Clinical Partnership Programs are the programs that many partner-institutions with their different expertise and roles work together to achieve a high volume and high quality of medical services. It usually involves primary health care services, specialty medical services, independent third-party services, and intra and inter-institutes quality control processes.
Monitoring of Diabetic Retinopathy for Enhancing General Diabetes Care
Diabetic retinopathy (DR) is one of the most specific pathological changes of diabetes mellitus, which has been used as the reference pathology for defining diabetic diagnostic cutting point (threshold) of fasting plasma glucose (FPG), 2-h post oral glucose load plasma glucose (2-h PG) and glycated hemoglobin (HbA1c). With the development of high-quality non-invasive digital fundus photography technology and quality-assured DR assessment technologies, it will be possible that this critical reference indicator be applied as an important routine systemic assessment tool for general diabetes care, in addition to FPG, 2-h PG and HbA1c.
Routine photographic monitoring of DR changes in general diabetes care may also be used as a effective tool for patient education, which may significantly increase patient compliance for diabetic care, and therefore a better diabetes control.
Fundus photography facility is required for general diabetes care. Two different approaches (modules) of DR image diagnosis with systemic quality controls have been developed for the purpose of general diabetes care, i.e., the clinicians’ image reading and the independent third-party image diagnosis service. Simplified ETDRS grading system with optional automatic quantitative measurement of the individual elements of early DR pathologies have been employed for the DR image diagnosis to meet the needs of general diabetes care. Patients with sight-threatening diabetic retinal pathologies will be referred for ophthalmic service.
Diabetic Retinopathy Screening Program for Preventing Blindness
Diabetic retinopathy (DR) is one of the major causes of visual loss nowadays in many countries. The application of the assessment of DR in general diabetes care will be essentially important for early detection and prompt medical intervention of sight-threatening DR. This is probably a much more efficient approach for preventing diabetes-related visual loss than the traditional DR screening by eye specialists.
In places where monitoring of DR for general diabetes care is not available, a screening program for sight-threatening DR should be estabalished. The DR image diagnosis (DR grading) is preferably performed with the conventional eye-care-centered grading standards by an ophthalmology-based image diagnosis (DR grading) service since the sreening program is eye-care-oriented. Systemic quality control management should be accepted for the screening process and the DR grading process.
Quality Control Program for Ophthalmic Intervention of Diabetic Retinopathy
Quality eye care service for diabetic retinopathy should be estabalished for diabetes eye care. This will include quanlity controlled ophthalmic image grading of DR and the planning/excution of ophthalmic treatments of DR (both laser and surgical) for the patients. The quality control management should include intra-institute and inter-institutes quality controls.