Since this past summer, I have been investigating ways that we can improve the follow-up rates of patients with chronic eye diseases that can cause rapid and irreversible vision loss (eg. diabetic retinopathy, glaucoma). I've been working on this project with the Aravind Eye Hospital in India, and we noticed that a large number of patients with these conditions often fail to return for scheduled follow-up treatments that must be done in a timely manner to maintain the health of the eye. Among the barriers that patients face, we found that travel time, waiting time, and the fact that patients have to give up a day's wages to come to the hospital to be major hindrances (costs are heavily subsidized by the hospital for patients who cannot pay). We also suspect that the reluctance to come to follow-up appointments for these reasons is amplified by a limited understanding of the severity of their condition. This may be due to either due to lack of health education among many of the patients, or due because in-hospital counselling time was too limited.
To address this issue, we developed a new categorization system where patients with very urgent cases would get a certain label, triggering a number of downstream changes in their care (e.g. longer counselling, more reminder phone calls prior to an appointment) and we are hoping that this will be a good starting point. However, I am curious as to whether anyone else has suggestions for how else we can work to tackle this problem? Thank you for your input!