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Best communication method is concise reports
Optometrists associate with multiple specialists when caring for patients, and the method of communication used can have a profound effect on the efficacy of comanagement. Depending upon the severity of a condition, many physicians have found that short reports are a more practical mode of communication and have the added benefit of keeping a reliable record of patient history.
Comanaging a patient could mean speaking with primary care physicians, ophthalmologists, endocrinologists, rheumatologists, cardiologists, neurologists, pediatricians, radiologists and internal medicine doctors on a daily basis, and, regardless of the medium used to communicate, a major issue is how much time it takes.
Written report vs. phone call
David S.H. Bell, MD, FACE, FACP, a practicing endocrinologist and clinical professor of medicine at the University of Alabama School of Medicine, appreciates the brevity and history of a written report to include in the medical record when comanaging a patient.
“Phone calls are inefficient,” he said in an interview with Primary Care Optometry News. “They take your time — that’s nonproductive time, nonrevenue generating time. If I’m seeing a thousand patients with diabetes who need annual eye exams, I don’t need 40 calls a week telling me my patient’s eyes look fine today. I certainly think phone calls, unless it’s an emergency phone call, are not the way to do it. I think it’s important to have a letter that goes into the patient’s chart.”
Identify pertinent information
Being prepared with relevant information for the specialist with whom you are corresponding is also a crucial factor in efficient communication. Christopher J. Quinn, OD, a Primary Care Optometry News Editorial Board member, said in an interview, “While a comprehensive eye exam collects a lot of information, a lot of the information doesn’t need to be reported. What is important is to make sure that the pertinent information that applies to the specialty that you’re requesting an evaluation from be included.”
Using EMRs
Generating a specific report for a specialist becomes even easier with an electronic medical record, or EMR. Lorie Lippiatt, OD, finds that it not only saves time but also puts the focus back on patient care instead of office management.
“We’ve become efficient in our communication process using electronic transmission and communicating back and forth via e-mail and e-fax, so it’s really reduced the need to communicate via telephone,” she said in an interview. “The more automated the communication process is, the more time we have to do what we should be doing, which is taking care of patients.”
In the future, Dr. Lippiatt foresees a significant shift from one method to another. “As we go through the next 5 years, we’re going to see a dramatic change in terms of technology and practitioners adopting new technologies in their practice,” she said. “And once they take that first step and realize how much easier practicing becomes by using EMR technology, it’s going to be easier for them to implement,” she said.
Stephen A. Brietzke, MD, agrees. As an associate professor of clinical medicine in the Endocrinology, Diabetes and Metabolism division at the University of Missouri, Columbia School of Medicine, Dr. Brietzke appreciates the value of EMR technology.
“EMRs are not as good now as they’re going to get,” he told PCON. “Right now we have a bit of a ‘Tower of Babel’ situation in that different EMR systems don’t necessarily share information with one another,” he said. “But a benefit is that there are different ways to do data-entry on an EMR; you can dictate information that’s then archived in a series of electronic documents, or you can complete the information in an automated form. But the value of EMR isn’t on the end of data entry, it’s on data retrieval. With EMRs, you don’t have to worry about not being able to locate a paper record.”
Some prefer phone calls
However, some clinicians are resistant to the impersonal aspect of written reports and EMRs. According to Louis J. Catania, OD, FAAO, a Primary Care Optometry News Editorial Board member, the relationships formed through direct contact by phone calls to other physicians is worth the inefficiency.
“Dialogue, rather than a static conversation, is probably the best way to provide appropriate care to your patient,” Dr. Catania said in an interview. “It’s the best way to learn, and it’s the best way to show other specialists and subspecialists that optometry can interact effectively in the best interest of patient care. As long as you’re prepared with the information valuable to the specialist, most of them will take the time to speak with you about a patient.”
For more information:
- David S.H. Bell, MD, FACE, FACP, can be reached at Southside Endocrinology, 1020 26th Street South, Room 204, Birmingham, AL 35205; (205) 933-2667; fax: (205) 933-2693; dshbell@yahoo.com.
- Christopher J. Quinn, OD, can be reached at Omni Eye Services, 485 Route #1, Iselin, NJ 08830; (732) 750-0400; fax: (732) 750-9079; quinn@omnieyeservices.com.
- Lorie Lippiatt, OD, can be reached at the Salem Eyecare Center, 616 East State Street, Salem, OH 44460; (330) 332-2080; llleyedoc@aol.com.
- Stephen A. Brietzke, MD, can be reached at the Division of Endocrinology, Diabetes and Metabolism, University of Missouri-Columbia School of Medicine Diabetes Center, D110A, Columbia, MO 65212; (573) 884-1606; fax: (573) 884-5690; brietzkes@health.missouri.edu.
- Louis J. Catania, OD, FAAO can be reached at Nicolitz Eye Consultants, 1235 San Marco Blvd., Suite 301, Jacksonville, FL 32207; (904) 398-2720 ; fax: (904) 398-6408; e-mail: lcatania@bellsouth.net.