Article

CLINICAL: INTERDISCIPLINARY CARE

JOIN THE TEAM

MANY OF our patients have a spectrum of health care needs. Patients with common causes of vision loss, including diabetic retinopathy, glaucoma and AMD, often present with concomitant systemic disease, such as diabetes, high blood pressure, obesity and cardiovascular disease.

Inter-professional collaborative care is the coordination of a full scope of experts to meet all of the patient’s health care needs.

Care delivery by a team of professionals results in cost effectiveness, limits unnecessary referrals, increases access of care and minimizes errors, reflecting a positive impact on the patient’s care while improving the patient’s satisfaction, according to the July 2009 issue of The Cochrane Database of Systemic Reviews.

Given the link between ocular and systemic disease, the aging population and the above practice benefits, inter-professional collaborative care should be employed in our practices to manage our patients. Here’s how you can get started.

LEARN ABOUT THEIR EXPERTISE

Collaborative care with other health care providers can only flourish through mutual respect. To build competent, inter-professional relationships and work as a unit, optometrists need to become familiar with the healthcare professions and allied health providers who may participate in the care of our patients. (See “Examples” for a few of the inter-professional services your patients may require.) It is essential to comprehend their expertise, knowledge, skills and abilities as we build proper communication within the distinct health disciplines. Begin your research by prioritizing those professional services that complement your specialties or areas of interest. For example, an O.D. who specializes in the management of diabetic retinopathy would do well to research endocrinology.

Examples

Inter-professional health care providers outside of eye care:

  • Geriatricians
  • Endocrinologists
  • Podiatrists
  • Occupational therapists/physical therapists
  • PAs/Nurse practitioners
  • Primary care physicians/internists/family medicine practitioners
  • Nephrologists
  • Dentists
  • Pharmacists
  • Dieticians/nutritionists
  • Audiologists/speech pathologists
  • Psychologists/psychiatrists
  • Cardiologists
  • Neurologists
  • Pulmonologists
  • Rheumatologists/Infections disease specialists

PUT IT INTO PRACTICE

Once you have gathered the broad strokes of which professionals you should prioritize working with, begin to develop your team. Seek these professionals within a 5- to 10-mile radius from your office, creating a close proximity for the convenience of your patients. Also, look for those physicians who accept a similar line up of insurance plans as your office does.

When possible, try to visit the offices of the professionals on your team. This visit can serve two purposes: (1) to familiarize yourself with their businesses and (2) to educate the professional on the services that you offer to your shared patients.

In practice, develop a contact list for your collaborative care team. Discuss this approach with your office team, and outline the process for referring to these professionals. After a prompt from the O.D., front desk personnel would consult the list to identify the necessary professional. Ideally, this staff member would then schedule an appointment for the patient at check out, ensuring patient follow up.

WORK AS A TEAM

Many doctors have adapted the concept of inter-professional collaborative care, resulting in multiple disciplinary clinics, such as Leon Medical Centers, integrated manage care, like Kaiser Permanente, and numerous interdisciplinary university and clinic institutions. Optometry is playing a key role in all these venues.

Future installations of this monthly column will focus on how to foster opportunities for inter-professional collaborative care; the proper dialogue between health care professionals and the Healthcare Effectiveness Data and Information Set (HEDIS), to name a few. OM