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Express Screening Process Aims to Put Diabetics on the Fast Track to Better Health
Date:2/19/2008

Program illustrates how partnering can resolve issues, improve health

PITTSBURGH, Feb. 19 /PRNewswire/ -- For people with diabetes, waiting just a few weeks for an appointment with an eye specialist can lead to further complications such as blindness, macular edema and other vision disorders. To address the urgency in securing a specialist appointment, the Pittsburgh Ophthalmology Society (POS) recently launched an initiative with Highmark to offer express appointments to members with diabetes needing diabetic retinal eye examinations.

Through this initiative, some 100 POS member physicians have agreed to see patients with diabetes being referred for eye exams on a "fast-track" basis -- sometimes on the same day the patient receives a prescription from his or her primary care physician. The invitation for express appointments is open to all patients -- not just Highmark members.

"Anyone who has worked in a physician's office for any length of time knows that offering priority or express appointments isn't always easy, considering the sheer volume of patients who must be seen on a daily basis," said Michael Madden, M.D., medical director for medical performance management at Highmark, who participated in the meetings with POS members.

The "fast-track" program came about as a result of collaboration between POS members and Highmark in May 2007. The POS members recognized screening rates that Highmark had tracked for the Healthcare Effectiveness Data and Information Set (HEDIS) in 2007 could be improved for diabetics.

POS decided its 150 members would be contacted about participating in the "fast-track" program. By late summer, nearly 100 POS ophthalmologists' members responded, volunteering to help in the express appointment initiative.

In October 2007, the POS was ready to introduce the program to referring physicians throughout the region.

"Our outreach began with letters mailed to PCPs and endocrinologists with a copy of the list enclosed and a reference to the Web site," said Roger P. Zelt, M.D., president of the POS.

"The most obvious reason that it's so important to improve DRE screening rates is because these vision disorders may be preventable if the patient responds to the right treatment," said Dr. Madden.

Although the program is still in its infancy, and no formal study of its impact exists, the initiative is succeeding. Its total effect will likely be gauged, at least on Highmark's member population, in coming months when Highmark tracks DRE screening rates for the upcoming HEDIS measurement year, according to Dr. Madden.

"The most important thing to us is to optimize patient care," said Dr. Zelt. "When there are shared goals between the providers and insurers along those lines, then we are thrilled to be involved in these sorts of activities."

A complete listing of participating physicians is available on the Allegheny County Medical Society's Web site at http://www.acms.org/pos.

Highmark Inc.

As one of the leading health insurers in Pennsylvania, Highmark Inc.'s mission is to provide access to affordable, quality health care enabling individuals to live longer, healthier lives. Based in Pittsburgh, Highmark serves 4.6 million people through the company's health care benefits business. Highmark contributes millions of dollars to help keep quality health care programs affordable and to support community-based programs that work to improve people's health. Highmark exerts an enormous economic impact throughout Pennsylvania. A recent study states that Highmark's positive impact exceeded $2.5 billion. The company provides the resources to give its members a greater hand in their health.

Highmark Inc. is an independent licensee of the Blue Cross and Blue Shield Association, an association of independent Blue Cross and Blue Shield Plans. For more information, visit http://www.highmark.com.


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SOURCE Highmark Inc.
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