BLOG: Optometry in the ‘new normal’
The calendar finally turned to the long awaited 2020, “year of the optometrist,” and so far, our special year is off to a rough start.
Although there was some controversy over the role of the optometrist in a pandemic, there is strong agreement on how we need to charge back into our essential role as primary care providers. There are certainly some alterations in our routine but in spite of that many of us are busier than ever.
There has been a profound change in how our patients consider eye care services. In 2019, the number one consideration for eye care was convenience. Our patients wanted services and product fast and easy and there was little concern about quality or care. Today that concern is safety. They want to be sure that any encounter with an eye care provider is safe and disinfected and that any optical product is virus free.
This new paradigm creates a wonderful opportunity for private practice optometrists who are up to the challenge of finding new ways to gather data, make clinical assessments and provide recommendations. Personal, one-to-one encounters with patients have always been the hallmark of private practice optometry. We never liked to measure the number of patients seen in a day but the quality of each encounter and our ability to meet each patient’s needs.
Just 4 months ago, the idea of telehealth optometry encounters seemed like a crazy and impersonal way to see a patient. The amount of technical data that need to be acquired in an optometry encounter seemed like a barrier to this type of care. But faced with a global pandemic and the risks related to the traditional capture of data, new ways to provide eye care are proving to be more practical than ever imagined.
Using a secure HIPAA compliant video platform is a good start. There are a number of these and most allow for photo capture that can create high quality images that can be uploaded into your electronic health record. With a little searching, I also found several online visual acuity measurement applications that your patient can use to measure their vision and provide you this data for your telehealth encounter.
I am only using e-health options for existing patients. Most are contact lens wearers who I saw just over a year ago and their prescription has expired. I have the full complement of clinical data from their in-office exam last year. There are many tests that can be performed in a real-time video chat including pupils, cover test and ocular motility. Having the patient move right up on the camera in each eye allows you to visualize the contact lens with a blink and in most positions of gaze.
Of course, the most import part of the exam, the doctoring, can easily be done in this virtual environment. If there are any abnormalities or suspicious finding, the patient must come to the office for a physical examination. But unusual symptoms, abnormal testing or suspicious findings change the risk-benefit ratio for a virtual wellness checkup and the in-person visit is justified.
The in-office experience has also changed. There are social distancing requirements in all parts of our building, and everyone must wear a mask on entering. We have expanded the waiting room to include other areas in the building to be able keep patients at a safe distance from one another. Wearing masks was initially a major concern as both patient and doctor fogged up the optics on each side of examination instruments. However, with a little practice and some minor mask adjustments, these problems can be avoided.
Our patients have changed their attitudes about their health and safely. Risk factors to contract viral infections are related to the natural immunity that comes with a healthy lifestyle. Avoiding obesity, diabetes, hypertension and dyslipidemia are now more important concerns, and advice on avoiding or reducing these risk factors is much more welcome from the family optometrist. It is more than just assuring that your vision remains vital into your senior years, it is now avoiding pandemics long enough to get there.
Things are different in the “new normal” and we are making the proper adjustments to continue our profession. The change in our patients’ attitudes is actually refreshing and there is a new appreciation that we are willing to risk our safety to take care of them. Leveraging technology with e-health visits and touch-free fundus imaging is more important than ever. For those willing to embrace change and find creative solutions the future remains bright. Some health care reform issues take a long time to affect optometry. We now know that other public health issues can change our profession in the blink of an eye.
Collapse