Eyeworld Supplements

AUGUST 2020 | SUPPLEMENT TO EYEWORLD | 3 Supported by Alcon Implementing tele-ophthalmology during (and after) the COVID-19 pandemic H ow has telemedicine changed our practice amid the pandemic? In February our insti- tution had three telehealth visits. By the end of May, we had nearly 4,000. Initially, it may have seemed difficult to apply telemedicine to ophthalmol- ogy, but we've now seen the proof; not only is it applica- ble, but there is a vast range of services we can offer our patients. This is a Darwinian mo- ment for all of us. It's a time when we have to adapt to survive, so it's very important for us to think creatively, think outside the box, and to have some practical solutions. In by Ranya Habash, MD continued on page 4 Keys to bringing back refractive cataract surgery 1. Realize patients still want lens options. 2. Explain what can and can't be done remotely to the patient. 3. Educate patients on what premium IOLs offer. 4. Provide a safe environment in your center. 5. Create a quality patient experience. monofocal implant will main- tain or worsen the presbyopia that they might already have and that a multifocal implant, for example, gives them near vision similar to someone in their 30s. One of my recent studies with trifocal IOLs found 99.2% of patients who received this lens said they would get it again, while 89% in the monofocal control group said they would get that option again. Both options can make patients happy, but patients deserve a choice. Editors' note: Dr. Thompson is the founder of Vance Thompson Vision. He practices in Sioux Falls, South Dakota. continued from page 2 fact, it's a great opportunity to spur medicine forward. CMS expansions during the COVID-19 pandemic were a game changer for us in terms of truly getting tele- health off the ground in oph- thalmology. Medicare started reimbursing for telehealth services at the same rate as regular, in-person visits. Prior authorization requirements were suspended. HIPAA re- quirements were relaxed to al- low interactions to take place on consumer-based technolo- gy. Time-based billing became the norm for physicians; this is total physician time (time reviewing medical records, time talking to the patient, time documenting, and time coordinating care afterward). Phone calls became reimburs- able at the same rate as video and E/M visits. All of these factors enabled the wide- spread use of telehealth and gave our patients the access to care they've always needed. In terms of the types of visits that can be conducted Telehealth best practices 1. Engage office staff. This has been the No. 1 factor that has helped us spur our telehealth offer- ings tremendously. 2. Structure your office line to allow for tele- health triage. Allow patients to request tele- health visits and be routed accordingly. 3. Be proactive. Go through existing schedules to see who is amenable for telehealth visits, high-risk patients who should be kept out of the clinic, etc. Identify these patients and label them for telehealth visits. 4. Add a telemedicine consent to your patient registration forms. This way the patient always has a telemedicine con- sent on file. This must be updated annually. 5. Develop templates for telemedicine en- counters. Documentation should include consent obtained, patient location, mode of communication used, and time spent. 6. Follow your same standard operating procedure. Stick to how you would run a clinic visit in person as much as you can remotely; this includes your technician and your scribe helping you with the visit. 7. Market your offerings. Announce that your prac- tice is offering telehealth visits during the pandemic and beyond. 8. Keep it simple. Tele- health is easy to overcom- plicate, and the simpler we can keep it, the better.

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