在联邦合格医疗中心进行眼病筛查、视力保健和护理导航所花费的时间。
Time spent on eye disease screening, optical care, and care navigation within a federally qualified health center.
作者信息
Weber Madeline K, Woodward Maria A, Lu Ming-Chen, Niziol Leslie M, Livingston Jade, Zuccaro Mildred Silva, Winter Suzanne, Ramachandran Rithambara, Johnson Leroy, Bicket Amanda K, Elam Angela R, Newman-Casey Paula Anne
机构信息
Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA.
Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, MI, USA.
出版信息
AJO Int. 2025 Apr;2(1). doi: 10.1016/j.ajoint.2024.100097.
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.
目的
量化在密歇根州一家联邦合格健康中心（FQHC）开展的通过远程医疗进行青光眼及眼部健康筛查与干预（MI-SIGHT）项目期间，花费在眼病筛查、视力保健和护理导航任务上的时间，目标是预测劳动力需求，为在资源匮乏地区扩大类似项目的规模提供依据。
设计
横断面研究。
方法
眼科技术人员记录了2023年10月1日至10月31日这22天内与MI-SIGHT项目参与者进行眼病筛查任务和视力保健所花费的时间，以及2023年12月4日至2024年2月2日这22天内护理导航任务所花费的时间。眼病筛查任务包括健康史询问、测量视力、对比敏感度、眼压、角膜厚度、拍摄眼部外观和眼底照片以及黄斑和视网膜神经纤维层光学相干断层扫描图像。视力保健任务包括验光、订购眼镜、协调眼镜领取、配镜和调整以及处理退换货。护理导航任务包括安排随访预约、协助保险事宜以及提供医学口译和教育。对各项任务所花费的分钟数进行描述性统计总结（均值、标准差、中位数、最小值和最大值）。全职等效值（FTE）计算为22天内全职工作时长的百分比。
结果
纳入了154名通过MI-SIGHT项目接受护理的参与者。技术人员在眼病筛查上花费了1个FTE的21.4%，在视力保健上花费了23.6%，在护理导航上花费了12.1%，其余FTE用于其他任务，包括外展、研究协调和研究（42.9%）。
结论
在免费眼病筛查项目中整合视力保健和护理导航服务耗时较长，但有助于为低收入人群提供全面、可及的眼部护理。MI-SIGHT项目为在FQHCs中扩大眼部护理服务以及改善医疗服务不足社区的视力状况提供了一个模式。本研究为指导在资源匮乏地区扩大类似项目规模的人员需求提供了见解。
摘要
通过远程医疗进行青光眼及眼部健康筛查与干预（MI-SIGHT）项目提供了一种新颖的眼部护理方法，即在一家联邦合格健康中心提供免费眼病筛查、视力服务和护理导航，以改善医疗服务不足社区的视力状况和眼部健康。这项时间研究提供了劳动力估算数据，以指导在资源匮乏地区扩大类似的综合眼部护理项目。
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