Quick Patient Guide for Telemedicine Visit with Your Ophthalmologist. Save Time & Optimize Your Telehealth Visit. #ProtectingSight

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:
  • 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.

How to make a Slit Lamp protective shield in 2 minutes. #ProtectingSight #ophthalmology #Covid19 #Coronavirus

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.

Slit Lamp plastic cover

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)
Photo courtesy Luisa Di Lorenzo, MD

Interviewed by EyeNet Magazine on the future of ophthalmic practice. Honored to work with friends, colleagues & leaders in a shared mission of #ProtectingSight. #ophthalmology

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.

Join me for the 3rd annual Ophthalmology Business Summit, March 14-15, 2020 in Chicago! #OBS2020

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

 

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Ophthalmology Business Summit
American Academy of Ophthalmic Executives®

It’s more important than ever to address the volatile market forces impacting your practice.
PhotoAll-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.

My ophthalmology learning begins each day with the latest pearls from CataractCoach.com (Uday Devgan MD)

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.

 

Ophthalmology EMR and Iris Registry clients: How to generate your CEHRT 2015 ID using the CHPL Search on CHPL.HealthIT.gov

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

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2. Updox (2015) – secure messaging

Screen Shot 2020-01-29 at 10.36.20 AM

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”

Screen Shot 2020-01-29 at 10.43.15 AM.png

Generate the ID and download the PDF!

The PDF states, “The CMS EHR Certification ID shown corresponds to the collection of products listed below. Submit this ID as part of the attestation process for the CMS EHR Incentive Programs.”

Congratulations to my brother Sonny Goel MD! 95,000+ Refractive Surgeries & the first ophthalmologist to perform SMILE procedure in Maryland!

81843195_1284196258433502_7323678967855054848_n.jpgCongratulations 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.

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

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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!)

 

Congratulations to the Yale Wishes Initiative! My letter to a 1stGenYale student on what I wished I had known when I entered Yale College & the Old Campus.

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I was delighted to learn of the Yale Wishes initiative and with the invitation to write a letter to a current 1stGenYale student.

Here’s the letter I wrote, which I adapted from a message I sent to my nieces when they started college a few years ago.


Dear 1stGenYale student,

I was that financial aid kid who worked extraordinarily hard in high school and was obsessed with academics, extracurricular activities, the SATs, and college admissions.  When I arrived on campus, I quickly wondered what I was doing at Yale. I felt the immediate wonder and burden of the Yale experience. I never thought I belonged and have often felt like I was living proof of the Imposter Syndrome.

With a 30+ years association with Yale, I’d like to offer you the following advice on maximizing the Yale experience:

  1. The college experience is a privilege not a right. With online resources, college-level courses, podcasts and blogs, you could achieve a world-class education for free online. Appreciate that the Yale community enhances the learning experience.
  2. Learn as much as you can in the next four years. Both from your professors and classmates.  You are surrounded by mentors. Classmates, grad student TAs, and professors you have not yet met are remarkable resources.  You should reach out to them if you are struggling with concepts and learning. A Yale student ID is a passport to those who possess a love of learning.
  3. Yale has vast hidden resources available to you. Take advantage of them. Libraries are places to study and explore. The book you find in the stacks will have resources adjoining ready to be discovered. Google Books & Wikipedia are nice starts but originality comes from researching primary sources.  There are endowed funds for the Library to purchase books they don’t own and which you may need for your research. The best kept secret is Scan & Deliver.  
  4. Remember that borrowed & purchased books should not simply collect dust. Books are meant to be opened, read, and enjoyed. You may not read every book in the curriculum and you will be fascinated that your classmates “read that book in high school.” Learn at your own pace and seek help when you don’t understand concepts.
  5. More than 25 years after graduating Yale College, my biggest regret is that I did not go to professor office hours often enough. You’ll be surrounded by world-class faculty and graduate students who have the skills to teach you outside the lecture hall.  Honor and respect them. Seek out your teachers for help. They are not there to complete your coursework. Rather, come prepared with questions and ask them to guide you in the journey of learning.
  6. Learn gratitude.  Write to teachers, counselors and mentors to thank them for helping you along your journey.  A text message doesn’t count. Put pen to paper.  
  7. Be careful not to judge yourself against your peers. You are now surrounded by many more classmates who have natural abilities which you do not have.  I was pre-med and an Ethics, Politics, and Economics major. I felt overwhelmed by the diversity of coursework and amazed at my classmates who could master both and with such ease!  
  8. Remember that success depends on those who have grit.  Success and failure are both part of success. You cannot be successful in life unless you fail on occasion. The mark of success is being able to give your best effort, be knocked down, and still stand up and fight again. (Read Teddy Roosevelt’s In The Arena and watch my high school classmate Angela Lee Duckworth’s TED Talk.) 
  9. Surround yourself with classmates that inspire you. Find ways to avoid those who do not inspire you or take away from your learning & growth experiences.
  10.  Limit social media.  Every post you make will be reviewed by a graduate school admissions officers and human resource departments.  Turn your phone into airplane mode, set an alarm for 30-60 minutes and then study uninterrupted. (I learned this from Shane Parrish’s wonderful Farnam Street blog & The Knowledge Project podcast.)
  11.  Finally … I envy you!  I wish I could drop everything and be a full-time student, surrounded by the Yale Community.  You deserve to be at Yale. As a first generation Yale student, you are a natural leader.     

I hope that you will look upon these next few years as a learning experience. I hope that you will utilize the unlimited resources that are available to you.  When you stand on Old Campus on Commencement Day, remember that generations of Yale alumni helped you along your journey. I promised that one day I would repay that generosity by paying forward to the next generation.

