Utilization and insurance coverage of tele-retinal imaging during the COVID-19 pandemic

Purpose : Greater utilization and insurance coverage for tele-retinal screening during the COVID-19 pandemic in 2020 may enhance awareness and expand remote retinal imaging services. In this study, we performed a retrospective, cross-sectional analysis of utilization and insurance payments of tele-retinal imaging services in the United States in 2020. Methods : We examined remote retinal imaging utilization and insurance payments from January 1, 2020, to December 31, 2020, using the OptumLabs® Data Warehouse (OLDW), a comprehensive database of de-identified administrative claims for commercial and Medicare Advantage enrollees in the U.S. We evaluated frequency of claims and insurance payment for services using Current Procedural Terminology codes 92227 and 92228 for remote eye imaging by any provider, and 92250 for fundus photography by non-eye care providers. Results : Use of remote retinal imaging declined rapidly from 3627 claims in February 2020 to 1414 claims in April 2020, but returned to 3133 claims by December 2020, similar to pre-pandemic levels in 2019 (2841 ± 174.8 claims). Proportion of insurance payments for remote imaging increased temporarily from 47.4% in February to 56.7% in April, then returned to 45.9% in December. Conclusions : Utilization of tele-retinal imaging declined steeply while insurance coverage increased during the initial COVID-19 lockdown in 2020, but returned to pre-pandemic levels by end-of-year. Changes in utilization and relaxed restrictions on insurance reimbursements for remote retinal imaging during the COVID-19 pandemic were not sustained.

Understanding Privacy Attitudes and Concerns Towards Remote Communications During the COVID-19 Pandemic

Since December 2019, the COVID-19 pandemic has caused people around the world to exercise social distancing, which has led to an abrupt rise in the adoption of remote communications for working, socializing, and learning from home. As remote communications will outlast the pandemic, it is crucial to protect users' security and respect their privacy in this unprecedented setting, and that requires a thorough understanding of their behaviors, attitudes, and concerns toward various aspects of remote communications. To this end, we conducted an online study with 220 worldwide Prolific participants. We found that privacy and security are among the most frequently mentioned factors impacting participants' attitude and comfort level with conferencing tools and meeting locations. Open-ended responses revealed that most participants lacked autonomy when choosing conferencing tools or using microphone/webcam in their remote meetings, which in several cases contradicted their personal privacy and security preferences. Based on our findings, we distill several recommendations on how employers, educators, and tool developers can inform and empower users to make privacy-protective decisions when engaging in remote communications.