Diabetic retinopathy causes vision loss and blindness in many adults with diabetes. It is important to find it early by having yearly eye exams. But many community clinics have trouble giving enough screenings to their diabetic patients. Before new telehealth tools were used, fewer than 10% of diabetes patients at LifeLong Medical Care’s William Jenkins Health Center in Richmond, California, got yearly diabetic eye screenings. This low rate happens in many places, especially after the COVID-19 pandemic made specialty care harder to access.
Many things make screening rates low in these clinics. Transportation is a big problem, especially for patients who depend on public buses or don’t have cars. Most patients served are monolingual Latino/x speakers. Language problems can make it hard to schedule appointments, understand referral instructions, and talk with specialists. Also, many patients have work schedules that change and make it hard to get eye care off-site.
Because of these problems, clinics are trying to use better technology and change processes to add diabetic eye exams into primary care visits. Remote-guided telehealth devices are showing promise in helping with this.
Spect is a company in Silicon Valley. It offers a portable diabetic eye screening tool used in primary care clinics and Federally Qualified Health Centers (FQHCs). Spect’s system uses a special camera that attaches to a normal iPhone. Trained medical assistants or doctors can take clear photos of the retina right at the clinic. These images are sent to a remote team of eye doctors and technicians who review them in real time.
This setup means primary care providers do not need to be eye specialists to do diabetic eye exams. The remote team helps staff during the exam. They make sure the images are good enough for diagnosis. After looking at the images, specialists send back detailed reports. This allows doctors to diagnose and refer patients quickly without making them leave the clinic.
At LifeLong Medical Care’s Richmond clinic, using Spect’s technology increased diabetic retinopathy screenings from 10% to 40% in one year. This shows that fixing problems with transportation, language, and scheduling can help patients get better care in community clinics.
Spect focuses on helping underserved groups, especially the Latino/x community. This group has a higher chance of developing type 2 diabetes. The US Centers for Disease Control and Prevention (CDC) says more than half of Latino/x adults will get type 2 diabetes in their lives. Diabetes complications, like vision loss from diabetic retinopathy, are often more serious and happen more often in Latino/x people than in others.
Problems like language barriers, cultural differences, and low health knowledge make it hard for Latino/x people to get preventive care. Offering eye screenings inside the clinic with remote help helps overcome these problems. Fully bilingual support and having clinic staff who know the patient community reduce patient discomfort accessing care outside the clinic.
The California Health Care Foundation gave $475,000 to Spect to help more Medi-Cal patients and monolingual Latino/x patients get diabetes eye screenings. This money helps spread Spect’s devices to more clinics and supports training so teams can keep the program running.
Clinics using Spect’s technology add eye screenings into regular visits. This improves clinic workflows. For example, while waiting for eye drops to dilate the eyes, providers can do other health checks like measuring blood pressure or talking about diabetes management. Doing many services at once makes visits more efficient and means fewer appointments are needed.
Primary care doctors can give better care in one visit. This fits with value-based care, where doctors focus on improving health outcomes instead of just doing procedures. Catching vision problems early can stop costly and disabling complications later.
Clinic managers see that training medical assistants to use Spect’s device helps reduce doctor burnout by sharing tasks. Also, Spect’s system gives real-time support so staff are not alone when using the equipment. This lowers mistakes and need for retakes.
Remote help from eye doctors and technicians is very important. But AI is becoming more involved. Spect and other companies are making AI programs that look at retina pictures for diabetic retinopathy and other eye issues like glaucoma.
AI can mark images that need urgent attention, help busy clinics manage their workloads, and see signs of other diseases. The eye is often called the “check engine light” of the body. Spect’s co-founder, Dr. Ankur Gupta, hopes to use eye exam data to find early signs of brain diseases like Parkinson’s and Alzheimer’s as well as heart risks.
