2720-LB: Bridging Primary Care and Ophthalmology at Emory Health Care: A Phase 1 Evaluation of AI Retinal Screening for Diabetic Retinopathy

Introduction and Objective: Effective collaboration between primary care and ophthalmology is critical to improving diabetic retinopathy (DR) screening access. AEYE Health was piloted across Emory Healthcare primary care sites in collaboration with ophthalmology. This Phase 1 study evaluated implementation from April to December 2025 for workflow efficiency, AI usage guidelines, and appropriate ophthalmology scheduling. Methods: Patients screened using AEYE Health across Emory Healthcare primary care sites were included. Ophthalmology verified findings per ETDRS criteria. Collected data included scheduling status, time to appointment, and referral adherence. Eye care providers conducted site visits at three of four clinics, and monthly stakeholder meetings reviewed access, scheduling, and workflow. Fisher's exact test, Pearson's Chi-squared test, and Kruskal-Wallis rank sum test explored associations between diabetic retinopathy and positive status. Results: Phase 1 included 1,635 total screening attempts and 771 screening encounters. AEYE Health identified 108 patients with more than mild DR; 114 patients with a negative result were reviewed from April to June 2025. Both groups underwent human-grade review, identifying false positives and glaucoma concerns. Most patients requiring referral had ophthalmology follow-up scheduled (56.14%, n=64), with delays from patient factors (78%), clinic error (6.5%), or outside provider care (6.5%). Glaucoma concerns appeared in positive (12.96%) and negative (23.68%) groups. Conclusion: AEYE Health strengthened connectivity between Emory Healthcare primary care and ophthalmology, improving eye health access and potentially reducing vision loss. Limitations included glaucoma and comorbid conditions, photography reliance, imaging staff learning curves, technical issues, and workflow integration considerations.