Article Date: 9/1/2012

Practice pulse
Practice pulse

STAGE 2 FOCUSES ON HEALTH INFORMATION EXCHANGE

Medicare/Medicaid Publish Final Rule on Stage 2 EHR Criteria

TIPSTRENDS & NEWS YOU CAN USE

■ Health and Human Services (HHS) Secretary Kathleen Sebelius recently announced the final rule on Stage 2 of the EHR incentive program, says the Centers for Medicare & Medicaid Services (CMS).

“The changes… will lead to more coordination of patient care, reduced medical errors, elimination of duplicate screenings and tests and greater patient engagement in their own care,” Secretary Sebelius says.

The first of three stages, which began in 2011, set the basic functionalities EHR must include, such as capturing data electronically and providing patients with electronic copies of health information. While Stage 1 established a core structure of objectives for providers, Stage 2, which will begin as early as 2014, increases health information exchanged between providers in order to benefit patients, according to CMS.

“Stage 2 is all about CMS making good on its promise to make patient data interoperable between providers and giving patients secure communications and online access to their health information,” says Kim Castleberry, O.D., of Plano, Texas, who began using EHR more than 20 years ago. “I believe this will effectively mandate patient portals for patient-and-provider communications of this data.”

Brian Chou, O.D., F.A.A.O., of San Diego, Calif., who's also a bit of an EHR guru, sees EHR as a benefit for the sale of product rather than a means to the incentive payments.

“Most O.D.s using EHR see present value in systems that have superb functionality with order tracking and prescribing glasses and contact lenses,” he says. “These O.D.s, myself included, care more about that basic stuff instead of chasing future promises and jumping through all these hoops and hurdles related to getting Medicare incentive payments.”

More than 120,000 eligible healthcare professionals, and more than 3,300 hospitals have qualified to participate in the program since it began in January 2011. To read the final Stage 2 rule, visit https://s3. amazonaws.com/public-inspection. federalregister. gov/2012-21050.pdf.

CORRECTION: In the July 2012 issue (“What SD-OCT Can Do for You: An Optometric Perspective”), OM reported on page 26 under “SD-OCT's financial impact,” that Medicare reimbursements have dropped from about $120 per eye to about $40 per eye. In fact, as of January 2011, SD-OCT is no longer billable per eye. In addition, the average total reimbursement for both eyes is $48.

CENTER WILL FOCUS ON AGING POPULATION ISSUES

Illinois College of Optometry Announces Center on Vision and Aging

■ The Illinois College of Optometry (ICO) has announced the founding of an ICO facility geared toward the aging population. It's called the Alfred and Sarah Rosenbloom Center on Vision and Aging.

“The over-80 population is growing four times faster than any other segment of the population,” Alfred Rosenbloom, O.D. says in an ICO press release. “ICO's reputation in terms of current and future education offers the opportunity to elevate standards and raise awareness for providing professional vision care to this age group. This may lead in time to the development of a geriatric care patient service model, including care for many underserved individuals in assisted living facilities and in nursing homes.”

The Center will ultimately have four roles, says the press release:

(1) to promote optometry students' and practitioners' knowledge and comprehension of the inter-relatedness of aging and vision care;
(2) to provide vision care, support services and counseling for older adults and underserved communities in and around Chicago;
(3) to develop ongoing relationships with geriatric care facilities in the Chicago area for education and patient care services;
(4) to sponsor geriatric research related to vision;

The Center is named for Dr. Alfred Rosenbloom and his wife. Dr. Rosenbloom was ICO's dean from 1955 to 1972, president from 1972 to 1982, and is currently a distinguished professor emeritus. Also, he was inducted into the National Optometry Hall of Fame in 2010.

AAO RECOGNIZES OPTOMETRIC CONTRIBUTIONS
American Academy of Optometry Announces 2012 Award Winners
The American Academy of Optometry (AAO) has released the names of its 2012 award recipients. These are individuals who “have made countless contributions to advancing the profession of optometry,” says an AAO press release.
The awards and their recipients:

CHARLES F. PRENTICE MEDAL AND LECTURE AWARD: Larry N. Thibos, Ph.D., F.A.A.O.

GLENN A. FRY AWARD AND LECTURE (AMERICAN OPTOMETRIC FOUNDATION AWARD): Susana T.L. Chung, O.D., Ph.D., F.A.A.O.

IRVIN M. AND BEATRICE BORISH AWARD: Melissa D. Bailey, O.D., Ph.D., F.A.A.O.

AAO-ESSILOR AWARD FOR OUTSTANDING INTERNATIONAL CONTRIBUTIONS TO OPTOMETRY: Olanrewaju Matthew Oriowo, B.Sc(Optom), M.Sc, Ph.D., F.A.A.O.

WILLIAM FEINBLOOM AWARD: P. Sarita Soni, O.D., M.S., F.A.A.O.

CAREL C. KOCH MEMORIAL AWARD: Roger J. Wilson, O.D., F.A.A.O.

