POA Forum: Food, Facts and Fun!

Each year, POA sponsors an event at Pennsylvania College of Optometry (PCO) that allows the Board of Directors and PCO students to discuss the benefit of joining the association. This year's event, titled "Food, Facts and Fun," took place Friday, September 12th in the Hafter Student Community Center.

E-health information exchange assures better patient care

In order for patients to receive better and safer care, all players in the healthcare system, like hospitals, doctors and pharmacies, must be able to quickly find, evaluate and understand a patient’s medical information. The process of securely sharing this information prevents a patient from receiving medications that interfere with those previously prescribed. The gap in communication between a patient’s physician and a doctor in the emergency room can have serious health-altering consequences.

To close this gap, electronic health information exchange, soon enabled by the Pennsylvania Patient and Provider Network (P3N), is here to help. For this to work correctly, local healthcare providers need to connect to a regional health information organization (HIO). The HIO connects to the P3N hub and patient’s information flows to other HIOs and participating healthcare providers. 

P3N, a service from the Pennsylvania eHealth Partnership Authority, is currently under development, but pilot programs will launch later this year in the Lehigh Valley and southwestern Pennsylvania. 

Electronic health information exchange is important for patients and providers alike. The information exchange benefits everyone by cutting down on redundant testing and medications. It will help to reduce unnecessary costs; in Washington state, a similar data-sharing initiative saved $33 million in Medicaid ER costs in the first year of the program alone.

For this program to be successful, maximum participation from doctors, hospitals, pharmacies and others in the healthcare system is a must. The more patient information provided, the better. 

For additional information, please see: www.pennlive.com/opinion/2014/07/in_emergencies_minutes_matter.html.

InfantSEE Success Story - Dr. Daniel Schott

The following InfantSEE success story came from Dr. Daniel Schott.

Schott Associates Eye Care in Potter and McKean counties have found a way to better its InfantSEE screenings by coordinating the appointment with the patient’s pediatrician. The Coudersport location owes its success, in part, to the office’s ideal location in Cole Memorial Hospital, but the other locations have also found this coordination tactic successful despite the pediatrician’s office being in another building.

At the child’s nine-month check-up, the infant comes to the office for a screening first. After the screening, the InfantSEE report is sent with the parent to be delivered to the pediatrician at the child’s visit. This way, the pediatrician is reviewing the report with the parent at the appointment and can stress the importance of early intervention in visual development.

Schott Associates Eye Care has found the nine-month visit to be the best time for this screening because infant cooperation is typically better at this age. Cooperation leads to more accurate data. Also there are usually no immunizations at a nine-month well-child visit, so if the patient must come in after visiting the pediatrician’s office, they are usually not cranky from receiving shots.

This has been a very successful way to market not only the practice, but also the importance of early childhood eye exams. In addition, the interaction with pediatricians in this manner has lead to other cases being referred to the practice. This is a win-win for all parties involved. 

Well done, Dr. Schott! Send your own InfantSEE success stories to Kelsey@poaeyes.org to be included in a future issue of the Keystoner and featured here on our blog.

AOA’s House of Delegates meeting

Richard Christoph, O.D.
POA President-Elect

During Optometry’s Meeting this year, my duty as POA’s president-elect was to attend AOA’s annual business meeting, the House of Delegates, as a POA representative along with POA president Dr. Marianne Boltz. Just as it is for POA, the House of Delegates sets policy for AOA. It is made up of representatives from each affiliated organization of AOA, which includes the 50 state associations, plus Washington D.C., the American Optometric Student Association and the Armed Forces Optometric Society.

As is protocol, the House of Delegates opened with a flag ceremony, the Pledge of Allegiance, an invocation and the Optometric Oath. During the meeting, there were reports and introductions from the member volunteers in the Sergeant At Arms, Credentials, Resolutions and Nominating Committees. There were also votes to approve the handbook and procedures, adopt the agenda and approve the actions of the Board since the last House meeting.

This year, three resolutions were brought forward for vote. One was related to optometric care of brain injury, including concussions. It recommends an optometric evaluation following brain injury to diagnose and treat ocular disorders or vision changes. The Vision Rehabilitation Section of AOA was involved in crafting this resolution. They have assembled an excellent resource, the Brain Injury Electronic Resource Manual, available online at aoa.uberflip.com/i/225867. The other two resolutions were modifications of existing resolutions regarding paraoptometrics. Because the paraoptometric section was dissolved and reformed as the paraoptometric resource center last year, some changes in wording were necessary to reflect the current status of paraoptometrics within AOA.

AOA’s secretary-treasurer, Dr. Andrea Thau, informed the House that AOA’s financial standing was strong. The new dues accounting procedures and restructuring of membership classes has resulted in more consistent cash flow for the organization, without a significant loss of membership. In fact, both total membership and dues revenues have increased.
The AOA-PAC chair, Dr. Ron Benner, reported on the status of AOA-PAC. Donations were down in every measurable way: total dollars, number of donors, average donation and percentage of donors all decreased for 2013 compared to the last few years. AOA has been relying heavily on a small number of larger donors who are approaching the end of their careers. If you are not already an AOA-PAC donor, please make it a priority to donate this year. In addition, please also donate to POPAC. Optometry has to be active at both the state and national levels to ensure our inclusion in healthcare reform. 

