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David J Ramsey,1,2,&ast; Claudia C Lasalle,1,2,&ast; Sidrah Anjum,1 Jeffrey L Marx,1,2 Shiyoung Roh1,2 1Department of Surgery, Division of Ophthalmology, Lahey Hospital & Medical Center, Beth Israel Lahey Health, Burlington, MA, 01805, USA; 2Department of Ophthalmology, Tufts University School of Medicine, Boston, MA, 02111, USA&ast;These authors contributed equally to this workCorrespondence: David J Ramsey, Department of Surgery, Division of Ophthalmology, Lahey Hospital & Medical Center, 1 Essex Center Drive, Peabody, MA, 01960, USA, Email David.J.Ramsey@lahey.orgPurpose: The COVID-19 pandemic had a disproportionate impact on patients from racial and/or ethnic minority groups, causing many to delay healthcare. This study evaluates the role telehealth visits played in helping patients with diabetes mellitus (DM) return for subsequent, in-person eye examinations after the outbreak of COVID-19.Methods: This retrospective, cross-sectional study analyzed 8147 patients with DM who had completed an outpatient ophthalmology and/or optometry visit in 2019 and who were due for return evaluation after the outbreak of COVID-19 in 2020. Factors associated with return for subsequent, in-person eye examination were assessed.Results: The mean age of patients was 68.8 (± 13.0) years, and 42% were women. 7.4% of patients identified as Asian; 2.9% as Black; 3.4% as Hispanic or Latin American; 0.92%, as more than one race; 1.78%, as other races; and 80.7% as White. Patients from racial and/or ethnic minority groups completed fewer in-person eye examinations after the outbreak of COVID-19 compared with White patients (35.6% versus 44.5%, χ2=36.172, P< 0.001). However, both groups accessed telehealth services at a similar rate during this period (21.1% versus 21.9%, χ2=0.417, P=0.518). Importantly, patients who received telehealth services returned for subsequent, in-person eye examinations at substantially higher rates, regardless of race (51.0% and 46.6%, r

Kristen H Kuo,1,2 Sidrah Anjum,1 Brian Nguyen,1,3,4 Jeffrey L Marx,1,2 Shiyoung Roh,1,2 David J Ramsey1,2 1Department of Ophthalmology, Lahey Hospital & Medical Center, Peabody, MA, USA; 2Department of Ophthalmology, Tufts University School of Medicine, Boston, MA, USA; 3Tufts University School of Dental Medicine, Boston, MA, USA; 4Heller School for Social Policy and Management, Brandeis University, Waltham, MA, USACorrespondence: David J RamseyDepartment of Ophthalmology, Lahey Hospital & Medical Center, Beth Israel Lahey Health, 1 Essex Center Drive, Peabody, MA, 01960, USAEmail David.J.Ramsey@lahey.orgPurpose: We conducted a cross-sectional study to assess the utilization of a tele-ophthalmology screening program in a low-risk, suburban population of patients with diabetes.Methods: A total of 214 diabetic patients without previously documented diabetic retinopathy (DR) underwent point-of-care non-mydriatic fundus photography through their primary care providers at five Beth Israel Lahey Health locations. The characteristics of the patients who received remote screening were compared with those patients who were eligible for screening but did not take part in the program. Time-driven activity-based costing (TDABC) was implemented to examine the cost of screening by tele-ophthalmology compared with in-person examinations.Results: Tele-ophthalmology screening was more likely to be provided for patients who were younger (OR 0.985; 95% CI 0.973– 0.997, p=0.016), who were obese (OR 2.04; 95% CI: 1.47– 2.84, p=0.008), who had an HbA1c above 8.0% (OR 1.60; 95% CI: 1.13– 2.26, p=0.031), or who had an eye examination in the past year (OR 5.55; 95% CI: 3.89– 7.92, p< 0.001). Those patients newly diagnosed with DR because of the program were more likely to have diabetic nephropathy (OR 7.79; 95% CI: 1.73– 35.05, p=0.007). TDABC identified a health system cost-savings of between $8 and $29 per patient screened by tele-ophthalmology compared with the cost