JULIUS F. NEUMUELLER AWARD IN OPTICS (AMERICAN OPTOMETRIC FOUNDATION AWARD): Kenneth Headington, O.D., M.S.

MICHAEL G. HARRIS AWARD FOR EXCELLENCE IN OPTOMETRIC EDUCATION (AMERICAN OPTOMETRIC FOUNDATION AWARD): Dennis L. Smith, O.D., M.S., F.A.A.O.

EMINENT SERVICE AWARD: Richard E. Weisbarth, O.D., F.A.A.O. and Joe Yager, O.D., F.A.A.O.

LIFE FELLOW AWARD: John F. Amos, O.D., M.S., F.A.A.O. HONORARY FELLOW AWARD: Susan I. Eger and James F. Jorkasky

GARLAND W. CLAY AWARD: Fiona Stapleton, B.Sc, M.Sc, MCOptom, Ph.D., F.A.A.O., Lisa Keay, BOptom, Ph.D., Isabelle Jalbert, O.D., Ph.D., F.A.A.O. and Nerida Cole, M.Sc, Ph.D.

AWARDS OF THE CORNEA, CONTACT LENSES & REFRACTIVE TECHNOLOGIES:

SCHAPERO MEMORIAL AWARD: Fiona Stapleton, B.Sc, MS.c, MCOptom, Ph.D., F.A.A.O. FOUNDER’S AWARD: Lester E. Janoff, O.D., M.S.E.D., F.A.A.O. (posthumously)

The AOA will recognize these winners on day three of its 90th annual meeting, Academy 2012 Phoenix, which will occur October 25 to 27 at the Phoenix Convention Center, Phoenix, Ariz. Visit www.aaopt. org for more information.

BUNDLING FEES CAPTURES SALES

Global Contact Lens Fee Secures CL Purchases

■ In response to OM's request for additional tips on how to get patients to buy their contact lenses from the optometrist, at the end of “Securing the Contact Lens Sale,” page 44 of the June 2012 issue, David Oosting, O.D., of Fremont, Mich., sent us an additional tip: Charge a global contact lens care fee.

“This fee includes the annual examination, first-time insertion and removal instruction, all follow-ups, all lenses, and all solutions. Anything that is contact lens-related is covered, e.g. CLARE, abrasion from over-wear, etc.,” he explains. “If the patient tears a disposable soft lens, it is replaced at no charge. By including all lenses and solutions, there is no reason for the patient to shop around, plus it “marries” the patient to the practice — it's one stop for everything.”

Dr. Oosting says he determines the fee by figuring out his practice's wholesale cost for the lenses and solutions, typically provided for a year, and adding a professional fee to it.

“Obviously, the initial year will cost more than subsequent years, and toric/multifocal fits also have a higher professional component. But by using this system, the temptation to compare ‘per-box’ prices is minimized,” he says. “If they ask, we can quote a per-box price, which is comparable to other lens sources. For VSP billing, we break it down into Exam, Refraction, Fitting, Lenses and Supplies.”

Dr. Oosting, who says he's been doing this with great success since opening his practice almost 25 years ago, adds that he tailors the program to meet the patient's individual needs. So, if the patient wants their supply shipped to them, his practice does it. If the patient wants a family member to pick up their next bottle of solution, his practice does it.

“We have very few patients who shop online for their contact lenses,” he says. “By offering this ‘prepaid’ service, we can emphasize the importance of professional care and minimize the contact lens as a commodity, treating it instead as a doctor-dispensed prescription medical device.”

If you'd like further information on Dr. Oosting's global fee idea, he invites you to e-mail him at oosting eyes@gmail.com.

FDA News
Ranibizumab injection (Lucentis, Genentech), which is currently approved for the treatment of wet age-related macular degeneration and macular edema following retinal vein occlusion, has received FDA approval for the treatment of diabetic macula edema.


RESEARCH Notes
• The intravitreal injection of ocriplasmin (a vitreolytic agent, from ThromboGenics), resolved vitreomacular traction and closed macular holes in significantly more symptomatic vitreomacular adhesion patients than did placebo injection, and was linked with a higher incidence of ocular adverse events than the placebo injection, which were mainly transient, says August's New England Journal of Medicine.
• Statin use in type 2 diabetes patients appears associated with age-related cataract, says August's Optometry & Vision Science.
• In a cohort of Medicare beneficiaries age 65 and older who had cataract, patients who underwent cataract surgery were less likely to have hip fractures within one year postsurgery vs. patients who did not have the procedure, says August's Journal of the American Medical Association.
• Early loss of estrogen appears to lead to premature aging and, thus, the increased susceptibility of the optic nerve to glaucomatous damage, says August's Menopause.
• Ocular Therapeutix has begun a Pilot Phase II study for its Travaprost Punctum Plug for glaucoma treatment, the company says.


Optometric Management, Volume: 47 , Issue: September 2012, page(s): 12 - 16