Electronic medical records help track diabetic eye exams

A patient and Dr. Bargwell

Making sure diabetic patients get all their lab tests has become routine for Dr. Bargwell’s practice at Metro Health Cedar Springs, north of Grand Rapids. “We use an electronic medical record through Metro Health that gives us the ability to create a flag if a patient hasn’t had an eye exam in the last year,” says Dr. Bargwell.

The system flags patients whether they are in the office for a regular visit or a sick visit. Dr. Bargwell also credits the office staff for their fine work in keeping the providers informed of patients that are due for diabetic eye exams.

“We also have the luxury of having two ophthalmologists about seven miles from our office,” he says. “They are part of the Metro Health system and are on the same medical record system. So we work almost exclusively with them to set up appointments. We can schedule appointments through the system and send notes back and forth.”

Another reason diabetics at the practice all get their eye exams regularly is because the staff schedules appointments, even when the patient chooses to use an ophthalmologist outside the Metro Health system. The referral coordinators then contact patients to remind them of appointments.

Dr. Bargwell receives the results from the eye exams and, as long as there’s no progression in their eye disease, the office follows up with routine visits. “If there’s a finding where the ophthalmologist suggests tighter glycemic control, we advise the patient to come in to adjust their medication,” Dr. Bargwell says.

If patients prefer to see their own ophthalmologist, the doctor reminds the patients to have the ophthalmologist fax a report to him. Sometimes he will call the other doctor and give them his fax number to make sure he gets the results.

Patient education is an important pillar of diabetic care. The office has a certified diabetic educator who is in the office two days a week. “We use her for patients who may lack understanding of their disease or their control is not where it needs to be,” says Dr. Bargwell.

“The challenge with diabetic patients is that the eye exam is just one piece of what we expect from them,” he continues. “Those patients require routine blood work, foot exams and prescription monitoring. I may want to see them three or four times a year, so it gets demanding for them to meet those expectations. I think we need to be understanding that the eye exam is important, but just one facet of their overall diabetic care.”