HELP PATIENTS SEE THEIR BEST

EMBRACE MEDICAL EYE CARE TO ENHANCE VISION

Barbara L. Horn, O.D.; Washington, Mich.

THE HEART of our profession is our patients, making it our responsibility to help them achieve optimal vision and ocular health. In today’s health care landscape, we achieve this, and become better doctors, by asking ourselves: How can we help our patients see better?

Here, I discuss some ways to answer this question, and in doing so, make our practices more effective.

DIAGNOSE

We diagnose chronic diseases. The eyes are the windows to the rest of the human body, indicating chronic diseases, such as diabetes, hypertension and Crohn’s disease.

Health services company Optum — working on behalf of UnitedHealthcare — evaluated how often eye care practitioners played a role in identifying eight chronic conditions. Among the study population, practitioners detected more than 4,000 cases of chronic conditions, such as multiple sclerosis, diabetes, Crohn’s disease and juvenile rheumatoid arthritis. The results represented 820,000 UHC members with continuous medical and vision coverage. On average, UHC members were diagnosed 15 days after a comprehensive eye exam first detected a problem.

Action steps. Make the possibility of early detection, along with continued eye health, clear to each patient, and encourage them to make annual exams. One way to do this is to schedule next year’s exam at the end of each of appointment. This ensures that the appointment is made and removes an obstacle in your patient’s attendance. Then, send a reminder notice via mail, or have staff call patients to remind them of their appointment.

STAY CURRENT

We are developing new technology to improve overall patient health and compliance. O.D.s need to stay on the cutting edge of new technology, as it becomes available, to position our patients to see their best.

According to a 2008 report in the “Canadian Journal of Ophthalmology,” of the 500 glaucoma patients tracked in the study, 25% reported missing at least one eye drop weekly, primarily because of forgetfulness. A greater number of patients in the study — 34% — demonstrated improper application technique. For these reasons, drug-delivery contact lenses could make a big difference for our patients.

One of the newer drug-delivery products could serve as an alternative to topical eye drops. It could come in the form of a proposed dissolving nanowafer. Baylor College of Medicine detailed plans for a slow-release drug dispersal polymer — about one-twentieth the thickness of a contact lens — that sits on the sclera and dissolves with time, according to the research published in the journal “ACS Nano.” The transparent disc is made of polyvinyl alcohol resin with tiny drug-laden reservoirs and slowly dissolves while maintaining a high concentration of medication in the tear film, in theory, providing better efficacy over eye drops.

Action steps. Although drug-delivery lenses are in early stages and research continues, the prospect is exciting and positions optometry and patient care for the future. To be aware of technology on the horizon, attend optometric meetings and conferences as well as read mainstream and trade media. Experience the exhibit halls to see what is offered and how it is used first hand. Also, participate in CE related to new equipment and products.

PROMOTE PUBLIC HEALTH INITIATIVES

We support public health initiatives and legislation that benefits patients. Examples: the Pediatric Essential Health Benefit, which became part of the Affordable Care Act, and Think About Your Eyes (TAYE). In 2014, practices participating in TAYE, presented jointly by The Vision Council and the AOA, had an increase in eye exams of up to 8%. Also, the AAO is working with Institute of Medicine on a study of the effectiveness of and future opportunities for public health strategy in the U.S.

Action steps. Promote these initiatives within your office; utilize community efforts to bring patients into your office. The AOA, among other organizations, provides press releases, patient educational materials, certification courses and other resources to successfully get the message across.

ADVOCATE

We advocate for full scope of medical eye care across the board. Optometry has evolved from a refractory profession to a primary eye care profession; we need uniform laws that allow us to handle quicker diagnosis and appropriate treatment. One of our profession’s top priorities is consistent laws nationwide for the use of diagnostic and therapeutic pharmaceuticals. Organized optometry is working toward this goal, and we’ve gained wins in the process.

Discuss the possibility of early detection, through annual eye exams, with patients.

For example, in 2014, the Arizona governor signed legislation allowing optometrists to prescribe additional classes of oral medications: oral versions of steroids, fluoroquinolones and glaucoma drugs. Also last year, Nebraska law granted O.D.s expanded oral prescriptive authority, allowing O.D.s to prescribe oral steroids, glaucoma drugs and immunosuppressant medications. And in 2015, the Louisiana governor signed legislation adding schedule II to the type of drugs an optometrist may prescribe, order and administer, and allowing doctors of optometry to perform ophthalmic laser and lid surgeries.

Action steps. Capture those patients who are already in your office and utilizing your services by including literature throughout. Those advocating organizations can help to provide that. Also, discuss the advancements with your patients through company newsletters and social media outlets. Our patients will not know that we are capable of offering an array of products to improve their sight, if we don’t tell them.

KEEP EVOLVING

Helping patients to see their best in the future will involve remaining innovative and flexible to implement new medical responsibilities, diagnostic tools, new technology and initiatives. Though there are uncharted waters ahead in our profession, and in our ever-changing world of health care, optometrists will always remain dedicated to doing what we do best — serving and treating our patients. OM

BARBARA L. HORN, O.D., is the owner of ExpertEyes in Washington, Mich. She also is a trustee for the AOA. Visit tinyurl.com/OMcomment to comment on this article.