Time spent on eye disease screening, optical care, and care navigation within a federally qualified health center

Abstract

Purpose

To quantify time spent on eye disease screening, optical care, and care navigation tasks during the Michigan Screening and Intervention for Glaucoma and Eye Health through Telemedicine (MI-SIGHT) program at a federally qualified health center (FQHC) in Michigan, with the goal of anticipating workforce needs to inform the scalability of similar programs in low-resource settings.

Design

Cross-sectional study.

Methods

Ophthalmic technicians recorded time spent with MI-SIGHT participants on eye disease screening tasks and optical care over 22 days from October 1 to October 31, 2023, and care navigation tasks over 22 days from December 4, 2023, to February 2, 2024. Eye disease screening tasks included a health history, measuring visual acuity, contrast sensitivity, intraocular pressure, pachymetry, taking external and fundus photos and macular and retinal nerve fiber layer optical coherence tomography images. Optical care tasks included refraction, ordering glasses, coordinating glasses pickups, dispensing and fitting glasses, and handling returns. Care navigation tasks included scheduling follow-up appointments, assisting with insurance, and providing medical interpretation and education. Minutes spent on tasks were summarized with descriptive statistics (mean, standard deviation, median, minimum, and maximum). Full-time equivalent (FTE) was calculated as the percentage of full-time hours over 22 days.

Results

154 participants receiving care through the MI-SIGHT program were included. Technicians spent 21.4 % of an FTE on eye disease screening, 23.6 % on optical care, and 12.1 % on care navigation, with remaining FTE spent on other tasks including outreach, study coordination and research (42.9 %).

Conclusions

Integrating optical care and care navigation services within a free eye disease screening program is time-intensive but can help deliver comprehensive, accessible eye care to low-income populations. The MI-SIGHT program offers a model for expanding eye care services in FQHCs and improving vision outcomes for medically underserved communities. This study provides insights into personnel needs to guide the scaling of similar programs in low-resource settings.

Precis

The Michigan Screening and Intervention for Glaucoma and Eye Health through Telemedicine (MI-SIGHT) program offers a novel approach to eye care by providing free eye disease screenings, optical services, and care navigation at a federally qualified health center to improve vision outcomes and eye health in underserved communities. This time study provides workforce estimates to guide the scaling of similar comprehensive eye care programs in low-resource settings.