Darren Chen Notes the Best Use for Video Visits for Ophthalmic Care

Certain types of ophthalmic care were more successful with video visits based on what was required to treat patients, said Darren Chen, MD student at Weill Cornell Graduate School of Medical Sciences.

Transcript

What were patients’ biggest concerns with virtual care for ophthalmic visits and how can they be addressed moving forward to create a better patient experience?

There was a free response section in our study that patients could fill out with any feedback that they had, and the main concern for many patients had to do with the video software itself. So, at least at Cornell the telehealth was all performed through the Epic EMR [electronic medical record] system, and the video visit functionality was built within that software itself. So, most patients hadn't used this system before, and they found it a little bit clunky and unfamiliar. There was also an issue that they would be put on a wait screen, and they wouldn't know how long they would have to wait in front of computers before their ophthalmologists would sign on the other end.

So, I think they probably would have been more comfortable using other more consumer-facing products like Zoom or Apple FaceTime—something with a more familiar user interface for them. So, I think that there's probably a potential gap in the marketplace that can be filled by some sort of software that links more consumer-friendly options like Zoom or Apple FaceTime into the Epic EMR system so that it's easy for providers to write notes and also for patients to feel more comfortable with the video visit itself.

There has been discussion about identifying when telemedicine is appropriate vs in-person visits. In your study of ophthalmic video visits, did you see anything that helped identify which visits can stay virtual and which should move back to in person?

I think a good way to answer this would probably just be to look at the utilization over time by subspecialty during the pandemic. So, we saw that oculoplastics and neuro-ophthalmology had the highest utilization with the most visits on a per-provider basis. And we saw that subspecialties like glaucoma and retina virtually had no visits at all, mostly because of the exams that are required to treat patients in those settings.

I think that also for oculoplastics and neuro-ophthalmology, telehealth is especially useful for follow-ups after surgery, especially like 3 to 6 months or even a year down the line for those less acute situations. And for neuro-ophthalmology patients who have been followed for a very long time by the same ophthalmologist, whether they need just another quick checkup or quick adjustment of their medication doses.

So, I think that those 2—neuro-ophthalmology and oculoplastics—will see a continued use of telehealth in those 2 fields. And that's just exactly what we're seeing in our clinics at Cornell here with our providers providing video visits on a weekly basis even until now.