title: Centralized Reading Center Improves Quality in a Real-World Setting.
abstract: OBJECTIVE
  Diabetic retinopathy (DR) screening is standard of care, but its utility diminishes unless high quality is maintained. This project describes the improvement in diagnostic accuracy achieved at a large health maintenance organization by implementing a centralized reading center.
  
  
  METHODS
  Data were extracted from the electronic health records of patients with diabetes who underwent DR screening between January 1, 2009, and December 31, 2013, at 13 medical centers. Certified ophthalmic assistants and technicians were trained to read DR images under the supervision of a retinal specialist. This program was pilot-tested prior to full implementation.
  
  
  RESULTS
  DR prevalence among the 13 centers in 2009 was 10.1%, far below the national average. After implementation, prevalence increased to 22.1%. The program also resulted in improved access to follow-up.
  
  
  CONCLUSIONS
  The results demonstrate the value of a reading center in decreasing diagnostic error and achieving other improvements in a real-world setting.
authors.forename: Sharon M
authors.initials: SM
authors.lastname: Hudson
authors.forename: Richard
authors.initials: R
authors.lastname: Contreras
authors.forename: Michael H
authors.initials: MH
authors.lastname: Kanter
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Munz
authors.forename: Donald S
authors.initials: DS
authors.lastname: Fong
mesh_terms: D000368:Aged; D000488:Allied Health Personnel / Q000592:standards*; D016208:Databases, Factual; D003930:Diabetic Retinopathy / Q000175:diagnosis* / Q000453:epidemiology; D003951:Diagnostic Errors / Q000517:prevention & control; D057286:Electronic Health Records; D005260:Female; D006279:Health Maintenance Organizations; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000592:standards*; D008875:Middle Aged; D010781:Photography / Q000592:standards*; D010865:Pilot Projects; D015995:Prevalence; D011320:Primary Health Care / Q000458:organization & administration; D011785:Quality Assurance, Health Care / Q000592:standards*; D011786:Quality Control