Andrew Hade was diagnosed with diabetes two years ago. While the Rockford, Illinois, resident was surprised, he was more shocked when he later found out he also has diabetic retinopathy.

“Retinopathy is a complication of diabetes that affects the back of the eye and can cause vision loss, blurry vision and other complications,” says Pamela Garcia, a nurse practitioner for OSF HealthCare.

Garcia adds that early symptoms of retinopathy include floaters, blurriness, dark areas of vision and difficulty perceiving colors. Mild cases may be treated with diabetes management and more serious cases could require surgery.

It's important for people with diabetes to schedule a thorough eye exam at least once a year. That’s because most patients, like Hade, display no symptoms of diabetic retinopathy until it’s too late.

“I initially was dismissive about the eye test, because, I had no symptoms,” he says. “It's hard to think of something being wrong that's not actually causing things that you're noticing are wrong. So, imagine my surprise when they're like, ‘You need to visit an eye care specialist to make sure this is not a systemic issue that's getting worse.'”

Diabetes

According to the Illinois Department of Public Health (IDPH), 30.3 million people in the United States (9.4% of the population) have diabetes – one-third of these people don’t realize they have it. In Illinois, 1.3 million adults (12.5% of the population) have diabetes, and 341,000 of those people don’t know it. Diabetes is the seventh leading cause of death.

People suffering from diabetes are at a greater risk for heart disease, stroke, blindness, and kidney failure. Diabetes impacts people of all ages and ethnic groups.

But people like Hade are being helped thanks to screening that works to detect diabetic retinopathy.

Vision screening

Three years ago, OSF HealthCare began offering LumineticsCore at eight sites and has since expanded to several OSF locations in Illinois.

LumineticsCore is an artificial intelligence (AI) platform manufactured by Digital Diagnostics, a leading diagnostic health care company. The cameras are used to detect diabetic retinopathy during a patient visit by analyzing retinal images for signs of disease without the need for a specialist to interpret the images.

In the first six months of using this technology in OSF HealthCare offices, 28 out of 100 people with diabetes tested positive, with about a 2% false-positive rate. That’s 28% of patients with diabetes who would have been at risk of losing their vision in the future if not for the screening to detect it early.

Rejanee Evans is an OSF HealthCare medical office assistant who administers the tests in a Rockford-area clinic. She averages about 23 screenings a month in her office. She says the testing is convenient for patients. They can be screened before or after an appointment and the testing takes about five minutes.

“For all our controlled and uncontrolled diabetes patients, we have our machine that consists of four pictures, two of the right eye, two of the left,” she says. “They get the results right after the exam. And if they have diabetic retinopathy, then we will refer them to a specialist where they will start treatment.”

If the results are negative, the patients will be monitored and tested again in a year.

“Some patients didn't even know about it, and it really helps them,” Evans adds. “Some patients say I'm having vision loss, or my prescriptions just aren’t right. Well, a lot of that has to do with diabetic retinopathy. They didn't know that it was their diabetes that is affecting their eyes.”

Garcia says there are ways to reduce the risk of developing diabetic retinopathy. “If you have diabetes, to prevent complications like this, it's recommended that you keep your cholesterol and blood sugars under control, as well as if you have hypertension, keeping your blood sugar under control,” she says.

Hade has simple advice for people with diabetes. Get tested for retinopathy. Even if you don’t have any symptoms.

“Now that I do know, I can take steps to prevent the worst possible result, which is, going blind,” Hade stresses. “I don't want to go blind, so getting the test makes it so I might be able to avoid that. Not taking the test means that I wouldn't know.”

For more information about diabetes care, visit OSF HealthCare. 

Pamela Garcia interview clips 

Andrew Hade interview clips 

Rejanee Evans interview clips 

B-roll

OSF HealthCare initially launched LumineticsCore at eight sights, which have been operating for a full year. Based on the successful integration of LumineticsCore at the initial sites, OSF expanded the use of LumineticsCore to 24 additional sites that have now been operating for nine months. Using LumineticsCore, OSF HealthCare has been able to inform 25% of nearly 1,500 patients with diabetes, that they tested positive for diabetic retinopathy (DR). Without convenient access to the exam, many of those patients might not have been tested for DR, the leading cause of blindness for adults in the U.S.

Digital Diagnostics is committed to bringing high-quality AI diagnosis to the point-of-care, starting with the diabetic retinal exam to prevent vision loss and blindness for people living with diabetes. “We are always seeking new ways to innovate and improve access to cutting-edge diagnostics for our patients so we can help them better manage their health conditions, including diabetes which impacts nearly 66,000 OSF patients,” said Mark Meeker, DO, vice president of Community Medicine for OSF HealthCare. 

