Table 3

Strategies to increase teleophthalmology use mapped to Chronic Care Model (CCM)

CCM componentTargetExamples of strategies
Health system organisation and
delivery system design
Health system, PCPs and clinic staff
  • Workflow changes including clinic staff checklists and delegation of referrals.*

  • Provider/staff training to increase familiarity with teleophthalmology.*

  • Convenient scheduling and location.*

  • Provide financial incentives to individual PCPs for diabetic eye screening performance.

Decision support and
clinical information systems
Health system, PCPs and clinic staff
  • Best practice alert in EHR when the patient is due for diabetic eye screening.*

  • Streamline processes for getting diabetic eye screening documentation into EHR.*

  • Provide PCPs with feedback/data on diabetic eye screening performance (eg, quarterly).

  • Generate lists of patients due for diabetic eye screening for clinic staff to contact.

Self-management support and
community resources
Patients, families, community members and clinic staff
  • Patient education materials provided at primary care clinic visits.*

  • Increase education about diabetic eye screening in diabetes self-management classes.*

  • Publicise teleophthalmology services* (eg, local media and community health fairs).

  • PCP clinic staff facilitate diabetic eye screening by calling patients and sending letters when due.

  • *Strategies that can address top barriers or facilitators from table 2.

  • EHR, electronic health record; PCP, primary care provider.