In December 2018, ahead of the launch of KeepSight in April 2019, Specsavers invested in the enhancement of its patient management system, enabling a consistent process for optometrists to denote patients with diabetes.
This, alongside measurement of e-referrals, has allowed the capture of anonymised data of Australian patients with diabetes so referral rates and trends can be monitored. In turn, these insights continue to drive further evolution of mechanisms to enhance consistency of care for these patients in primary optometry practice.
As providing care for patients with diabetes has increased as a focus, Specsavers has identified several trends from its patient-base.
Firstly, the quantity and proportion of patients with diabetes that Specsavers is providing care for has increased. In quarter one of 2019, patients with diabetes made up 4.9% of Specsavers’ patient base. This was significantly lower than the reported population prevalence of 8% as estimated by the National Health and Medical Research Council and was aligned with the reported estimations that around 50% of people with diabetes were failing to have their eyes tested within the recommended time frames.
Following the introduction of KeepSight and the measurement and adaption of practice processes aligned to patients with diabetes, Specsavers’ diabetes patient-base has grown to a 2020 year-to-date average of 6.8%. While this percentage has been undoubtedly affected by COVID restrictions, tracking of eye test volume throughout the year has seen a balanced rise in the quantity of patients with diabetes being seen by optometrists, except for Q2 when COVID closures saw numbers drop by almost half.
While Specsavers’ dataset is national and representative of Australia in terms of demographic and socio-economics as a result of large market share, it is worth noting that due to Specsavers’ founding position as a KeepSight partner, the rate at which patients with diabetes are receiving care at its practices may not be representative of the entire industry. However, despite this, the data does show that the focus on diabetes eyecare and commitment to KeepSight has incrementally increased attendance rates. Specavers recognises that normalising routine optometric attendance is the key to early detection and management of the sight threatening effects of diabetes and so accessibility, consistency of care and effective recall communication form the core of the initiative.
It will take a several years to properly understand the impact of KeepSight on patient numbers, as the recommended review cycle for these patients is 1-2 years.
We will continue to report on optometric attendance for this group as we near the program’s two-year anniversary in April 2021.
The rate of referral to specialist care has remained steady throughout the 2019-2020 period, with an average of 5.5% of patients with diabetes visiting Specsavers practices for eye checks being referred, around 3,000 patients per quarter from 400 practices across Australia. Of those, an average of 2.5% of referrals over the two-year period were deemed ‘very urgent’, requiring specialist care within 24 hours (an average of 80 patients per quarter nationally); 27.3% were ‘urgent’, requiring specialist care within two weeks (an average of 865 patients per quarter nationally); and 70.2% were ‘routine’, requiring specialist care at the next available appointment (an average of 2,200 patients per quarter nationally).
This consistency over time demonstrates the adherence of optometrists to the thresholds of urgency outlined in the RANZCO Referral Pathway for Diabetic Retinopathy.