For clinic IT managers, AI-screening systems can automate routine image checks. This helps reduce the amount of work for specialist reviewers and speeds up results. Automatic alerts for unusual findings can start quick patient contact to avoid missed diagnoses.
AI can also connect with electronic health records (EHR) to simplify documentation, billing, and appointment scheduling based on screening results. This cuts down on paperwork and keeps data consistent.
Automating appointment reminders by phone or text can lower no-show rates and improve patients’ chances of getting yearly exams.
Spect’s portable eye exam device is small and works in many clinic settings. It can be used where there are no eye specialists or no costly fixed equipment. Trained medical assistants or other clinic staff can operate it with remote support.
This is especially useful for clinics in rural or underserved urban areas where eye care is hard to reach. Bringing diabetic eye screening to patients during their usual primary care visits cuts down on extra referrals, trips, or specialist visits.
Recently, Spect’s service is used by over 130 providers in six states, including many FQHCs. This shows that portable, AI-assisted eye screening is practical and in demand in community health care.
Dr. Justin Chin, a doctor at LifeLong Medical Care, said they saw a good chance to offer diabetes eye screenings on site using Spect. This helps patients get care faster in a place they trust.
Vanessa Villaverde, a healthcare administrator, said technology can close care gaps for hard-to-reach groups. She said, “We believe Spect’s solution will help close the gap in diabetes eye exams for people on Medi-Cal, especially those who are Latino/x, speak only one language, or live in rural areas.”
Michael Leung from Spect explained that the technology makes things easy for providers who don’t know much about eye exams. He said the eye is a powerful sign for health, and AI may help use eye exams for more health checks in the future.
By focusing on these points, community clinics can raise diabetic eye screening rates more easily and reduce long-term problems for patients and health systems.
Telehealth and AI-supported eye exams are becoming more common. Spect’s model shows a way to bring specialist exams into primary care clinics. This fits with health care approaches that aim to improve results while controlling costs.
Using more portable, AI-enhanced eye screening tools could improve care for millions of diabetes patients, especially in communities with fewer resources. Seeing many conditions from one eye photo can support care that checks many health issues at once.
Clinic leaders, owners, and IT staff who invest in these tools and include them in their daily work have a chance to improve access to care, lower avoidable vision loss, and manage chronic diseases better at the community level.
Access and transportation challenges were significant barriers, particularly for a predominantly monolingual Latino/x population. Many patients felt uncomfortable navigating the healthcare system outside their community clinic and reported issues like lack of reliable transportation and time off from work.
Spect enabled in-house diabetes eye screenings using a portable device, allowing clinics to perform exams on-site. Within a year of implementation, screening rates at LifeLong Medical Care increased from about 10% to 40%.
Spect utilizes a specialized camera attached to an iPhone, enabling medical assistants or physicians to conduct eye exams with remote assistance from a virtual team that analyzes the images and provides reports.
The investment aims to increase equitable access to diabetes eye exams, particularly for underserved demographics such as Latino/x and those on Medi-Cal, reducing long-term complications of diabetes.
Providers receive real-time guidance and support from Spect technicians during eye exams. After image capture, ophthalmologists analyze the images and send diagnostic reports, simplifying the process for primary care providers.
Undiagnosed diabetic retinopathy can lead to preventable vision loss and blindness, exacerbating other serious diabetes complications such as cardiovascular disease and kidney failure.
Spect aims to leverage AI to detect other health conditions beyond diabetic retinopathy, including neurodegenerative diseases and cardiovascular risks, enhancing its role in preventive health.
Portable devices like Spect’s camera reduce reliance on stationary and expensive equipment, enabling community clinics to provide essential services directly to patients, thereby increasing healthcare accessibility.
Spect’s founders envision a future where eye screening devices are common in households, allowing individuals to monitor their eye health and potentially detect other health issues early.
Spect’s approach allows primary care providers to address multiple health issues during a single visit, promoting comprehensive care that aligns with value-based care goals to improve patient outcomes.
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