Next, there was a presentation regarding the Think About Your Eyes Campaign. AOA members who participate in this campaign may receive discounts. The purpose of its media campaign is to increase the number of eye exams performed. For more information, please see www.thinkaboutyoureyes.com. 

Dr. Teri Geist reported on AOA’s public relations efforts as of mid-June, stating that AOA had over 1 billion positive media impressions so far in 2014. 

The advocacy team also reported on their activities for the past year. Between state government relations, third party, federal relations and the clinical resource group, the activities are far too numerous to list here. Some of the newer legislative initiatives are as follows: to advance scope at the state level; to address issues with insurance and vision plans, such as discount on non-covered services, credentialing and restrictive material ordering; telemedicine issues like online exam and kiosks; and Medicaid issues, specifically inclusion and reimbursement. 

The Clinical Resources Group is involved with the creation of an optometric registry, an important tool for optometrists to fully participate with PQRS, meaningful use and other incentive programs. The statistics gathered through this registry will provide individual doctors with valuable information about their own practice, and benchmark data to compare themselves with others. It will also provide state associations and AOA with aggregate data that can be used in negotiations with government entities and insurance plans. Most importantly, it will enable optometrists to improve the quality of care provided to patients. AOA expects this to roll out in early 2015. Doctors will need to be using electronic records to participate.

And lastly, elections were held for 2015 and the following slate of officers was elected: Dr. Steven Loomis (president-elect), Dr. Andrea Thau (vice president), Dr. Christopher Quinn (secretary-treasurer), Drs. Barbara Horn and Samuel Pierce (trustees; three-year term), and Dr. James DeVleming (trustee; one-year term). Dr. David Cockrell assumes the office of president and Dr. Mitch Munson assumes the office of past-president. Drs. Greg Caldwell, Robert Layman, and William Reynolds continue their three-year terms as trustees.

Latest VOSH PA Mission

Paul Halpern, O.D.

A new Volunteer Optometric Services to Humanity of Pennsylvania (VOSH PA) mission site was opened in Pont Sondé, Haiti about sixty miles northwest of Port-au-Prince and just inland from the sea. The mission was sponsored by Sové Lavi, which is liberally interpreted to mean "save lives." Founded by one-time Haitian presidential candidate and American food industry capitalist Dumas Simeus, Sové Lavi is a community-based group that concentrates on uplifting health care in Haiti.

This mission was unique; we stayed in a small hotel located adjacent to the Sové Lavi sponsored community health clinic. This very clean, but small two-story building was a hodge-podge of little examination rooms connected by narrow hallways and located on the main street of the town. Because the building lacked a large standing area, the patients were forced to line up along the heavily traveled street prior to registration causing some episodic breakdown of behavior. As is usually the case, once registered and in line for care, the most outspoken of the patients became sweet and tame.

Our volunteers saw about 1,125 patients and referred 35 for cataract surgery to the ophthalmology residency program at the University of Haiti Medical School in Port-au-Prince. Unfortunately they are not equipped to provide tertiary care for glaucoma patients so we could only provide them with a year's supply of glaucoma medication and our good wishes. We successfully treated several trachoma cases, most notably a seven-year-old who returned for a follow-up the next day and was essentially clear. As is VOSH policy, we instructed the family on the necessity of good personal hygiene as the best way to combat this condition.

We did one remote village clinic on our last day in Noé, a very poor community with few resources. The living conditions were the worst that I personally encountered in all my ten trips to Haiti. Our team made the best of it and did great work despite the circumstances.

On this mission, we were fortunate to have a Surgical Eye Expedition (SEE) physician from Harvard University, Paul Cotran. Dr. Cotran is a fellowship trained glaucoma specialist and educator. He stayed with the group for two clinic days and then moved on to the hospital at the university to tend to the cataract patients we had referred. It is important to note that I saw some of the worst glaucoma sufferers that I have ever come across. At least six patients were totally cupped out and stone cold blind. As Dr. Cotran and I began to see these people and others with emerging glaucoma, we became increasingly frustrated with our inability to provide proper care for them.

We came to the conclusion that Haitian eye surgeons and ophthalmology residents needed to be trained to do more complex and lasting procedures to treat glaucoma. We need to make this care geographically available to the people, perhaps at yet-to-be created Centers of Excellence located in north, central, and southern Haiti. Spaced about 100 miles apart these centers could bring glaucoma care closer to the people. The discussion broadened by taking it online and to various national and international glaucoma experts for extra input and suggestions. A plan began to evolve that centered on ways to best treat for long-term wellness and to also train local ophthalmologists to provide the care needed. It is most important that we stay at the forefront of this exciting new effort.

Finally, we are indebted to the wonderful group of volunteers that made this trip. They were spectacular under difficult conditions. They never faltered; they only asked what else they could do. I don't understand how we are so fortunate to be blessed by this quality volunteerism but we, as an organization, must recognize, treasure, and when possible, reward them.

For more information about VOSH PA, visit www.vosh-pa.com.