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56 | EYEWORLD DAILY NEWS | MAY 16, 2020 DAILY NEWS ASCRS VIRTUAL ANNUAL MEETING only doctors who have called them, so we take a moment to discuss general safety guide- lines for COVID. Keeping our practice in patients' mind and keeping our doctors' minds on their patients is critical during a crisis." Christina Weng, MD, MBA Associate professor of ophthalmology Cullen Eye Institute, Baylor College of Medicine Houston, Texas Working as a surgical reti- na specialist in an academic setting, Dr. Weng finds several challenges that telemedicine can't quite overcome: 1) patients who need injections, 2) urgent and emergent pa- thology, and 3) cameras and equipment needed to assess the retina and posterior segment. Dr. Weng still sees most of her injection patients, criti- cal postoperative follow-ups, surgical complications, and patients who are experiencing acute symptoms (flashes, float- ers, pain, vision loss, or eye redness). The clinic is taking precautions when carrying out those visits. Dr. Weng champions a large teleretinal screening program for diabetic retinop- athy in Houston, Texas, but telemedicine in the COVID-19 era is different. The ultimate aim is to provide contactless care, she said. Ophthalmolo- gists are turning to platforms like FaceTime and Zoom that allow for video calls. At her institute, they are using tele- visits built into the EHR system and are able to bill for these exchanges. Additionally, the EHR has a mobile version that can be downloaded. Most of the "visits" involve the patient describing their symptoms and history, but people are getting innovative with eval- uation methods, she said. "While the quality of images across a phone or computer camera will not parallel that from a slit lamp, it does allow for a general assessment and more-informed triage," Dr. Weng said. Another challenge is some elderly patients are not familiar with computers, smart- phones, and apps, and some may not have access to these. For these patients, phone calls may be a better option than video chats, Dr. Weng said. "This type of telemedicine has been available for quite some time, but it was seldomly used until COVID-19 forced us to change the way we work and live," Dr. Weng said, add- ing that she thinks this shift in providing care will be a per- manent one. "I hope that this brings a heightened awareness to the value of convention- al, fundus-based teleretinal screening, a cost-effective way to prevent blindness in millions of people." April Maa, MD Associate professor Emory Eye Center, Emory University School of Medicine Clinical director of TECS, VISN 7 Regional Telehealth Service Atlanta VA Medical Center Decatur, Georgia Dr. Maa works with the VA, which had a telemedicine screening program prior to the pandemic, Technology-based Eye Care Services (TECS). The goals of TECS were to prescribe glasses and identify patients requiring an in-per- son eye exam at the primary medical care home. Challenges in the VA system pre-pandemic included geography (patients living far away from the main eye clinics) and access (not enough appointment availabil- ity). However, since the COVID-19 pandemic, her focus has shifted, since many of the veterans are high risk, and TECS requires a techni- cian to be present in person with the patient. "Routine eye screenings don't need to be done during this time," Dr. Maa said. "We've shifted our experience in telemedicine to helping the field find another way to see patients during the pandemic." She mentioned a newly designed video protocol to connect with patients and added that they are piloting a protocol for ophthalmic urgent care, which allows for a spe- cialist to be patched in through the VA Video Connect system if, for example, a primary care doctor has an eye question when seeing a patient via video appointment. Post-COVID-19, there's go- ing to be a substantial backlog because many patients who do need care but are not having acute problems are not being seen at this time. There may be the possibility to do a "digital- ly integrated visit," where a technician could perform tests and check on the patient in the office, even if the physician isn't present, and the physician could follow up with the pa- tient after all the information is gathered, Dr. Maa said. "It's unfortunate that the pandemic is here, but at the same time, it's a good opportu- nity for practices to incorporate telemedicine as part of their toolbox for taking care of patients," Dr. Maa said, adding that it's an important tool for being successful in the long run. continued from page 52 All live sessions will be made available on the platform for on-demand viewing by May 26, with many sessions available within 24 hours of the meeting. In addition, please enjoy the extensive selection of on-demand papers, skills videos, films, and posters available for viewing at your convenience. Missed a session?

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