DJMJ reborn: Premium surgeons return from pandemic
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I remember the date vividly: March 17, 2020.
Shutdowns began across the U.S. to limit the spread of COVID-19, and a 28-cataract surgery caseload day was canceled. The problem worsened as most of these patients needed their second eye done that day, leaving them nonfunctional for months to come.
The challenges that followed were immense, trying to figure out the furlough issue with employees, PPP loan money application process and telemedicine initiation while also just trying to survive and not get sick from the virus at a minimum.
The return of premium surgeons, helping to bring sight back to their patients, was a mixed response varying from state to state. Illinois was one of the worst, and I was not close to operating back to normal numbers for almost 1 year from that March 2020 date. As we head into the traditionally busiest fourth quarter of the year, numbers are returning, patients are again gaining confidence 18+ months later, and premium surgeons are finally returning from the pandemic.
Various other issues, however, have changed the ophthalmic landscape, with many smaller practices closing and/or merging, along with the psychological consequences of such taking a toll. Luckily, my practice survived after 29 years, and to avoid the stresses of the last year and a half, I returned to doing what I enjoyed most to keep the mind balance in harmony: professionally deejaying music. My last show, in which I was honored to be a headliner at a major club in Chicago, had the theme of “DJMJ Reborn.” In essence, all of us as premium surgeons are reborn in some manner and are looking at ways to keep the momentum going, such as by using remote patient monitoring.
Remote patient monitoring
Recently, thanks to the expertise of Ranya Habash, there is new guidance from the American Society of Cataract and Refractive Surgery regarding remote patient monitoring (RPM) and helping our patients gain better access to care during this pandemic era. RPM will bring new revenues to the practice as well. Here is the verbatim guidance from the ASCRS:
“Remote patient monitoring (RPM) puts technology in the hands of our patients. This improves patient engagement and increases compliance, while keeping providers better informed when patients are not in the office. With patients taking charge of their healthcare, and digital solutions emerging rapidly, RPM is a major opportunity for practices in this new age of medicine.”
So, how do we set up an RPM clinic? There are several ways, and here are some suggestions.
Step 1: The provider identifies candidates for monitoring and places an order or prescription for RPM. The order should specify daily measurements, with results sent to the ordering provider. Conditions that may benefit from RPM include patients with glaucoma, age-related macular degeneration, diabetic retinopathy, dry eye, strabismus, amblyopia, stroke and neurologic/neurodegenerative disease.
Step 2: The clinic staff enrolls and educates the patient on the RPM process: which test, how to perform it and how often. The setup process may include printed and prerecorded instructions. Instructing the patient to perform a daily measurement is the simplest approach. For IOP measurements, multiple same-day IOPs may be desired.
Step 3: The patient acquires and transmits measurements daily.
Step 4: The patient is scheduled for a monthly virtual check-in with the provider. This is usually a phone call to review the month’s results and provide/document the ongoing treatment plan.
This arrangement has a relatively simple billing and coding process, and with proper documentation in the patient’s chart, RPM is the new way in the pandemic era to not only gain technology access to our patients, but to increase needed revenues lost during the pandemic.
Remember to keep a balance in life during these trying times. I look to my music hobby to bring joy to my mind and my colleagues. DJMJ never left but just got reborn. Stay safe and healthy, and I hope to see everyone live in the halls of an upcoming eye conference.
- Reference:
- Medicare program; CY 2021 payment policies under the physician fee schedule and other changes to Part B payment policies. 42 CFR Parts 400, 410, 414, 415, 423, 424, and 425. https://www.govinfo.gov/content/pkg/FR-2020-12-28/pdf/2020-26815.pdf. Published Dec. 28, 2020. Accessed June 26, 2021.
- For more information:
- Mitchell A. Jackson, MD, can be reached at Jacksoneye, 300 N. Milwaukee Ave., Suite L, Lake Villa, IL 60046; email: mjlaserdoc@msn.com.
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