Outreach | Department of Ophthalmology

The Department of Ophthalmology at the University of Pittsburgh School of Medicine strives to increase access to ophthalmic care in Pittsburgh.

Access to Eye Care
Access to Eye Care refers to the timely use of personal health services, and a patient's ability to access care is influenced by both individual (income, education, disability, level of trust in the healthcare system) and environmental factors (location and the number of providers).

According to Dr. Andrew Williams, access to care is more than finding appointment slots and filling them. It involves completely understanding all the individual social factors and barriers individuals face in maintaining those appointments. To improve access, we need to assess barriers to care, which are closely tied to social health determinants.

Drs. Williams and Sahel published an article about addressing social determinants of vision health, which the Eye & Ear Foundation wrote about.

Understanding Barriers to Care in Our Community
To begin understanding the barriers to care that people in our community face, a survey was conducted with attendees at the 2020 Mission of Mercy event. Three-fourths of screening attendees reported at least one barrier. When asked what obstacles they had in visiting an eye doctor, common themes emerged:

Medical Cost/Insurance
Difficulty navigating the system for appointments
Transportation
Provider accessibility

The group published an article based on its findings called “Characteristics Associated with Barriers to Eye Care: A Cross-Sectional Survey at a Free Vision Screening Event.”

Addressing Social Determinants of Health and Barriers to Care
The team thinks about solutions to this complex task through the lens of Awareness, Adjustment, Assistance, Alignment, and Advocacy:

Awareness
The first step in addressing patients’ needs is identifying what needs are most urgent and most prevalent. In the clinic, this involves administering social risk screening questionnaires. The UPMC Vision Institute has been piloting these screenings to gather data about barriers patients face.

Assistance
The primary way the Department of Ophthalmology assists patients facing barriers to care is through their Patient Navigator, Dana McGinnis-Thomas, MHA. She is the liaison between the patient, healthcare system, and community. McGinnis-Thomas employs creative thinking and problem-solving to address nearly any need that would otherwise prevent patients from receiving the eye care they need.

A recent study found that she received 130 referrals for 125 patients over a three-month period. Of that group, 98% were resolved with intervention, and 90% with resolution. It is a highly successful program with 4.87/5 patient satisfaction.

“Building trusting relationships with the patient and community partners is critical to successful patient navigation,” states McGinnis-Thomas.

Adjustment
Clinical care must be provided that accommodates social barriers, like adapting written education materials concerning health literacy and offering telemedicine appointments.

Alignment
To assist the greatest number of patients with the best possible care, the Department is focused on aligning its programs and goals with long-standing, established organizations in the community. Two examples of their community vision outreach programs are Eyes on Wheels and the Mission of Mercy, which can only exist in partnerships with community-based organizations. More information on these two interventions can be found below.

Advocacy
Policies must be promoted to address health and social needs. This means promoting investment in research on health disparities and community-engaged research and advocating for policies that advance access to eye care.

Healthy Vision Lab

Led by Dr. Williams, the Healthy Vision Lab is an interdisciplinary research group that seeks to improve vision health by understanding and addressing barriers to care. The Healthy Vision Lab combines epidemiology, big data analysis, and health services research to address important public health issues in ophthalmology, such as follow-up for chronic eye disease and social determinants of vision health.

Ongoing projects include utilizing a national database to measure the magnitude of follow-up loss in glaucoma care, understanding reasons for appointment “no show,” measuring the success of patient navigation in ophthalmology, and examining the impact of community-based initiatives for vision health.

Community Outreach Efforts

Clothing Closet
Thanks to a generous donation from a clothing company, the Department of Ophthalmology was able to establish a small clothing closet at the UPMC Vision Institute for patients who may need a change of clothing during their appointment.

Eyes on Wheels
Eyes on Wheels is a student-run, free, mobile health clinic dedicated to eliminating barriers to eye care for patients in the Western Pennsylvania area. Originally established as Guerrilla Eye Services in 2005 by Evan “Jake” Waxman, MD, PhD, and medical students at the University of Pittsburgh Medical School, Eyes on Wheels offers free, comprehensive eye exams to individuals with barriers to care at various community clinics around the Pittsburgh region while providing medical students with a rare, essential opportunity to experience hands-on patient care early on in their medical education.

eyeVan
The mobile eyeVan was donated to EEF in 2023 from the Brother’s Brother Foundation to assist Dr. Jake Waxman and the Eyes on Wheels team in providing free community vision clinics in the Pittsburgh region. The doctor's office on wheels is equipped with medical technology to provide eye exams, screenings, and treatments for people in underserved communities, and is used as part of Eyes on Wheels.

Garden Collaboration with the Western Pennsylvania School for Blind Children
Students and staff at Western Pennsylvania School for Blind Children help with the gardens and landscaping of the Bruce and Barbara Wiegand Roof Terrace and the Rehabilitation Gardens at the Vision Institute. The WPSBC operates a robust horticulture education and therapy program for children and adults. Their students, who operate the greenhouse on their campus, now visit the Vision Institute to gain experience in landscape design and maintenance.

Hillman Scholars Program
With support from the Henry L. Hillman Foundation, research labs in Ophthalmology have been added as a site to the Hillman Scholars Program at the University of Pittsburgh, which hosts students each summer to gain experience working in STEM. Students from economically disadvantaged districts are encouraged to apply and given a stipend for their time.

Mission of Mercy
The Mission of Mercy event is a two-day free health clinic held at the David L. Lawrence Convention Center in downtown Pittsburgh that provides free dental, vision, and hearing care for patients who are uninsured, underinsured, or otherwise lacking access to quality care.

THRIVE
The Departments of Ophthalmology and Otolaryngology at the University of Pittsburgh are collaborating on a project called THRIVE: Treating HeaRing and Improving Vision: Education. Thanks to a grant from the Eden Hall Foundation, community health workers will be key to increasing access to care for vision and hearing.