Practice Transitions

Continuity of Care: Comprehensive Eyecare During COVID-19

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By David W. Nelson, OD, MBA

May 27, 2020

Comprehensive eyecare is so much more than a prescription for a pair of glasses. As a practitioner, I have had the opportunity to work within a network of like-minded leaders to do what is needed in a time like this – focus on medical optometry, and ensure my patients have the best possible eyecare.

I was fortunate to have partnered with Keplr Vision in January 2019. We joined Keplr because we felt they promised the most for our practice doctors and staff, as well as opportunities for enhancing patient care. What we found was that promise held up during the worst pandemic in a century. That commitment to patient care and medical optometry has never been more apparent than it has been during the COVID-19 crisis.

Response in a Crisis
I ran a business for many years, grew my practice to three locations, and was honored to serve as the 2001 president of the American Optometric Association. In 2001, the world changed, and at that time, I found myself changed. I took a new stance on continuing a focus on optometry even in times of uncertainty. While the years of recession were hard, we powered through, but this time is something very different in terms of recovery.

If I was still a sole proprietor living through COVID-19, I would have shouldered far greater financial risk, for myself and my employees. I have read that most businesses have approximately four weeks of cash on hand in the event of closure. Many optometric practices are no different. Most practitioners who continue to operate their own practices applied for and received stimulus dollars. Without this financial assistance, they may be struggling to stay in business. Too many practices are wondering if they can survive this crisis.

Keplr administrators correctly recommended to discontinue services in nearly all locations as soon as the pandemic was apparent in late March. We shut down for deep cleaning, removed non-essential items such as magazines and brochures, and prepared for reopening with social distancing in mind. Keplr’s central team ordered over 100,000 surgical masks as well as thermometers, which allowed us to reopen for emergency care the first week of April.

As part of the recovery response, Keplr operations and optometrists, myself included, coordinated a 20-plus page guide to safely reopening their offices in this unprecedented time.

Giving New Meaning to Comprehensive Care
The Centers for Disease Control recommended that optometrists should delay routine care with little understanding of what today’s optometrist does in everyday practice – what most of what we do is not routine. Over the last 30 years, optometrists have evolved to treat and manage eye diseases in every state. Today, even if a patient is presenting for a comprehensive exam for broken glasses, I am never quite sure what I will find through my history, system and medication review, eye health assessment, and refraction.

For example, one patient, age 38, who presented with “cloudy vision” in March was found to have impending venous occlusions in both eyes due to uncontrolled hypertension. I sent her to the emergency room, and she was admitted for three days in the hospital due to hypertensive crisis.

During our two weeks of emergency-only services, a local ER sent me a patient with a corneal abrasion to avoid exposing her to other patients possibly infected with COVID-19.

Another patient with broken glasses had not been seen for 10 years and was found to have high intraocular eye pressures requiring an immediate ophthalmologic referral. Keplr made it possible for me to not only continue to provide essential eyecare, but also to reduce the volume of patients seen at our local emergency rooms.

A Network of Optometric Leaders
Staying medically relevant has always been a priority for me, and it is one of the reasons I felt comfortable partnering with Keplr. The Keplr model has been developed specifically to attract and serve full-scope, private optometric practices, producing a support system of the best practitioners in optometry today.
My Keplr colleagues and I regularly confer to assess medical eyecare strengths and share helpful strategies. And as we continue to work through new procedures and guidelines resulting from COVID-19, this has proved to be especially beneficial. We lean on each other, share best practices and adapt as appropriate based on the local need.

Just like the entire world, there is no doubt that the COVID-19 crisis has tested all of us in the Keplr Vision organization. And fortunately for us, we are coming out stronger on the other side. As part of Keplr I am part of something bigger. We are weathering the storm together, able to ensure excellent, safe continuity of care even in the midst of a world-altering event.

 

David W Nelson, OD, MBA, 2001 AOA President,
practices at Eye Contact Madison, a Keplr practice in Madison Wis. To contact him: Dr.DavidWNelson@eyecontactmadison.com

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