This application proposes a training plan to develop Lindsay A. Rhodes, MD into an independent clinician- scientist specializing in health services research, including novel care delivery models such as telemedicine. Dr. Rhodes is a board certified ophthalmologist with subspecialty training in glaucoma and with prior research experience in telemedicine. This training program will consist of mentored research, advanced coursework leading to a Master of Science in Public Health in Outcomes Research, and multi-disciplinary conferences. Mentored research will be conducted under the direction of a mentoring team composed of Dr. Christopher Girkin, Professor and Chairman of the UAB Department of Ophthalmology, Dr. Cynthia Owsley, Professor and Vice Chair for Clinical Research at the UAB Department of Ophthalmology, Dr. Stephen Mennemeyer, Professor in the UAB Department of Health Care Organization and Policy, and Dr. Gerald McGwin, Professor and Vice Chair in the UAB Department of Epidemiology. The proposed mentored research plan will evaluate a novel community-based care delivery model for open angle glaucoma. The overarching hypothesis is that a telemedicine-based detection and management program using a comprehensive remote optic nerve assessment (CRONA) performed in community clinics and then transmitted to a remote reading center can access at-risk minority populations as accurately as standard in-person care by a glaucoma specialist, at lower cost, and with a platform for eye health education designed to improve patient adherence to filling glaucoma medications. This hypothesis will be tested utilizing data obtained from a recently developed telemedicine demonstration program at the University of Alabama at Birmingham, entitled Eye Care Quality and Accessibility Improvement in the Community (EQUALITY), along with a smaller cross-sectional study. EQUALITY deployed an integrated telemedicine program within two primary eye care clinics (Walmart Vision Centers) located within retail centers that serve predominantly African American communities in underserved areas of Alabama. Primary eye care providers in these retail-based clinics performed dilated comprehensive eye exams with the additional use of automated optic nerve structural and functional assessment to assist in the detection of glaucoma. The data from the comprehensive eye exam and optic nerve assessment was then transmitted electronically to a tertiary glaucoma center, located geographically remotely from the primary eye care clinics, where it was evaluated by an ophthalmologist with fellowship training in glaucoma. The training and mentored research program proposed in this application will enable Dr. Rhodes to achieve her goal of becoming an independent clinician-scientist who can meaningfully contribute to the creation of novel care delivery methods to address our growing health care needs.

Public Health Relevance

Glaucoma is a blinding eye disease increasingly common in older adults and often diagnosed late in the disease course. It is essential to develop novel health care models, utilizing telemedicine, to improve the ability of routine eye exams to detect glaucoma at an earlier stage, and to provide a platform to manage this disease in community-based clinics so that further vision loss is prevented.

Agency
National Institute of Health (NIH)
Institute
National Eye Institute (NEI)
Type
Mentored Patient-Oriented Research Career Development Award (K23)
Project #
5K23EY025724-02
Application #
9253404
Study Section
Special Emphasis Panel (ZEY1)
Program Officer
Agarwal, Neeraj
Project Start
2016-05-01
Project End
2021-04-30
Budget Start
2017-05-01
Budget End
2018-04-30
Support Year
2
Fiscal Year
2017
Total Cost
Indirect Cost
Name
University of Alabama Birmingham
Department
Ophthalmology
Type
Schools of Medicine
DUNS #
063690705
City
Birmingham
State
AL
Country
United States
Zip Code
35294
Stanley, Jordan; Huisingh, Carrie E; Swain, Thomas A et al. (2018) Compliance With Primary Open-angle Glaucoma and Primary Open-angle Glaucoma Suspect Preferred Practice Patterns in a Retail-based Eye Clinic. J Glaucoma 27:1068-1072
Peterson, Kristen M; Huisingh, Carrie E; Girkin, Christopher et al. (2018) Patient satisfaction with care in an urban tertiary referral academic glaucoma clinic in the US. Patient Prefer Adherence 12:775-781
Rhodes, Lindsay A; Huisingh, Carrie E; Quinn, Adam E et al. (2017) Comparison of Bruch's Membrane Opening Minimum Rim Width Among Those With Normal Ocular Health by Race. Am J Ophthalmol 174:113-118
Rhodes, Lindsay A; Huisingh, Carrie E; McGwin Jr, Gerald et al. (2016) Eye Care Quality and Accessibility Improvement in the Community (EQUALITY): impact of an eye health education program on patient knowledge about glaucoma and attitudes about eye care. Patient Relat Outcome Meas 7:37-48