By Dr. Rahul Bhola, pediatric ophthalmologist and medical director of ophthalmology at CHOC Children’s
Like many physicians continuing to offer care during the COVID-19 pandemic, I have transitioned many appointments to telehealth, so patients can still get the care they need while practicing social distancing. At CHOC Children’s, we adjusted our policies and practices to maintain a safe environment for our patients and families who need in-person appointments.
For in-person appointments, we require masks and practice proper hand hygiene to protect the health of everyone we serve. Before entering our building, CHOC nurses screen all visitors and staff. Screenings include a temperature check and asking symptom and exposure-related questions. In line with CHOC’s limited visitor policy during the COVID-19 pandemic, only one parent/guardian may accompany the child for their appointment. Our clinic is taking other necessary precautions such as thoroughly disinfecting clinical areas and rearranging seating in our lobby to ensure social distancing.
Since March, my office has successfully completed over 900 telehealth visits, on top of non-elective in-person appointments.
Since telehealth is new to many families, here’s an overview of what parents can expect at their first virtual appointment, plus answers to parents’ most common questions on telehealth for ophthalmology.
A synchronous (live audio-video) CHOC ophthalmology telehealth appointment is divided into four components. I call them the four C’s: Contact, Connect, Consult and Care.
Our front desk reaches out to the family to confirm their contact information. We send a Zoom link to the family, along with information about how to connect to Zoom and download a Visual Acuity app that we use during appointments to check vision.
As the appointment day approaches, our technician connects with the family to resolve any technical issues before the physician consultation. The technician also goes over the at-home visual acuity check and evaluates basic medical history.
On the actual day of the telehealth appointment, the physician connects with the family to go over the relevant medical history and visual acuity and performs focused examination including external and ocular motility exam. If needed, pictures and videos from the family can be sent to the physician for further evaluation. This enables us to diagnose a majority of anterior segment ocular issues, visual acuity concerns like amblyopia, refractive errors and ocular motility disorders.
During the telehealth appointment, we discuss the treatment care plan and review any medical issues or concerns the patient is experiencing. Throughout this process, we can fulfill their needs ranging from prescription refills or broken glasses, without them having to step outside the comfort of their home.
Our office will then schedule a follow-up visit depending on the medical necessity.
How do your patients and families feel about telehealth?
I have found that many patients love telehealth! Our families feel supported and secure, since there was no interruption in their child’s care plan. I’ve also found that our families feel grateful that during this time of uncertainty, their physician was able to connect with them and address any urgent issues, and then follow them in clinic as needed.
Due to the positive response we have received from our families, we plan to continue offering telehealth appointments in the future.
Does telehealth compromise quality of care?
No. We carefully scrutinize the kind of visits that can safely be performed via telehealth without compromising on quality of care. If your ophthalmologist decides your child’s visit can safely be conducted via telehealth, rest assured your child will still receive the high level of care you’re used to receiving in person. After the telehealth appointment if we feel the need for an in-person appointment, we will work with our families to schedule that appointment promptly and safely.
Sometimes, an exam conducted via telehealth reveals something requiring an in-person appointment. In those cases, we work with our families to schedule appointments promptly and safely.
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