Due to the Coronavirus (COVID-19) pandemic, the American Academy of Ophthalmology now finds it essential that all ophthalmologists cease providing any treatment other than urgent or emergent care immediately.

I started wearing face masks in the office. I will continue to be available for urgent & emergent care. I have also instituted tele-medicine which has already proven valuable for patients who are under quarantine. Currently, I offer tele-health visits to established patients only.

Here’s a Quick Patient Guide to save time & optimize your tele-health visit.If you wish to have a tele-medicine visit, contact your ophthalmologist and provide the following information:

• Medical insurance. Traditional Medicare has started to cover tele-medicine visits due to the coronavirus pandemic. If you have a Medicare Advantage, commercial insurance or no insurance, inform the office staff. Depending on your insurance, a tele-medicine visit may include a co-pay, co-insurance, deductible or be considered a non-covered service. You may be asked to make a deposit prior to consultation.
• Pharmacy. Be sure to mention your current local pharmacy, pharmacy location, phone number and allergies! Many pharmacies are located at the border of towns and the exact address is helpful for EMR systems.
• Cell phone number. Please test your device, such as a smart phone (iPhone, Android), tablet (iPad) or desktop computer prior to your appointment. Video call a friend or family member for audio and video! You may want to use selfie mode on the device. In some instances, having a family member or friend available is most helpful to highlight eye structures during the consultation.
• Email address. This is critical for many electronic medical record (EMR) systems which utilize a patient portal. After your visit, you may receive an email with patient instructions.
• Video conferencing platform. Inform the office of your preferred communication platform and contact information. This includes either the cell phone number or email address associated with the platform. Your ophthalmologist may offer the following options:
  • FaceTime
  • Google Hangout
  • Telemedicine patient portal, such as Doxy.me
  • Other platforms including Facebook Messenger, Skype, WhatsApp, &Zoom
• Pre-Test. Take a free online vision test BEFORE your tele-medicine visit! The results will greatly help your ophthalmologist during your telehealth visit. All of Dr. Goel’s patients are asked to take a Pre-Test prior to consultation. Helpful platforms include:
  • Essilor Test Your Vision (Visual Acuity, Astigmatism, Light Sensitivity, Near Vision, Color Vision, Amsler Grid).
  • ZEISS Online Vision Screening (Visual Acuity, Contrast, Color Vision)
• Light source. A penlight, flashlight or good lighting area may be most helpful. A family member or friend can also use the smart phone (or a second device) with flashlight on.
• Appointment Time. The office will give you an appointment time. A technician or scribe may call you prior to your appointment time to review your chief complaint, symptoms, medical history, medication list, etc. This will likely be by a phone call. The ophthalmologist will then be able to call via video to review your history and perform a tele-health consultation.
• If you are one of Dr. Goel’s or Dr. Miano’s established patients (seen at the Cherry Hill, NJ or Atco, NJ offices within the last few years) and need an urgent / emergent visit, call Regional Eye Associates or use the online form here.
• If you have a sudden loss of vision, trauma, chemical injury or other injury, you should call 911 and go to the nearest emergency room.

Dear Colleagues,

I’ve made a quick 2 minute video which gives the dimensions of slit lamp protective shield. At the bottom of this blog post, I also include essential websites (AAO, AMA, Medicare) to keep up-to-date on coronavirus & telemedicine.

After I created the video, I used a utility knife to make a slit lamp shield using the harder plastic.

Website links for ophthalmology and practice administrator colleagues on Coronavirus & Telemedicine:

1. American Academy of Ophthalmology Coronavirus Updates (**Updated frequently. I recommend visiting the AAO site often**)
2. AAO/AAOE’s Telemedicine primer and essentials. How to code for phone calls, internet and tele-health consultations.
3. Medicare Telemedicine Healthcare Provider Fact Sheet
4. AMA Quick Guide to Telemedicine in Practice
5. American Academy of Ophthalmic Executives (AAOE). Among many benefits, practice administrators and leaders have access to a wonderful etalk listserv which has saved me thousands of dollars in practice management pearls. (Disclaimer: I am on the AAOE board)

I was recently interviewed by EyeNet Magazine on the future of ophthalmic practice.

