Improving efficiencies and the patient journey after COVID 19

Colin Kerr

Posted: Friday, October 23, 2020

Improving efficiencies

Not everything has been negative about COVID due to reconfigurations in the way some private ophthalmologists are now working since the outbreak of the COVID-19 pandemic.
That is the view of Dr Arthur Cummings, medical director and consultant ophthalmologist at the Wellington Eye Clinic, Dublin, who spoke at the 38th Congress of the ESCRS.
Dr Cummings, who addressed the topic “Shutting down and restarting your practice: the experience of a private clinic during the Covid-19 pandemic” said COVID took Ireland by surprise with the first case on February 29, 2020. Lockdown was announced on 27 March, he said, one month after the very first case and lasted for 7 weeks until 18 May for Irish ophthalmologists.
In preparation for lockdown, they carried out a critical staff analysis with four categories – critical, essential, helpful and non-essential.
They reviewed processes with patient-staff contacts to be limited and worked with their IT providers to allow managers and key staff at the clinic to work remotely. PPE was sourced and additional sanitisation stations installed. A COVID cancellation list was established on a shared tracker platform that all staff could access from February.
“Our EMR with remote access made the process of contacting patients very straightforward. We had an SMS feature to keep patients updated quickly and easily regarding cancelled appointments and we diverted phone lines to the administration manager’s mobile phone allowing phone lines to stay open,” said Dr Cummings.
Dr Cummings said that directly after lockdown they were in a temporary “New Normal”. Optometrists and nurses phoned patients who were due post-operative appointments to conduct virtual appointments and reduce wait lists for reopening. They also had weekly zoom meetings with the full team to keep them up to date and brainstorm on marketing and eventual “getting-back-to-work” plans.”
They adapted their marketing efforts to take into account the fact that many patients would be working from home and hosted a weekly public webinar series specifically for these patients with topics including dry eye, increased screen time and eventually, after about 6 weeks, refractive surgery.
“It became apparent,” he said, “that young professionals were least affected economically so we had increased engagement with them. We increased posts on our social media channels and also introduced a “Meet The Team” series.”
Before the reopening, each staff member submitted their individual patient suggested journey and processes changes and they had a half day Zoom meeting where these were consolidated and discussed. The team voted for the best ideas and the final process was a hybrid of all the staff ideas. The process changes included an e-pack for patients which included links to the Wellington Clinic’s online medical history form and online payment options. They also introduced longer opening hours to facilitate wait lists and social distancing. The clinic was physically reconfigured to allow for social distancing and increased health and safety requirements. All staff completed a Return To Work COVID Declaration in line with Irish Government guidelines.
The clinic re-opened on 18 May and has remained opened since then with no confirmed cases of COVID among patients or staff. Revenue is recovering, said Dr Cummings and patient age has reduced with an increase in the number of patients under the age of 30 attending for refractive surgery.
“There is an increased demand in the Presbyopia age group for IOL procedures and there is improved staff satisfaction because of improved efficiencies in the patient journey and processes, so not everything about COVID has been negative,” said Dr Cummings