Table 4 Primary care provider (PCP) and clinical staff perceptions of implementation strategies’ impact on teleophthalmology use

Clinical reminders

Patient Rooming Checklist that reminds PCPs/Medical Assistants (MAs) to ask patients about last diabetic eye screening during a clinic appointment

Remind clinicians

9 (81.8%)

11 (78.6%)

Patient reminder phone calls

Yearly reminders (e.g., by mail, phone, or text message) to patients who had teleophthalmology performed previously and are due again for diabetic eye screening

Intervene with patients to enhance adherence

8 (72.7%)

8 (57.1%)

Improving EHR documentation

Consistent location of electronic health record (EHR) diabetic eye screening documentation

Change record systems

7 (63.6%)

12 (85.7%)

Patient education materials

Patient education materials (e.g., handouts, brochures, etc.) refined with patient stakeholder input

Develop educational materials

4 (36.4%)

9 (64.3%)

Provider and rtaff education

Presentations at regularly scheduled provider and staff meetings to provide education and updates on teleophthalmology use

Conduct educational meetings

2 (18.2%)

2 (14.3%)

Quarterly individual performance reports

Quarterly emails with individual provider-level data on the number of teleophthalmology referrals and comparison data with other providers

Audit and feedback

1 (9.1%)

0 (0.0%)

Implementation team

Monthly meetings with an implementation team of PCPs, MAs, and clinic administrators to develop implementation strategies and obtain ongoing feedback

Organize implementation teams and team meetings

0 (0.0%)

2 (14.3%)

Provider performance-based incentive

PCPs electing to have financial bonus for quality measure tied to their performance on diabetic eye screening rate among the PCP’s patient panel

Alter incentive structures

0 (0.0%)

0 (0.0%)

Bi-monthly group Performance reports

E-mail newsletters with updates on teleophthalmology program

Audit and feedback

0 (0.0%)

0 (0.0%)