I am honored to work with friends, colleagues & leaders in a shared mission of protecting sight and empowering lives.

AAO Members can access the online version here.

Screenshots of the magazine article are below.

Colleagues,

I’m delighted to invite you to the 3rd annual Ophthalmology Business Summit, on March 14-15, 2020 in Chicago.

With reimbursements falling and a shifting healthcare market in flux, the third annual, leadership-focused “boot camp” pairs your real-world experience with a broad range of intimate strategic sessions geared to helping you run a sustainable modern practice.

Cordially,

Ravi

Ophthalmology Business Summit American Academy of Ophthalmic Executives® It’s more important than ever to address the volatile market forces impacting your practice. 2020 Ophthalmology Business Summit March 14-15 | Chicago All-new program with tools and tactics for sustaining a healthy, viable practice. Program Director: Ravi D. Goel, MD Keynote Speaker: Ruth D. Williams, MD With reimbursements falling and a shifting healthcare market in flux, the third annual, leadership-focused “boot camp” pairs your real-world experience with a broad range of intimate strategic sessions geared to helping you run a sustainable modern practice. Past Academy President Ruth D. Williams, MD, will deliver a keynote address exploring ways to foster a healthy practice culture that builds trust and increases productivity. Program Director Ravi D. Goel, MD, has engaged business experts and Academy leaders to deliver a focused curriculum with tools for overcoming your most complex business challenges. See the session summaries below or visit aao.org/business-summit to review complete descriptions and register. The Ophthalmology Business Summit is sponsored in part by Modernizing Medicine and Ophthalmic Mutual Insurance Co. (OMIC). Register Now Discount registration ends soon and seats are limited. Claim your space today. For registration questions, call 866.561.8558 or email registration@aao.org. 2020 OPHTHALMOLOGY BUSINESS SUMMIT CURRICULUM SATURDAY MARCH 14  8-9 a.m. | Opening Session Successful Leadership Drives Culture Keynote Speaker: Ruth D. Williams, MD 9-11 a.m. Respond to Changes in Your Practice Environment: A 20/20 Perspective Robert E. Wiggins, MD, MHA Arvind Saini, MD, MBA and Sara Burns Rapuano, MBA, OCS 11:15 a.m.-12:45 p.m. Audit-Proof Your Practice Sue J. Vicchrilli, COT, OCS, OCSR 12:45-1:45 p.m. | LUNCH 1:45-4 p.m. A Healthy Practice is Lean: Simple Fixes to Maximize Efficiency and Improve Patient Experience Sara Burns Rapuano, MBA, OCS 4-5 p.m. Keeping the Fire Lit: Strategies for Preventing Burnout Robert F. Melendez, MD, MBA 5-6 p.m. | RECEPTION SUNDAY MARCH 15 8:30-10:30 a.m. Smart Money: Ensure Financial Wellness for Your Practice in 2020 Ann M. Hulett, CMPE 10:45-11:45 a.m. Protecting Your Practice: Risk Management Session Open Mic Linda D. Harrison, PhD 11:45 a.m.-12:30 p.m. The Compassionate Practice: Establishing Equity Between Your Patients and Staff (Maximizing Communication from Millennial to Baby Boomer) Ravi D. Goel, MD and Robert F. Melendez, MD, MBA Register Now For registration questions, call 866.561.8558 or email registration@aao.org.

I learn clinical pearls each day from CataractCoach.com, which was started by my friend Uday Devgan MD.  I honestly don’t know how he has the energy to create so many superb cataract surgery videos.  Uday has gone 500+ straight days with a blog post which includes new cases and reviews of ophthalmology principles.

The site includes an opportunity to submit challenging clinical cases.  The cases submitted by colleagues worldwide have been phenomenal and have made me a better surgeon.  I often hear Uday’s voice when I come across a clinical challenge in the OR.