If you need help, assistance, or an ear to listen to, reach out to parents, siblings, extended families, and members of the Yale family (classmates, professors, deans and heads of colleges).  Send me a message and I’d be delighted to help you along your journey.

You are surrounded by those who want you to succeed in life. Do not waste these next four years on stress, the loss of learning opportunities, nor regret.

For God, For Country, and for Yale …

Sincerely,

Ravi D Goel, MD

TD 1993

Delighted to be 1st cataract surgeon to implant Alcon PanOptix Trifocal Intraocular Lens at Wills Eye Surgery Center in Cherry Hill, NJ

 

I was delighted to be the first cataract surgeon to implant the FDA-approved Alcon Panoptix Trifocal intraocular lens at the Wills Eye Surgery Center in Cherry Hill. Colleagues & ophthalmic device companies continue to inspire with new technologies.

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Here’s an Alcon-produced patient-friendly video which explains the highlights of monofocal vs. multifocal / tri-focal lenses:

LEARN MORE ABOUT CATARACTS

A cataract is the clouding which occurs in the natural lens of the human eye. When we look at an object or enjoy colorful scenery, we depend on a clear pathway for light to travel from the outside world to the eye. Light and visual information travel through the cornea, pupil, and lens to the retina. The retina then sends this visual information to the brain.

Cataracts can cause multiple symptoms, including blurred vision, glare, halos, poor contrast and generalized visual discomfort. Patients may have difficulty driving, watching television, focusing on a computer, tablet (iPad, Kindle, Nook), smartphone, or reading. The haziness of vision may be similar to looking through a windshield during a rain or snowstorm. As cataracts progress, patients may feel that their vision no longer lets them enjoy common activities such as driving, watching television or walking safely.

More than 20 million patients in the United States have cataracts with an estimated 30 million patients affected by 2020. With the growth in our population and older patients leading active lives, cataract progression can result in a decrease in quality of life as well as the increase in the risk of falling, fractures, and depression.

Cataracts are treatable by cataract surgery, which is among the most common procedures performed in the United States. Dr. Goel is board certified and perform cataract surgery using the latest technologies and at the state of the art Wills Eye Surgery Center of Cherry Hill.

We often follow patients for many years while their cataracts are developing and until symptoms have an increased impact on daily activities. Patients are encouraged to learn about cataracts and watch our educational YouTube videos. We also use the latest lens technologies and can recommend the proper lens implant to replace the cataract once removed. Intraocular Lens (or IOLs) are commonly tailored to each patient’s eye health and visual demands.

Symptoms:

  • Blurred Vision
  • Glare/Halos
  • Poor Contrast or Dimness of Vision
  • Double Vision
  • “I can’t see that small line at the bottom of the tv screen”

Visit http://www.reanj.com to learn more about cataract surgery options.  Or call the office at 856-795-8787 to schedule a cataract consultation with Dr. Goel.

 

Growing Your Practice Through Collaborative Partnerships

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I was inspired to create the talk, Growing Your Practice Through Collaborative Partnerships, after listening to podcasts and reading many leadership books in the last few years.

Through collaboration, you can amplify your strengths, shore up your weaknesses, save time and money. Shared authority, resources, and accountability between practices can help you achieve common goals that would otherwise be very difficult or expensive to accomplish.

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In this session, I introduce numerous leadership and collaboration concepts to help ophthalmic and medical practices realize their full potential.

You’ll learn:

  • The three behaviors of a collaborative leadership style, essential when forming partnerships.
  • Common collaboration missteps that can throw your plan off track and how to overcome barriers.
  • Leadership and partnership lessons from some of today’s business experts.
  • Common themes among Collaborative Leaders, Level 5 Leaders & Serving Leaders.
  • The essentials of OKRs – Objectives and Key Results (Andy Grove & John Doerr)

 

I’ve tried to maximize my commuting and leisure time and have discovered wonderful podcasts which help formulate mental models.  These include:

  1. We Study Billionaires Podcast (Preston Pysh and Stig Brodersen)
  2. The Knowledge Project (Shane Parrish)
  3. Ted Talks
  4. Naval Podcast (forgot to mention in talk!)

 

I reference many books I’ve read recently in this talk including:

  1. Peter D. Kaufman (editor) and Charles T. Munger. Poor Charlie’s Almanack: The Wit and Wisdom of Charles T. Munger
  2. Morten T. Hansen, Collaboration: How Leaders Avoid the Traps, Build Common Ground, and Reap Big Results
  3. Jim Collins, Good to Great: Why Some Companies Make the Leap and Others Don’t
  4. Kenneth R. Jennings and John Stahl-West, The Serving Leader: Five Powerful Actions to Transform Your Team, Business, and Community
  5. Daniel Goleman, Emotional Intelligence: Why It Can Matter More Than IQ
  6. Walter Isaacson, Benjamin Franklin: An American Life
  7. John Doerr, Measure What Matters: How Google, Bono, and the Gates Foundation Rock the World with OKRs
  8. Ray Dalio, Principles: Life and Work
  9. James Clear, Atomic Habits: An Easy & Proven Way to Build Good Habits & Break Bad Ones
  10. Spencer Johnson, M.D., Who Moved My Cheese?: An A-Mazing Way to Deal with Change in Your Work and in Your Life
  11. Guy Spier, The Education of a Value Investor: My Transformative Quest for Wealth, Wisdom, and Enlightenment
  12. Mohnish Pabrai, The Dhandho Investor: The Low-Risk Value Method to High Returns