“Working with Digital Diagnostics allows us to offer an expanded set of services to our patients, while empowering our clinicians to help their patients decrease disease progression through prevention, not just through treatment.”

“The positive impact our partnership with OSF HealthCare is having in the lives of patients’ is exactly in line with our mission,” says Digital Diagnostics’ Senior Vice President of Commercial, Sean Murnane. “Offering LumineticsCore to patients in a setting where they are already comfortable, coupled with the high-quality care offered at OSF, furthers our organizations’ collective goal of improving patient outcomes.”

OSF Ventures, the investment arm of OSF HealthCare, has joined nine other investors in a $75 million Series B financing round to support Iowa-based Digital Diagnostics' efforts to speed growth, implementation and sales, plus deepen the development pipeline for digital tools aimed at improving patient access to early disease detection and treatment. OSF Ventures participated in the latest financing that was led by global investment firm KKR and also includes Cedar Pine, Kinderhook Industries, 8VC, Optum Ventures, , Gundersen Health System, Edward - Elmhurst Health Venture Capital and the University of Iowa.

Digital Diagnostics has a mission to benefit patients by transforming accessibility, affordability, equity and the quality of health care through technology that enables disease detection at the point of care that would typically involve specialists. The company currently has two autonomous artificial intelligence (AI) products, including the first-ever FDA De Novo cleared AI diagnostic platform that can make a diagnosis without physician review. The company’s IDx-DR platform can, within minutes of an easy exam, detect diabetic retinopathy (DR) (including macular edema (ME)) in the early stages for people who might not have had previous access to a diabetic eye exam.

OSF Medical Group has piloted use of the Digital Diagnostic platform. OSF Medical Group President Jeff Tillery, MD, has been impressed with the accuracy and ease of use of the equipment.

“That’s exciting because our goal always is to prevent disease or at a minimum, detect it early for better treatment results," says Tillery.

Diabetic retinopathy is the number one cause of blindness in the U.S.

OSF Ventures Vice President Mayank Taneja believes Digital Diagnostics is focusing on tools that can be scaled easily and that impact a large percentage of the population.

“Diabetes is a large and growing problem in the U.S. with more than 34.2 million people who are vulnerable to developing DR or ME. In addition, we know one-third of Americans don’t wear sunscreen and many, particularly vulnerable populations, are not educated about melanoma and other types of skin cancer and disease,” Taneja stresses. “OSF HealthCare and many health systems need options to address health equity and a key to that is providing more access to diagnosis and treatment through easy-to-use tools at a significant entry point – the primary care office.”

Digital Diagnostics is also focusing on improving outcomes for patients with other diseases.  One example is in dermatology where a platform is deployed for easy referrals and AI support using highly standardized skin images to detect melanoma, squamous cell carcinoma and basal cell carcinoma.

John Bertrand, Co-Founder and CEO of Digital Diagnostics commented, “We know OSF is committed to using ethical principles as it relates to the creation of algorithms to benefit patients, and we are proud that we have done that with our flagship product, IDx-DR. We plan to use what we’ve learned in the design, development and validation of IDx-DR as we push to make AI a standard of care.” Bertrand adds, “OSF HealthCare also shares our goal of transforming health care so we’re proud to have the Ventures team among our supporters.”

Like it was for many people, 2021 didn’t start out great for 47-year-old Betsy Huffman of Bloomington, Illinois. Her new year began with a long recovery from a December 2020 hospital stay connected with complications from undiagnosed Type 2 diabetes.

Huffman then suffered a mild stroke earlier this year. Her follow-up treatment involved trips to a cardiologist and a pulmonologist. It’s difficult for her to discuss without crying. Huffman’s mother also had diabetes, so she knew the difficult lifestyle changes and new medications she faced.  They are changes Huffman knew she’d have to stick to for the rest of her life. That’s also why, admittedly, she kept putting off yet another trip to a medical office to get a dilated eye exam to check for diabetic retinopathy – the number one cause of blindness in the U.S.

Huffman, who is a legal assistant at a Bloomington law firm, experienced blurry vision at times, but chalked it up as a response to new medications. Despite the repeated urging of her OSF HealthCare primary care doctor, Huffman ignored getting her eyes checked for retinopathy – until recently. New high-tech eye testing equipment arrived at her primary care office and after a regular check-up, all Huffman had to do was walk down the hall for her eye exam. An excited care team cheered her on, telling Huffman she could be the first to use the new equipment. Huffman had time off from work so, no more excuses.

