The pandemic pushed telemedicine to the fore, but for many practices, that was just the beginning.

According to EB’s exclusive, recent 2020 Trends in Telemedicine Focus Group Study, 88% of practices implemented telemedicine as a tool during Covid-19 closures—and, the vast majority (76%) also say they will continue to offer telemedicine as an ongoing option for patients.

While global consulting giant Deloitte estimates that only one-quarter of all Americans had opted for a telemedicine appointment to date, the pandemic is changing that posthaste. In 2020, the telehealth market is expected to experience a skyrocketing year-over-year increase of 64.3%, according to a recent report from Frost & Sullivan. And, by 2025, the health platform is projected to see sevenfold growth.

One thing is certain: Increasingly, telemedicine is playing a dual role as a long-term tool for providing both care options for patients and revenue for practices. And, thanks to the U.S. Department of Health and Human Services’ relaxation of restrictions and removal of previous HIPAA barriers, practices can feel more comfortable continuing to offer telemedicine now that they’ve reopened.

To dig into the meteoric rise of telemedicine in vision care, EB checked in with numerous eyecare professionals and groups successfully using the platform across the country. Read on to learn more.

PATIENT PREFERENCES

Consumer research conducted since the onset of Covid-19—and appearing in The Vision Council’s VisionWatch Market Analysis Reports—details multiple reasons for offering telehealth. The Vision Council’s research found that 44% of consumers surveyed reported in May that they would postpone or cancel their eye exams during the pandemic.

The good news? The research also revealed that telemedicine is increasingly viewed by consumers as a way to bridge the gap. The VisionWatch results pointed to younger consumers—plus previous chain and online eyewear purchasers—as most apt to take advantage of telehealth resources.

The two most likely demographic groups? Individuals whose family income is more than $100,000, and younger consumers, ages 18-34.

TRENDS IN TELEMEDICINE

...from the EB 2020 Trends in Telemedicine Focus Group Study.

KEY CONSIDERATIONS

If you’re still thinking about implementing telemedicine—or are relatively new to the platform—be sure you do your homework.

➤ Resource Check-in. That includes checking with state, professional, and insurance resources. Not all are on the same page. In the case of insurance companies, for example, not all plans reimburse the same, and a few aren’t in sync with the Medicare guidelines either.

➤ Reimbursements. Making sure your practice is getting the maximum reimbursed may require some employee training, as well as reassignment of staff responsibilities. It’s important, for example, to designate specific employees to obtain patient consent and manage virtual appointment scheduling as well as educate patients about accessing your platform(s) of choice.

➤ Appointment Logistics. What about the logistics of how you’re conducting these remote visits? The American Optometric Association (AOA) reminds members to address key points like “blocking out time for telehealth-based visits” and locating “a dedicated (quiet and private) space” for those visits.

Lee Ann Hoven, O.D., who owns Advanced EyeCare in Durango, CO, adds it’s important to understand how long a telemedicine visit can take from start to finish. “We have found that a 10-minute appointment can quickly turn into 25 minutes if the patient is having trouble logging in or their internet is not sufficient,” she says.

PICKING A PLATFORM

For now, the Centers for Medicare & Medicaid Services is allowing non-HIPAA-compliant platforms (as long as they’re not public facing) like Apple FaceTime, Skype, and Facebook Messenger video chats.

Long term, that’s not a solution, however, and, fortunately, there are several telemedicine platforms tailored to optometry (see Platforms to Ponder sidebar). ECPs say that deciding which one is right for you and how you want to use it is a process. Simply put, learn before you leap.

Dave Anderson, O.D., of Miamisburg Vision Care in Miamisburg, OH, explains, “I have used two different platforms and am currently using doxy.me. It’s simple and doesn’t require software or apps.”

PUTTING IT INTO PRACTICE

Participants in EB’s Trends in Telemedicine Focus Group Study reported using telehealth services in multiple areas. The big four: follow-up visits (71%), initial consultations (68%), off-hour emergency visits (53%), and prescription refills (53%).

We also asked Drs. Anderson and Hoven about the use of telemedicine services in their practices. Neither had used telemedicine prior to the pandemic and both implemented it during shutdown.

“I used telehealth for a large variety of conditions and visit types during closure,” explains Dr. Anderson. “I had several patients that were in the midst of specialty contact lens fits, myopia management, or dry eye/MGD treatment protocols that required follow-up. The best option was a telehealth visit.”

As for Dr. Hoven, “When the pandemic started, we began offering telemedicine for patients with complaints about eye comfort such as an infection, allergies, or foreign bodies. We also used it to make follow-up or progress calls for conditions.”

FACILITATING REOPENING

“Now that we’re open again,” explains Dr. Anderson, “I have continued to use telemedicine for myopia management, some contact lens follow-ups, and other chronic disease management such as allergies and dry eye.”

Dr. Hoven adds, “Patients are still more comfortable coming into the office for their initial evaluation, but now they really appreciate the ability to have follow-up completed with telemedicine.”

A side benefit? “Now that we have had to reduce our patient schedule and the number of patients that can be in the office,” explains Dr. Hoven, “we can use our office time more efficiently and productively.”

TRAINING + TIMING

That productive use of office time includes training. “The biggest thing is helping staff understand what needs to be directed to in-person care,” explains Dr. Anderson. “I set up an extensive triage questionnaire to help staff determine if a patient can be seen via telehealth.”

The staff member needs to be comfortable offering this new service, explaining how it works, and discussing insurance benefits as well as payment options prior to the telemedicine appointment. The staff member also has to be sure that the patient is very clear on how and when the doctor or technician will contact them and that the patient is able to utilize the appropriate form of communication.

Fortunately for those staffers, some things are easier, but some definitely are not. On the plus side, nearly 7 out of 10 (68%) of participants in EB’s Trends in Telemedicine study find billing and coding for telemedicine services to be easy.

On the other hand, while it seems like telemedicine should be quicker than a face-to-face appointment, Dr. Hoven explains that’s not always the case. “Because of potential [technology] glitches, we usually try to appoint our telemedicine calls prior to lunch or at the end of the day where we will have more flexibility should some unforeseen circumstances occur.”

Glitches aside, 88% of ECPs surveyed by EB say telemedicine is a real help to their practices.

“The biggest benefit,” says Dr. Hoven, “is that we now have another way to care for patients and make sure [they] are well taken care of. Telemedicine can also set us apart from some colleagues.

“Our challenge, however,” adds Dr. Hoven, “will be to learn the appropriate billing and coding methods so we can be sure we are being compensated fairly for the time we have spent with the patient.”

FUTURE FOCUS

Many optometrists think telehealth may change how health care providers manage eye conditions such as red eyes and dry-eye follow-up. Dr. Anderson sees another reason that telemedicine is here to stay. “Many times,” he says, “it’s counseling that is needed, not in-office testing.”

AOA President William T. Reynolds, O.D., shares both the positive potential of telemedicine and a warning about its misuse. “At the AOA, we continue to fight against those who place profits ahead of patient safety and undermine the benefits of a comprehensive eye exam,” he says.

On the other hand, says Dr. Reynolds, “We see the technology and health care landscape evolve, accelerated by the Covid-19 public health emergency. And, we know how critical it is to evaluate available technology solutions.

“In 2019, the AOA and our industry partners began proactively reviewing and revising our 2017 policy statement on the appropriate use of telehealth in eye health and vision care. Together,” concludes Dr. Reynolds, “we are setting the direction of responsible eye telehealth that delivers the highest standard of care.”