The recent outbreak of COVID-19 has forced changes for many different industries. In the medical world, many practices have shut their doors except for emergencies and moved as much of their daily practice as possible to online care. This new-aged healthcare is called telehealth or telemedicine.

What Is Telehealth?

Telehealth is the distribution of healthcare and healthcare information through new technology like email, phone calls, video conferencing, and more.  It allows long-distance patient and clinician contact, care, advice, reminders, education, intervention, monitoring, and remote admissions. According to the American Academy of Pediatrics, this can be done via video chatting, image sharing, and other technologies that leverage the latest innovations relevant to healthcare.

The Origin of Telehealth

Though the commonality of telehealth has grown exponentially in the last few months, these types of programs have been around for over 50 years. Developed by NASA to monitor the health of astronauts in space, NASA has since conducted and continues to support telemedicine-related projects. For example, the Space Technology Applied to Rural Papago Advanced Health Care (STARPAHC) was the first regional healthcare delivery system for the isolated Papago Indian Reservation in Arizona.

Telehealth In Eye Care

While it can’t replace in-person care, many experts believe it “can serve as a critical tool for physicians as doctors of optometry work to identify patients necessitating in-person care and those who can be provided physician direction remotely as the COVID-19 public health crisis continues.” The President of the American Optometric Association (AOA) Barbara L. Horn, OD, shared,

"Together with our partners, we are setting the direction of responsible eye telehealth and ensuring that those who place profits ahead of patient safety and undervalue the benefits of a comprehensive eye exam provided in-person by a doctor of optometry cannot continue to undermine the highest standard of comprehensive care."

The  University of Alabama at Birmingham School of Optometry recently announced that they’ve introduced telemedicine in their eyecare clinic. Beth Steele, associate dean for Clinical Affairs, explained, “With this new service, our team of doctors can provide care to a greater number of patients and to meet more needs.”

How to Utilize Telehealth

Kenneth Lawenda, OD, and Robert Moses, OD, explained that “These services can increase availability to specialty care for patients in rural and underserved areas, improve monitoring of patients with chronic disease, as well as provide education to patients thereby improving understanding and compliance.” To help get ODs familiar with using telehealth in their practices, the  AOA shared their guide to telehealth. There are 3 main steps to help eye care professionals prepare to incorporate telemedicine into their practices:

1. Understand how the billing and coding work.
2. Know if it’s covered by your malpractice insurance. Ask your insurance provider if telehealth services are covered by your policy and to show you where in your policy it explicitly states it. Then review your policy’s exclusions and endorsements for any language limiting or omitting vision telehealth services.
3. Review your state’s requirements for telehealth. It’s important to know what the state in which you practice includes guidelines for utilizing telehealth technologies. Then, ask your insurance provider if you’re covered for the full scope of coverage defined by your state.

Considerations for Telehealth Platforms

After deciding to utilize telemedicine, you then face the challenge of choosing a platform to use to provide digital care. Here are a few things to consider while making the decision:

1. Understand the payer policies. Confirm whether the recommended billing codes by the manufacturer are accurate and appropriate.
2. Know the potential limitations of telehealth services and make these known to your patients. Don’t be afraid to refer patients for an in-person diagnosis and/or care if need be.
3. Ensure the telehealth platform abides by the provisions outlined in the AOA's 2017 Position Statement Regarding Eye and Vision Telehealth Services.

The Ethical Dilemma of Telehealth

The AOA’s Ethics and Values Committee explored the possible ethical conundrums facing ODs using telemedicine. They posed the question, “How can [doctors of optometry] ethically incorporate its use into their practices to benefit patients?” Drs. Lawenda and Moses worry that the ignorance surrounding telemedicine could lead to inappropriate care. They warn that these new technologies should be incorporated into daily practice to enhance traditional care, not replace it. They said, “Incorporating telehealth/telemedicine services must not lead to a reduction in the standard of care patients require and deserve."

EyePromise’s Version of Telehealth

To help our partners provide the best care to their patients, EyePromise has developed a safe and effective way to get patients their eye vitamins even during quarantines. The EyePromise Auto Refill Program is an auto-ship program that delivers a 3-month supply of whatever EyePromise nutraceutical you prescribe directly to your patients’ door based on their last order. This program helps maintain the safety of you and your patients. It also helps increase patient adherence and practice revenue. Learn more about incorporating this nutritional telehealth program in your practice. Like any kind of new medical practice, thorough research and consideration should be done before deciding to add a telehealth program to your practice.