Embracing Coronavirus Change for the Future of Our Practice

The coronavirus pandemic sure has shaken our society as a whole. One day, we’re flourishing and the next, we’re shut down! Now that we’re back up and running, things are certainly different. Some of this is temporary but other aspects will change us for years to come. In order to continue to thrive, we must embrace the new normal and find creative ways to serve our patients.

Sanitation

The first way to make sure patients feel comfortable coming into our practices is to put in place strict sanitation measures. The safer patients feel, the more likely they are to continue coming in. When patients call for an appointment, staff can assure patients of the measures being taken. At my practice, we also have an explanation of these modifications on the office website. This guides patients on what to expect and reassures them that it’s safe to come in. Requiring masks is one of the most important measures we can take. This applies to anyone coming into the practice, including doctors, staff, patients and delivery drivers. Although masks may be controversial, there is data supporting their use and ultimately everyone is safer when they are worn. Shields can be used on slit lamps as well, helping to create a barrier between doctor and patient. Strict sanitation protocols are helpful. We use a color-coded system to indicate the sanitation status of an exam room, putting up a red card as we room patients and a green card once a room has been cleaned. The more cleaning we can do in front of a patient, the better. Patients often ask if the equipment has been cleaned, so doing it in front of them avoids having to do it twice. Patients at our practice comment frequently about how comforted they are by the measures we’re taking. Many patients are unfortunately viewing eye care as discretionary during this time. The more comfortable we can make them, the less likely they are to put off their visits. Although we hope that masks are temporary, other sanitation measures will likely continue beyond the pandemic. From this point on, patients will scrutinize the cleanliness of a practice more so than they ever did before. Putting together a solid sanitation protocol ensures we continue to meet their needs moving forward.

Telemedicine

Applications for Telehealth

Despite our best efforts, some patients still won’t feel comfortable coming in to see us. In some cases, we can reach these patients with telemedicine. Because our practice is exam-focused, we have fewer telemedicine applications in eye care than some other specialties do; however, there are still some scenarios in which this can be very useful.

The best long standing application we have for telemedicine in eye care is the use of fundus photography for diabetic retinopathy screening. During the pandemic, perhaps patients don’t feel comfortable coming into our office for a dilated fundus exam but may be willing to pop in for a quick undilated fundus photo. A follow-up evaluation can then be done via telemedicine to discuss the interpretation.

Dry eye follow-ups can also easily be done with telemedicine. The office can send the patient a symptom questionnaire, such as SPEED, to assess for change from baseline. A telehealth appointment can then be scheduled to discuss how treatment is going, reinforce recommendations and make changes to the treatment plan.

Another condition that can be assessed via telemedicine is allergic conjunctivitis. If a patient calls with ocular itching, they can be offered a virtual visit. The patient can then be assessed visually and asked a series of questions to determine whether anything more serious could be going on. If not, the appropriate treatment can be prescribed and a virtual follow-up can be scheduled to assess progress.

Billing & Coding for Telemedicine

It is important to realize that only evaluation & management codes can be billed for telemedicine, so visits must be medical in nature to qualify. Modifer 95 is currently being used to describe visits done by telehealth.

Telemedicine Platforms

During the pandemic, we can communicate with our patients using platforms we already have and use such as Facetime, Facebook Messenger, Google Hangouts, Zoom and Skype. Despite not being HIPAA-compliant, these forms of communication are being permitted during this public health emergency. If you find that telemedicine is better serving your patients, it may be worth investing in a HIPAA-compliant program, so you may continue this service post-pandemic. Such platforms include Skype for Business/Microsoft Teams, Zoom for Healthcare, Updox, VSee, Doxy.me, Google G Suite Hangouts Meet, Cisco Webex/Webex Teams, Amazon Chime, GoToMeeting and Spruce Health Care Messenger.

Lessons from COVID-19

Although most of us wish we didn’t have to live through this pandemic, it has allowed us to pause and think about a few things. By improving our office sanitation, we can demonstrate to patients that we care about their health, first and foremost. Rather than being burdened by these new measures, we can use them as an opportunity to stand out as a clean and safe practice.

The pandemic has also allowed us to explore telemedicine as a means to reach our patients. Post-pandemic, this can help us to continue to serve our patients with transportation issues, those who live in rural areas or those who simply desire the convenience of telemedicine. This may not look like the traditional face of marketing, but it may be a way to set yourself apart in this day and age.