BLOG: Patient care in the time of COVID-19
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The rate at which the COVID-19 pandemic has escalated makes the days (all of 2 weeks ago) when I was asking patients to reschedule if they showed any signs of illness seem quaint. Now, like most of you, we are fully shut down.
Thankfully, options for telemedicine have been brewing for a long time, so there were multiple tools available to me when it became a necessity. Here, I share what I am doing.
Taking care of patients
We still need to take care of emergencies, so we needed a way to triage patients. We are using Weave Optometry Software to seamlessly connect our phones to our office software. If a patient calls with an urgent issue, they are directed to a specific voicemail account. Then I am alerted that a patient left an urgent message. I can send and receive text messages and calls on my phone that, on the patient end, appear to be coming from our business phone number. Patients are able to take pictures of their eye and text them to me, and I can take the appropriate action to help them. That may be to call in a prescription or to make arrangements to see them in the office.
COVID-19 will be what finally pushed many of us into a more permanent telemedicine option for our patients. For me, I have finally starting using the HIPAA-compliant EyecareLive platform. I’m still in the onboarding process, but patients will be able to share images and video conference with me in a privacy-conscious environment, and even take vision tests. Further, when they create a login for the app, they will input their insurance information so I can bill with the most recent information.
When a patient needs to be examined urgently, I first have them respond to the following questions:
- Do you have a fever or upper respiratory symptoms such as cough, sore throat, trouble breathing or a runny nose?
- Have you traveled to a high-risk area in the last 14 days?
- Have you had close contact with anyone diagnosed with COVID-19?
- Are you high risk for COVID-19, meaning older than 60 years, pregnant or nursing, or immunocompromised?
If they are not high risk and have a truly urgent need to be examined, I will meet them at the clinic. They text the office when they have arrived. I meet them in the parking lot wearing a standard surgical mask and I give one to the patient if they don’t already have one. Finally, I use a noncontact thermometer to check their temperature. They will enter through a side door so that they don’t pass through the lobby or any common spaces, and the exam room will be appropriately disinfected. I use a clear sheet protector to enlarge the shield on my slit lamp and a face shield when I’m not behind the slit lamp. If a patient is high risk, I have reached out to another community provider who has the appropriate masks and protective equipment to see these patients safely, and they will be referred to them.
Providing contacts and glasses
My office uses a program called CLX that allows us to have an online store through our website. This way, patients can continue to order and pay for contact lenses, verify their prescriptions, and have the lenses shipped to them. We originally started using the software because we didn’t want patients to take their partial orders elsewhere and lose that sale, and it has set us up perfectly to handle the current situation. We are also extending prescriptions for 6 months so patients can order contact lenses without needing an exam to check their prescription.
With glasses, I have one optician going into the office alone to complete orders. If a patient breaks their glasses, we can duplicate a previous order. I am also looking into other options such as FittingBox that will allow patients to virtually try on frames that are in our office inventory. It has some limitations, particularly for bifocals or high prescriptions, but may work for the majority of patients.
The learning curve here is steep, and we all feel a bit like we are scrambling, but we are slowly figuring out ways to keep providing care while social distancing. I’d love to hear what you are doing. Please write a comment.
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