Dr. Geffen is interested in refractive surgery and contact lenses. He discloses relationships with Alcon, Bausch + Lomb, Eyecare Live, Johnson & Johnson Vision, Novartis, Sun Pharma, and TearLab.
The profession has the opportunity to improve patient health via technology
A novel coronavirus has brought the world to a halt this year and is boosting another tech business: telemedicine. The United States public is hunkering down and buying up supplies to keep at home for the time it takes to get this under control. People still are needing medical care, but they are afraid to go to their doctor’s offices.
This is an opportune time for optometry to become more aggressive in this area. Our patients are receiving solicitations from medical groups such as Sutter Health which encourages them to take advantage of video visits. Other groups are soliciting your patients to try this new way to get care.
J.D. Health in China has seen its monthly consultations by telemedicine grow tenfold since the outbreak of COVID-19.1 This outbreak has exponentially increased patient awareness for this service. With optometry seeing competition for “examinations” and screenings from several online sources such as 1-800 Contacts and Visibly (Opternative), the profession needs to start building this area.
U.S. President Donald J. Trump has declared a National Emergency with COVID-19, which makes telehealth services more important than ever.2 All laws for licensing requirements in states for telehealth are being waived, so optometrists can now treat in any state via telehealth.3
Telehealth makes sense
Telehealth is a way for optometrists’ practices to provide a needed and safe alternative to patients for their eyecare needs. Obviously not every visit is appropriate to conduct remotely; however, using available technology it is a great way to screen patients to see who really needs to come into the office.
Once the OD has triaged the patient, the OD has the ability to refer the patient to the most appropriate source for further care, our office or some other specialty. Many insurers offer telehealth to their covered individuals through their general medicine sites. They typically do not keep eyecare specialists online for these visits. To ensure patients are getting the best care, ODs must own the eyecare telehealth market.
To participate in telehealth, OD offices need to be prepared. A Health Insurance Portability and Accountability Act of 1996 (HIPAA) compliant site is a must. (This means no FaceTime visits.) Using non-compliant sites puts an OD at risk for major fines. Many options are available today, I have found only one that is dedicated to eyecare. Eyecare Live is a compliant site which was developed by eye doctors for eye doctors.
Remember that documentation is just as important for telehealth visits as an in-office visit. Telehealth visits are billed using typical evaluation and management (E&M) codes (99201-99215). Be sure the statement that the visit is by telemedicine is placed in the file. ODs should check with their malpractice carriers to ensure that their coverage extends to this type of service.
Keep moving forward
Telemedicine services could help make the optometric practice more efficient for the doctor and staff as well as more convenient for the patient. Think about all the red eyes you are seeing in practice and how many times a patient texts or emails a picture of a minor subconjuctival hemorrhage. Telehealth could be of great value in this time of uncertainty in our country.
1. The Economist. Millions of Chinese, cooped up and anxious, turn to online doctors. Available at: https://www.economist.com/business/2020/03/05/millions-of-chinese-cooped-up-and-anxious-turn-to-online-doctors/. Accessed 8/3/20.
2. WhiteHouse.gov. Proclamation on Declaring a National Emergency Concerning the Novel Coronavirus Disease (COVID-19) Outbreak. Available at: https://www.whitehouse.gov/presidential-actions/proclamation-declaring-national-emergency-concerning-novel-coronavirus-disease-covid-19-outbreak/. Accessed 8/3/20.
3. American Optometric Association. AOA guide to telehealth-based care during COVID-19. Available at: https://www.aoa.org/coronavirus/aoa-guide-to-telehealth-based-care-during-covid-19. Accessed 8/7/20.