The ophthalmic community is lobbying the government to allow eyecare professionals to deliver telehealth consultations under Medicare during COVID-19, as e-referral platform Oculo unveiled a new videoconference feature in response to the crisis.
Optometry Australia (OA) and Specsavers have lodged submissions with the Department of Health to modify optometry Medicare Benefits Schedule (MBS) item numbers 10916 (brief initial consultation) and 10918 (subsequent consultation) for telehealth purposes.
If adopted, it is believed telehealth services will protect eyecare providers and patients from potential infection and allow patients to access critical eyecare at home. Older Australians requiring regular ocular medications will have easier access to services, while triaging and referral services can be maintained both to eye specialists and in-person optometry.
It comes after Federal Health Minister Greg Hunt announced “a radical transformation in the way we deliver our health services” by expanding Medicare-subsidised telehealth services for all Australians. As it stands, the current initiative does not extend to optometry.
Specsavers director of optometry Dr Ben Ashby said the COVID-19 crisis has led to a significant reduction in optometry visits, with the optical chain itself announcing a scaling back of operations to remain open for urgent and essential care only.
He said the sector was equipped to offer telehealth services, with a new and tested video conference function within the Oculo platform ready for launch next week.
“Introducing telehealth for optometry will help to ensure appropriate referral and critical care is maintained around Australia,” he said.
“Reduced access to optometry would [also] result in people having to go straight to a general practitioner for any eye-related issues, including referral to an ophthalmologist. Inevitably this will contribute to overstretching general practitioners, ophthalmologists, hospital eye services, and hospitals which are focused on COVID-19 patients.”
In a post on its website, OA said tele-optometry is a key element to ensuring patients access time-critical and urgent eyecare.
“We understand that further telehealth announcements are scheduled, and continue to advocate strongly for optometry’s inclusion,” the association said.
“We strongly encourage practices to begin offering, or preparing to offer, telehealth services to their communities. We believe that, given a Medicare rebate is not currently available, it is appropriate to charge a reasonable private fee for this service,”
To support optometrists, OA has developed a tele-eyecare guide for optometrists. It is also hosting a brief webcast to share advice at 2pm AEDT Thursday 2 April.
Oculo launches new video conference function
In direct response to the COVID-19 emergency, the cloud-based clinical communications network Oculo announced it had introduced a new video conference function for optometrists and ophthalmologists to continue delivering care to patients requiring ongoing support for chronic conditions.
More than 3,000 optometrists and 700 private ophthalmologists have signed up with Oculo. Its customers include Specsavers, Luxottica Australia, Bupa Optical and other corporate and independent optometrists.
CEO Dr Kate Taylor told Insight that the company’s 11-strong development team had been working around the clock to implement the new feature for several weeks.
“The implication of cancelling significant amounts of routine outpatient activity are going to be felt long after the crisis phase of COVID-19 has passed,” Taylor said.
“There is an acute need to ensure that there are appropriate innovations in place to not just to relieve the burden of these appointments but to move them away from centralised sites where virally-infected patients are likely to congregate to sites that are closer to and safer for patients. Doing so will ensure continuity of care, minimise risk for hospital staff and prevent unnecessary travel posing significant health risks to patients.”
Taylor said the pandemic is placing unprecedented strain on health systems. At the same time, the eyecare needs for people with pre-existing chronic diseases – including diabetic eye disease, glaucoma and macular disease – remain.
Professor Bill Morgan, of the Lions Eye Institute in Perth, added: “Patients with glaucoma and AMD are on average in their 70s and 80s, a known risk factor for an adverse outcome with COVID-19 (~15% mortality). Diabetes patients tend to be somewhat younger (typically in their 60s), but because diabetes is a known significant risk factor, they fall into the high risk COVID-19 band also.”
