December 2025

OPHTHALMOLOGY

ADVANCING DIABETIC EYE SCREENINGS THROUGH PRIMARY CARE INTEGRATION

Annual eye exams are essential for patients with diabetes, yet many health systems face challenges in ensuring timely screenings. To address this, Paul J. Bryar, MD, led an initiative to make diabetic eye screenings more accessible and convenient for patients while simplifying the process for primary care teams. This resulted in nearly 65% of patients with diabetes at Northwestern Memorial Hospital completing eye exams, compared to 40% of patients nationwide.*

Streamlined workflow for clinicians
Dr. Bryar and the project team collaborated with primary care physicians, medical assistants and administrators to design a solution that fits seamlessly into existing workflows. The team introduced an Epic OurPractice Advisory (OPA) that alerts clinicians when a patient is due for screening and opens a SmartSet for point-of-care retinal imaging. Patients automatically receive instructions for a walk-in screening at the ophthalmology clinic, no appointment required.

Fast, high-quality imaging
Screenings use a nonmydriatic camera to capture high-resolution retinal images without dilation in just two minutes. While not a substitute for a comprehensive eye exam, this approach effectively identifies diabetic retinopathy and other ocular complications, enabling timely referrals for full evaluation and treatment planning.

Positive outcomes and growing impact
Since its launch, the program has expanded across multiple primary care and endocrinology practices. Automated patient outreach via Epic patient portal messages has increased referrals, and hundreds of patients have been screened. Completion rates have risen significantly, demonstrating the effectiveness of this integrated model.

Scalable solution for vision preservation
“By automating outreach and empowering patients, we’re seeing a dramatic increase in screenings,” says Dr. Bryar. “This model supports care teams and helps preserve vision for patients with diabetes.”
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The initiative earned Grand Prize and Colleagues’ Choice awards at Northwestern Medicine’s Improvement Day, highlighting its potential as a best practice for health systems nationwide.

*US Department of Health and Human Services. HealthyPeople 2030. Increase the proportion of adults with diabetes who have a yearly eye exam—D-04. Accessed January 20, 2022. https://health.gov/healthypeople/objectives-and-data/browse-objectives/diabetes/increase-proportion-adults-diabetes-who-have-yearly-eye-exam-d-04external icon
Paul J. Bryar, MD, Vice Chair of Clinical Operations in the Department of  Ophthalmology and Professor of Ophthalmology and Pathology at Northwestern Medicine

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