programs can help health plans and providers more accurately document HCC risk adjustment factors for chronic conditions and complications in their populations and close gaps in care.10
  • How quickly can we expect to see measurable results?

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    • Each program is unique and performance will vary based on your organization’s objectives however, teleretinal programs can help you achieve up to 90% (5-Star level) documented compliance in 12 months.11

Looking for more information?

Download our interactive eBook, The Solution is in Sight: The Complete Guide to Successful Teleretinal Programs, to learn more about what teleretinal imaging can do for your patients and primary care practice.


The Welch Allyn RetinaVue 700 Imager (RV700) is a high-resolution ophthalmic camera used to acquire, save and transmit digital images of the human eye. Anterior and posterior ocular structures such as the surface of the eye, cornea, and fundus including retina, macula and optic disc can be imaged. It is a prescription use only medical device.

The Welch Allyn RetinaVue Network is a web-based software system application intended for use in storing, managing, and displaying patient data, diagnostic data, and images from computerized diagnostic instruments. Original and enhanced images can be viewed by trained healthcare professionals.

References
  1. Based on a technical comparison against key market competitors (06-2020).
  2. The EyeArt 510(k) clearance is based on a pre-registered, prospective, multi-center pivotal clinical trial (ClinicalTrials.gov ID NCT03112005). www.eyenuk.com (last accessed February 15, 2021)
  3. Abramoff, Michael & Lavin, Philip & Birch, Michele & Shah, Nilay & Folk, James. (2018). Pivotal trial of an autonomous AI-based diagnostic system for detection of diabetic retinopathy in primary care offices. npj Digital Medicine. 1. 10.1038/s41746-018-0040-6.
  4. Garg, S., MD, PhD. Teleretinal Imaging for Diabetic Patients. Retinal Physician, October 2018, 48-52.
  5. CAUTION Investigational device. Limited by Federal (or United States) law to investigational use. Welch Allyn® AutoDx-DR is intended to be used by healthcare providers to automatically detect more than mild non-proliferative diabetic retinopathy in adults age 22 or older diagnosed with diabetes who have not been previously diagnosed with diabetic retinopathy. AutoDx-DR is indicated for use with color JPEG or PNG images from ophthalmic cameras that capture a retinal area including the macula and optic disc, are a minimum of 512x512 pixels and are less than 5 megabytes in size. Welch Allyn AutoDx-DR is Medical Device (93/42/EEC) Class IIa, Notified Body: DQS Medizinprodukte GmbH (CE0297). Manufacturer: Welch Allyn, Inc. 4341 State Street Road, Skaneateles Falls, NY 13153, USA. EC REP: Welch Allyn Limited, Navan Business Park, Dublin Rd, Navan, Co. Meath, C15 AW22, Ireland. This medical device is a regulated health product which, pursuant to such regulation bears a CE mark.
  6. Stebbins, Y. Wang, Tang, Suri, S. Wang, Purohit, Johnson, Chaum. Determining the Accuracy of a Deep Learning Automated Algorithm for the Detection of Diabetic Retinopathy and Macular Edema. Hillrom. 2020 Nov; 30.
  7. Commercial Coverage Policy data on file. Welch Allyn; 2019.
  8. Medicare Program; CY 2021 Payment Policies under the Physician Fee Schedule Proposed Rule [CMS-1734-P], 08/17/2020, https://s3.amazonaws.com/public-inspection.federalregister.gov/2020-17127.pdf
  9. 84472 Federal Register / Vol. 85, No. 248, CMS–1734–F: Two practice sites are involved in these services: the acquiring site (for example, a primary care practice) and the reading site (for example, the ophthalmology practice). Both codes can be used to report diagnostic and monitoring services and the distinction is in who provides the service: physician (CPT® Code 92228) or clinical staff only (CPT® Code 92227).
  10. Understanding the Role of HCCs in Risk-Adjustment Programs; A Comprehensive Primer for Hierarchical Condition Categories, ©2017 Advisory Board, HYPERLINK "http://www.advisory.com" www.advisory.com
  11. Mansberger SL, Gleitsmann K, Gardiner S, et al. Comparing the effectiveness of telemedicine and traditional surveillance in providing diabetic retinopathy screening examinations: A randomized controlled trial. Telemed J E Health. 2013 Dec; 19(12): 942-8.