“I just didn't want to face it. I don’t know. Being blind is a fear though. That's why I'm glad they did this because like I said it gave me a push because I probably still would not have made that appointment yet.”

Maintaining good blood sugar, blood pressure and cholesterol levels helps prevent diabetic retinopathy and diabetic macular edema. “OSF Innovation regularly seeks to understand the pain points and experiences of our frontline care givers and patients,” explains Becky Buchen, senior vice president of OSF Innovation. “With the knowledge that many patients with diabetes were not getting regular dilated eye exams from an ophthalmologist, our Performance Improvement team within Innovation, in collaboration with our Medical Group, launched a pilot with Digital Diagnostics, a company that received the first-ever Food and Drug Administration (FDA) clearance of IDx-DR, a digital diagnostic tool that can diagnose diabetic retinopathy during a patient visit without the need for a physician or eye care specialist.”

The technology takes photos of the back of retina and uses artificial intelligence to evaluate the extent of damage to blood vessels. The test typically takes a few minutes and in most, but not all cases, doesn’t require eyes be dilated.

Unfortunately, Huffman’s exam showed a positive result for diabetic retinopathy. While she’s scared of what’s to come, Huffman now has a follow-up appointment with an ophthalmologist to establish a care plan to determine next steps in her diabetes management. Huffman has no regrets about getting the IDx-DR exam at her OFS HealthCare primary care office.

“The fact that it was right there and to be able to do it and get it over with … it’s a good thing!”

Michael Mansfield, a medical office assistant with OSF, is passionate about this effort. He recently delivered a report to Kimberly Hart, a patient diagnosed with diabetes within in the past 12 months.

“This is your diagnostic result – no diabetic retinopathy detected, so no referral needed to an ophthalmologist, so that’s great. Next steps, we’re gonna re-test in 12 months,” he tells her. Hart responds, “Ok.”

Hart admits she’s still coming to terms with her diabetes diagnosis and the lifestyle changes it requires, but her results come as a relief.

“That is awesome news. I don’t want to have those diseases related to my diabetes so I’m pretty excited about that and I’m glad you get the results right away. You don’t have to wait, (she laughs).”

OSF HealthCare launched the diabetic eye exams in eight primary care locations starting in May. Among the 147 OSF patients with diabetes tested using IDx-DR, 21% had a positive diagnostic result for diabetic retinopathy.

OSF Innovation finds solution to a growing problem

Dr. Mark Meeker, vice president of Community Medicine at OSF HealthCare, says the number of people with diabetes receiving treatment is growing to tens of thousands across the OSF Ministry. Most primary care providers aren’t proficient in giving dilated eye exams because it isn’t part of routine visits. Yet many patients with diabetes put off going to an additional appointment at a different office to get a dilated eye exam every year or two.

Dr. Meeker says he recently saw a patient who put off getting his eyes checked because he gets docked for every absence from work, even if it’s for a legitimate reason such as a doctor’s visit. So, with busy schedules and work realities, Dr. Meeker stresses it’s important to make exams as convenient as possible. IDx-DR makes in-office testing quick and easy, plus it uses artificial intelligence to diagnose diabetic-related eye damage – so it’s much more accurate than a typical eye exam given in a primary care setting.

He explains, “The AI can see the early changes of diabetic retinopathy that we may not be able to see with our own eyes. If the AI sees that, then, the appropriate referrals can be made.”

Testing in primary care offers a one-stop shop approach for patients, but Dr. Meeker says it also off-loads exams from extremely busy eye doctors so they can focus on treating already-diagnosed conditions. It also helps medical providers know their patients better so they can help them keep their diabetes under control and stay on top of eye care to avoid complications.

Dr. Meeker says seeing is believing for some patients who get to see the photos taken during the exam and potential areas of concern the images reveal.

“So the ophthalmologists have tremendous technologies to treat diabetic retinopathy now with lasers and whatnot. But there's nothing as good as prevention. And the way you prevent it is to tightly control the diabetes to begin with. So as soon as we see those retinopathy changes, if we can really get the attention of the patient to really pay attention to their sugar control, we can decrease that progression through prevention, not just through treatment.”

OSF HealthCare should learn later this summer if it receives a grant that would cover costs for two years of training to expand the new, high-tech diabetic eye exam from eight primary care offices to additional sites in communities served by OSF. Currently the IDx-DR exam is available at:

Diabetic Retinopathy (IDx-DR) exams are currently available at these OSF Medical Group Sites

Betsy Huffman, patient who screened positive for risk of diabetic retinopathy

Kimberly Hart, patient with diabetes who screened negative for risk of diabetic retinopathy

Dr. Mark Meeker, vice president for Community Health, OSF HealthCare