I’m honored to have my second submission posted to Dr. Devgan’s website.

1. Bleeding from Pupil Expander! Now What? (July 11, 2018) – I think I was one of the first guest surgeons on the site!

2. Two-Handed Capsulorhexis Technique (February 4, 2020) – I learned this technique from Uday’s site!  My own apologies that the video filter was dark on this recording.

With thanks to Dr. Devgan for educating colleagues worldwide!  He’s constantly on the cutting edge. Check out http://www.CataractCoach.com and please submit videos to this wonderful site.

I have spent the last few days most confused about MIPS reporting.  My two ophthalmologist practice uses an ophthalmology specific EMR and plans to report using the IRIS Registry (American Academy of Ophthalmology).

An essential part of MIPS reporting is PI (Promoting Interoperability).  The IRIS Registry portal directs you to the CMS website to obtain your official CEHRT 2015 ID.  This certifies that the EMR product you have meets 2015 federal standards:

https://chpl.healthit.gov/#/search

When I typed in my EMR System and clicked the yellow button, the basket showed 46% and I was unable to generate an ID number.  I thought my EMR was de-certified!

I emailed my EMR vendor, and after a turbo meeting, I realized I was making a simple mistake …

In order to generate a CEHRT 2015 ID, you need to add ALL of the individual components which make up your EMR.  This includes the other vendors which make up the various components (secure messaging, electronic prescriptions, patient portal, IRIS Registry).  Each vendor has a unique name which you may need to obtain from your EMR vendor.

In my case, we use 6 different vendors.  With EMR tech support, I searched each component and added them like an Amazon shopping cart.  Once I added 4, I reached  100%, and with all 6 entered generated CEHRT 2015 ID.

For me, I needed to search for the following 6 products, select the 2015 version, and click the Yellow “+Cert ID” for each one:

1. MDOffice (2015) – EMR vendor
2. Updox (2015) – secure messaging
3. Regulatory Compliance Platform (Eye Care Leaders) 2015
4. Rcopia (DrFirst) Version 3 2015 – electronic prescriptions
5. Sophrona Solutions 2015 – patient portal
6. FigMD Inc. 2015 – IRIS Registry

Once I created the shopping basket, I could easily use the CMS ID generator to create a “Your CMS EHR Certification ID”

I then typed the number back into IRIS Registry and FINALLY enter my PI information!

My advice: Contact your EMR company to find out the “official names” for each of these vendor products as reported to federal program.  This may be different for every practice & EMR!

1. EMR vendor
2. Secure Messaging vendor
3. Regulatory Compliance Platform (if necessary)
4. Electronic prescription vendor
5. Patient portal vendor
6. IRIS Registry or other registry database vendor

Hope this helps!

(Optional)

Below are screenshots as I added each component:

1. MDOffice (2015) – EMR vendor

2. Updox (2015) – secure messaging

This process continued for:

3. Regulatory Compliance Platform (Eye Care Leaders) 2015

4. Rcopia (DrFirst) Version 3 2015 – electronic prescriptions

5. Sophrona Solutions 2015 – patient portal

6. FigMD Inc. 2015 – IRIS Registry

Finally, 6 items are in the basket and I then clicked “Get 2015 EHR Certification ID”

Generate the ID and download the PDF!

Congratulations to my brother Sonny Goel MD! He’s performed more than 95,000+ refractive surgeries since starting clinical practice in 1997.  He’s now the first to perform the SMILE procedure in Maryland!  SMILE is an acronym for “Small Incision Lenticular Extraction” and is a unique advancement in vision enhancing procedures.

And nothing beats a patient testimonial on their own social media channel:

Congratulations again to my older brother and his dedication to #ProtectingSight.  Wonderful to see the opportunity which patients have to benefit from better vision.

To learn about the SMILE procedure, please visit http://www.GoelVision.com.

(He coined the name before me!)