Table 2

Patient and primary care provider barriers and facilitators

PatientsBarriers
  • Unfamiliar with teleophthalmology.*

  • Misconceptions about diabetic eye screening.*

  • Logistical challenges* (eg, time, transportation, out-of-pocket cost).

  • Eye problems requiring in-person examination (eg, glasses or glaucoma).

  • Anxiety about receiving bad news regarding their eyes.

Facilitators
  • Recommendation from primary care provider.*

  • Convenience of teleophthalmology* (eg, same-day scheduling, location, quick).

  • Belief that diabetic eye screening is important for preventing vision loss.

  • Knowing that pharmacologic pupil dilation is usually not necessary.

  • Teleophthalmology is considered a high-quality service due to University affiliation.

Primary care providersBarriers
  • Difficulty identifying when patients are due for diabetic eye screening.*

  • Unfamiliar with teleophthalmology.*

  • Time constraints (eg, many competing tasks during clinic visit).

  • Concerns about conflicts with local eye doctors.

  • Concerns about patients’ barriers (eg, out-of-pocket cost).

Facilitators
  • Ease of referral process and results communication.*

  • Perceived benefits to patients (eg, convenience, cost).

  • Improved patient adherence with diabetic eye screening.

  • Benefits to the healthcare organisation (eg, increased reimbursement for improved quality metrics).

  • *Top barrier or facilitator identified at patient or primary care provider stakeholder meeting.