Managed Care

Integrated Eyecare Networks: Use Technology to Coordinate Care

By Chad Fleming, OD, FAAO

Oct. 21, 2015

SYNOPSIS

Healthcare reform demands connectivity. See how ODs can access new technology that facilitates coordinated care through an integrated eyecare network.

ACTION POINTS

POSITION PRACTICE FOR FUTURE. OD-only groups will have limited success in negotiating with ACOs compared to integrated eyecare networks that include OMDs.
TECHNOLOGY CAN HELP YOU CONNECT. Use software to link to a group of providers that coordinate care for patients to limit the amount of redundant testing and “new patient” documents that need to be filled out.
SAFELY SHARE DATA. Technology links the OD and OMD practice together, then you can efficiently schedule patients and transfer documents in a HIPAA-compliant and Meaningful Use-qualifying manner.

With the Affordable Care Act enacted, coordinating care with other health care providers through an integrated network is more important than ever. Here is how my practice is making the new health care marketplace work for our patients, and our practice growth. Technology, like OcuHub, that helps make the connection with other health care providers, can help.

Join Larger Health Care Community

As many optometrists have already transitioned to a medical model of practicing primary eyecare, there is a natural need for the OD to be a part of the larger health care community. The optometrist, who is managing diabetes eyecare and other medical eye-associated diseases, has to be a part of a community of providers that coordinate their care. It is best for the patient to have a team of providers that coordinate efficiently and effectively. This begins with an integrated eyecare network, whose members can seamlessly communicate with each other, regardless of EHR type, or the presence of an EHR at all. The future of independent optometry is going to be highly dependent upon being a part of a larger group. Think group….remain independent.

Position Your Practice for the Future

Our practice has five ODs, and as we move forward, it continues to remain top priority to have access to patients. To continue to have that access, we must be on insurance panels for them to continue to see us. Our practice believes that OD-only groups will have limited success in negotiating with Accountable Care Organizations compared to integrated eyecare networks that include OMDs. If our independent practice is a part of a larger eyecare network that can provide primary-through-tertiary care, then our patients can continue to receive the care they have chosen in coming to our office without having to be in a group practice they did not choose.

Technology Can Help Connect You to Health Care Community

Our practice has been using OcuHub successfully since the middle of 2014. OcuHub is the software that links independent optometry and ophthalmology practices as a group of providers that coordinate care for patients, thus limiting the amount of redundant testing and “new patient” documents that need to be filled out.

Through OcuHub, we are able to communicate with our non-EHR cataract referral center in an electronic way that allows for us to continue to meet our Meaningful Use guidelines without having to a choose a different ophthalmologist using EHR. Our practice is a part of Kansas Eyecare Services, a group of independent optometrists and ophthalmologists, yet we are positioned to present ACOs with an integrated eyecare network that utilizes a single software, OcuHub, linking us all together in coordinated care.

We utilize OcuHub to complement our EHR software to work in an integrated eyecare network. The ODs and OMDs within the network use OcuHub because it ties us all together independent of our own EHRs or non-EHR based practices.

More Efficiently Share Data

Once the technology in OcuHub links the OD and OMD practice together, the staff at our practice is able to more efficiently schedule patients and transfer documents in a HIPAA-compliant and Meaningful Use-qualifying manner, independent of the EHR used by each practice. When coordinated care is more efficient and effective, the workflow for each staff member, who is part of the referral process, becomes smoother and quicker. Coordinated care is the hardware, but it is the software that communicates through the hardware that eases the burden for staff.

For instance, before OcuHub, it took one staff member at our office communicating to one staff member at the referral center’s office. They both had to put everything aside to address the referred patient immediately. With OcuHub, our staff can communicate all necessary information to the referral center through one document and find a scheduled time for the consult, without the referral center staff picking up the phone. The referral center staff then processes the information when convenient. Once the consultation is complete and the patient is to be returned to our practice, there is no longer a need for my staff member to be tied up on the phone for patient scheduling and document transfer. The referral center staff can do all that through OcuHub.

