Without Bounds

doctor using a laptop for telehealth appointment

The Departments of Ophthalmology and Otolaryngology at the University of Pittsburgh have a mission to improve vision and hearing care for patients in underserved areas by attempting to meet them where they are with the services they need.

To address this, the Departments are hiring a project manager, purchasing equipment, and creating new models of care delivery that will utilize community health workers, and include remote testing, remote screening, mobile clinics, and telehealth applications.

Led by Dr. Jake Waxman in the Department of Ophthalmology, and Dr. Catherine Palmer in the Department of Otolaryngology, faculty in both Departments are addressing access to care problems by partnering with community leaders and health-care colleagues to field ophthalmic and audiology equipment and train local personnel in its use. Supervised remotely by our providers, they will screen, triage and initiate diagnostic and treatment plans in settings that include low-income primary care sites, rural Emergency Departments, older adult living facilities, and outpatient testing centers.

Specifically, Ophthalmology will use heat maps to identify areas with poor access to eye care and collaborate with electronic health record leaders to collect social determinants of health data. To provide tailored care access, eConsults, remote screening, remote testing, teleconsultation, and in-person encounters at primary-care sites will be offered. Additionally, the Departments eyeVan mobile unit will visit nursing homes and assisted living facilities.

The UPMC Center for Audiology and Hearing Aids has started providing teleaudiology, including testing at a distance. There is also a telehearing practice to program hearing aids and then mail to patients who are unable to visit the Oakland clinic. Both Departments are also working with social service networks to create workflows and training curricula for community health workers.

The goals are to:

  • Increase exam rates and the number of people served
  • Detect more cases of preventable eye disease and hearing loss in each target population
  • Reduce the need for transportation to a hub hospital for urgent and routine vision and hearing care
  • Improve patient satisfaction and awareness of the importance of regular eye exams

This project is possible thanks to generous philanthropic support from the Jewish Healthcare Foundation, Brother’s Brother Foundation, Henry L. Hillman Foundation, PA Medical Society, and Eye & Ear Foundation Board Member Nancy Washington.