Successful co-management depends on effective communication with the team

There are few systemic diseases that we see in optometric practices more frequently than diabetes. A 2020 report by the U.S. Department of Health and Human Services/the Centers for Disease Control estimates that, in 2018 alone, 34.2 million people, or 10.5% of the U.S. population, was diabetic. Given these numbers, it has become increasingly important that primary eye care providers develop a practice-wide system for effectively co-managing both the ocular and systemic health of patients who have diabetes. The success of this system depends on productively communicating clinical findings with other members of the patient’s health care team.

COMMUNICATE EFFECTIVELY

In this instance, communication includes exam notes, imaging, laboratory findings, and letters that the optometrist sends to the retinal specialist, primary care physician, endocrinologist, etc.

The sharing of this clinically relevant and time-sensitive information can become a big challenge. For example, faxing reports to our primary care doctors and general practitioners was a typical means of transferring information. Yet, it was not unusual for the primary care provider (PCP) and/or endocrinologist to tell the patient that the optometrist’s fax “was not received” or “it must have been misfiled.” Fortunately, with modern technology and a more sophisticated, well-established system, we can prevent these frustrations.

CONSIDER A SHARED EHR

One of the most effective means of sharing clinical findings with other members of the patient’s health care team is to use shared EHR software. Our practice, for example, currently shares an optometric/ophthalmology EHR software that allows our team to “post” or send letters, exam notes and imaging to other doctors within our system as soon as we sign our charts. Our affiliated providers are then able to access these notes the same day. When scheduling patients for a consultation with our surgical team and specialists, this sharing of systems has proven to be efficient and virtually foolproof.

UTILIZE OFFICE MANAGERS

To make sure an EHR communicates with the software systems of referring/co-managing doctors, work with the office managers of your most common referring doctors. In our experience, they are happy to work with co-managing optometrists to establish direct, HIPAA-compliant portals for the transfer of examination notes and pertinent clinical findings.

These portals can be set up through a dedicated email. Office notes, reports, and images can be scanned and sent directly from most modern software systems.

Tip: Copying the email to yourself ensures the information was received and not lost in cyberspace.

TRY THE PHONE

And while often overlooked in the digital age, nothing gets our message across more quickly, or speaks more clearly to the urgency of a situation, than a phone call to the physician.

As a general rule, I always phone a patient’s PCP in situations in which I have ordered special testing or sent a patient directly to the emergency room. (Thankfully, these cases are rare.)

As we see more and more patients who have significant systemic diseases such as diabetes, establishing the systems that deliver on effective communication is more important than ever. Simply put: Our patients’ disease management outcomes and our reputation depend on it! OM

DR. EARLEY serves as a therapeutic optometrist at Medina Vision Centre, Inc. in Medina, Ohio, where he spent 23 years as vice president/secretary, and was director of human resources. He is the clinic director of Bright Eyes Vision Clinic, a free clinic serving the uninsured, and a member of the American Optometric Association and the Ohio Optometric Association. Dr. Earley speaks on specialty contact lenses, macular degeneration, and practice management. He is a consultant for Alcon, and serves as a KOL for Notal Vision, Maculogix, and MacuHealth. Email him at drearley@medinavisionandlaser.com.