The software allows staff to schedule referrals to and from the referral center without having to be on the phone during each office’s respective office hours. If a referral center needs to schedule a patient back for continued care to the optometrist, then they just log into Ocuhub and use the scheduling function to find out when the next available time is for the optometrist to see the patient. The optometrist practice is a gatekeeper to a “open” schedule, (i.e. once the appointment is scheduled by the referral center, the optometrist office gets an e-mail to confirm the appointment before it actually goes into the PMS). The advantage of Ocuhub is that if a referral center works with 100+ ODs, they do not all have to be on the same PMS/EMR. The scheduling function alone is integrated into multiple different PMSs.

Change Mindset

Prior to the addition of Ocuhub to our practice, we had the medical mindset that began before I started with the practice 13 years ago. We are looking to continue to partner with primary care providers within the area to assist them in meeting their HEDIS score and CMS Star ratings and providing them with a network of providers to assist in the care of their diabetes patients. Our recent goals have been to work closer with other independent OD and OMD practices in growing together and planning for continued change in healthcare reform.

Understand Patient’s Perspective in Sharing Data & Care

In coordinating care, patients do not have unnecessary redundancies in their care. Unnecessary redundancies result in more time required of the patient and greater costs to the insurance carrier, or ultimately, the patient. Many patients want to stay within a group of doctors that can care for them effectively and efficiently. Also, no one, including you and I, enjoy filling out all the “new patient” documents in a doctor’s office. I have to fill out a new patient multiple-page form for a dentist I am seeing at the end of the month. I do not want to take the time to do this.

With coordinated care, independent doctors’ offices are able to work in such a way that patient information, demographics, insurance providers, history and other personal information, are transferred to the coordinating doctor without having staff repeat everything over the phone or referral centers having to add 3-4 staff members just to provide for information intake, especially for the older population. This is in the processing that occurs behind the screen; patients only see the picture and perceive the quality of care they are receiving. In a coordinated care model, patients perceive the care as more effective and efficient, which results in happier patients.

Another advantage: In a coordinated care model, where ODs and OMDs, work in an integrated network, the specialist can make a quicker and better diagnosis because they have the whole picture.I’ve watched a retinal specialist diagnose a glaucoma concern on a patient who has been under tight control in glaucoma care by the optometrist, however, the optometrist did not communicate this in the referral documentation, therefore, the retinal specialist could only conclude that the glaucoma was not being addressed. For the best patient care, all doctors want this type of miscommunication to be avoided. When accurate and thorough information is passed among doctors in an integrated group, everyone wins. For the best patient care, all doctors want this type of miscommunication to be avoided. When accurate and thorough information is passed among doctors in an integrated group, everyone wins.

Reach Out to Local MDs & Surgeons

I would highly recommend visiting with the referral center that most of your cataract referrals go to, and then I would visit with the retinal group in your area. Obviously, settings throughout the country will be a little different, but the hub of the wheel is the referral centers. Present the idea to them letting them know that the coordinated care model will complement what they are doing with their current software, and that coordinated care solidifies current referral patterns and creates an opportunity for more referrals.

For example, all diabetes yearly eye exams should be referred to the primary eyecare provider, which leads to more referrals to the OMDs. It has been the introduction and addition of Ocuhub, and the concepts that they have brought to the table, that has breathed new life into our integrated eyecare network. We are a part of a group that has 100+ ODs and eight OMDs.

Varying Levels of Cost & Commitment

Forming an integrated eyecare network will vary in cost and commitment. As many optometrists may already be involved in an independent professional association, the cost is usually set up as a share of the company or association, so there could be an initial investment of around $2,000. This cost is associated when ODs, or OD and OMD, work together to form a corporation that is the umbrella for professionals to work under. If an optometrist is not a part of something like this, they can still work together using the OMD as the hub, and all referring ODs as the spokes, to form an integrated group that works together to create systems and processes that are consistent from practice to practice with a company like Ocuhub acting as the link for all independents to act as a group.

Chad Fleming, OD, FAAO, is a partner with Wichita Optometry, P. A. in Wichita, Kan., and founder of OptometryCEO To contact: optometryceo@gmail.com

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