Read more from the Q&A issue

• Methodology: Keep the questions coming
• How can optometrists create a successful dry eye disease spa?
• How can an optometrist include the patient’s opinion when it comes to glaucoma treatment?
• How can O.D.s differentiate the neovascular form of AMD from similar diseases?
• How can an optometrist obtain diabetic patient referrals from a primary care physician?
• What should optometrists know about effective management of myopia?
• What is the value optometrists can provide and communicate for the fee charged?
• How can optometrists set up an appropriate fee schedule for specialty contact lenses?
• How can O.D.s get more engaged in luxury frame sales?
• How can optometrists get more new patients?
• How can an optometrist create a successful practice sans third party health plans?
• How do O.D.s create a system for quick and efficient coding?

A: Although the U.S. is emerging from the COVID-19 cloud, the pandemic is not over. As a result, many states have related protocols and rules that remain in effect. In addition, many practices may consider keeping some of their COVID-19 protocols for cleaning, disinfection and social distancing in place after the pandemic ends. Given these facts, it makes sense to discuss how to efficiently schedule our ocular disease patients, who, as a result of their condition, often need to be seen more frequently.

Here, I provide the steps the practice to which I belong has taken with these patients.

Go digital

A scheduling issue that has come out of the COVID-19 pandemic is patients presenting without following the practice’s guidelines for appointments. The time it takes to stop these patients from entering the practice and/or giving them masks, etc., can add up. To cut down on this issue, we’ve updated our practice website, which links to our social media channels, with information regarding these rules, adjusted hours, available appointment times for medical exams, sanitizing efforts, etc. As a brief, yet related aside, to educate these patients about the importance of being seen for their condition, the practice does routine Facebook Live panels (see below) with a few of our doctors, on the topics of glaucoma, refractive surgery, cataracts, etc. One Facebook Live invited patients to post questions that were then weaved into that one-hour discussion.

UTILIZE A "CALL TEAM"

Using a “call team,” or staff members designated to manually review scheduled follow-ups and phone patients directly, is a tried-and-true means of efficiently scheduling these patients. In the early days of the pandemic, staff called all patients to set-up a “glaucoma only” clinic for one-half day per week. Instead of waiting for patients to call, staff pro-actively contacted them. Utilizing a “call” team does require more staff hours, but it also convinces patients to present for their appointments: Staff remind them that in-person visits are vital to their ocular health.

OPTIMIZE STAFF

Regardless of the COVID-19 pandemic, new or existing ocular disease patients often require diagnostic testing (VFs, OCTs, topography/tomography, etc.) to aid in monitoring their condition. Some practices will have a technician team that focuses on pre-visit testing, while another team performs the visit workup and assists the doctor in the exam room. Other practices try and keep one staff member with a patient from start to finish to limit staffing and possible COVID-19 exposure. Maximizing staff efficiency leads to a smoother clinic.

MEDICAL EYE CARE SERVICES

Respondents to OM’s Q&A Survey answered the query “For what percentage of patients do you estimate you currently provide medical eye care services?” Here are the results:

 

 

GROUP SPECIFIC PATIENTS

To see ocular disease patients efficiently, we have grouped them by ocular disease. For example, cataract surgery workup patients are placed in a cataract lane, where their steps are minimized, as the needed diagnostic equipment is all in one area. This leads to shortened exam times and minimizes patient interaction, which aids in social distancing.

PERFORM HYBRID EXAMS

This exam flow includes a technician or nurse-driven case history, entrance testing, advanced diagnostics (i.e., glaucoma patients undergo VF and OCT) and non-contact tonometry. Once all the information is gathered, the patient is sent home. The doctor then reviews the information prior to a virtual patient exam by either audio and visual telehealth or audio only, depending on patient preference. This allows us to maximize our spread-out exam times by offering after-hour or weekend “tech-only” visits for patients. We utilized this for glaucoma follow-up patients and found a lot of success here in the refractive surgery evaluations as well.

PROVIDE TELEHEALTH VISITS

Telehealth visits have been a way of saving time when it comes to refractive surgery and refractive cataract surgery long-term follow-up visits. After the immediate post-op period, these exams shift heavily to patient happiness and visual satisfaction, which can be communicated virtually. These visits allow our staff to focus on other clinical testing and workups.

Overall, telehealth can be utilized in any medical eye care practice, but likely offers more advantages to practitioners who have patients traveling longer distances for follow-up.

“I LOVE IT WHEN A PLAN COMES TOGETHER”

Synonymous with all facets of eye care, efficiently scheduling ocular disease patients during the COVID-19 pandemic hinges heavily on effective communication: The more you plan, rehearse and scrimmage out patient scenarios beforehand, the easier each day will go. OM

DR. IBACH practices at Vance Thompson Vision. He specializes in anterior segment surgical care, including cataracts, corneal diseases, glaucoma and refractive surgeries. Dr. Ibach maintains a large collaborative glaucoma clinic that focuses on long-term disease care and has participated in numerous FDA and industry-sponsored clinical trials.