 Recent research shows that patients referred for screening examinations i.e., those without retinopathy require different follow-up then those referred for surveillance examinations i.e., those with retinopathy. Using a more targeted, risk-based criteria for scheduling eye examinations together with system level interventions designed to assure their application may lead to improved healthcare outcomes. Although, the efficacy of such approaches have been demonstrated in other systems and organizational research, it has not yet been demonstrated for diabetes eye care. 