Going remote: the bigger picture

With the right IT infrastructure in place, we were able to arrange remote access to the practice from the word go. Our clinicians would monitor the emergency email and respond to patients accordingly.

In the early days, it was all about reassuring patients and assessing via telephone and WhatsApp calls whether they needed to be seen as an emergency. We later, like many, moved to Zoom. We were much more comfortable doing something to reassure our patients than just leaving them in the lurch or making them go to hospital.

I could recount numerous cases of patients who had teleconsultations; we saw them as an emergency in practice and avoided them making a trip to the hospital. The scope and skills of independent prescribing delivered by our optometrist and fellow director, Keyur Patel, worked to give them treatment and relief.

During the early days of the pandemic, we did remote consultations, we did home deliveries, and we kept our contact lens solutions and supply going. We tried to be there for our patients in every way that we could, and IT played a massive part in that. If the pandemic had happened 10 years ago, the world would have gone to pot.

Remote consultations

Having a prior relationship with Advanced Ophthalmic Solutions (AOS), when it developed its remote consultation solution towards the end of 2020, we became a beta tester for the software. Once it was brought to market and we knew it worked, we moved to this for all remote consultations. It’s simple and easy to use.

The support team sets up the patient on AOS and it is only the clinician who provides the video call. It took almost no time at all for the clinical team to feel comfortable doing remote consultations.

The patient receives a link-coded email with a personal pin and registration code. The patient is then required to download the app for access. Yes, it relies on a smartphone and sometimes it fails due to user error or the internet connection not being strong enough, but that is rare and, generally, it has been welcomed by patients.

Extending remote

Observing the benefits of remote consultations via the AOS platform, we took the decision to extend this service. We began using it not just for emergencies or when a patient requested it, but for pre-screening and triaging a patient before they attended for an appointment. We are a specialist practice and have patients attending from far and wide. Offering a remote consultation and seeing the patient ahead of their appointment enables us to gain massive amounts of beneficial information.

Yes, they may have previously shared an email of their history, or we have had a telephone conversation, but to actually see the patient and ask them the questions is so much more interactive and helps you pre-judge what appointment time is needed.

We provide these video consultations free of charge – we have never charged for a telemedicine consultation as our patients are private or on a care plan. I appreciate that it is harder depending on a practice’s fee structure. And while we pay a small monthly fee for AOS, it’s a small sum to pay when it allows such a greater level of efficiency of appointments for patients when they do come in. It also means that we have saved appointments because of the nature of video calls, enabling us to decide if a patient really does need to be seen in person.

With personal protective equipment, including masks, a way of practice life today, remote consultations have other benefits too. During a remote consultation, you do not have to wear a mask, which means you can hear the patient better. It also gives the patient the opportunity to see you; it allows the passion and enthusiasm you have for solving their problem to be seen, which is real endorsement for you and your practice.

Pre-pandemic

Before COVID-19, I had a slight hesitancy about the concept of remote consultations, but there was also not a unique platform available back then; even GPs did not have one. Remote consultation was massively accelerated by the pandemic. While I have a different view now, I also believe that never will or should remote consultations fully replace an eye examination in practice. However, there are just some things, such as contact lens reviews, that in-person appointments are not always needed for.

In my practice remote consultations are here to stay. Video consultations are an enhancement not a replacement to the eye care service I provide. The enhancement is that you give greater service, and have greater communication, and greater levels of interaction between you and the patient. It takes less time to do a 15-minute remote consultation than it does for the patient to come in, put their shopping down, be late, park the car, and use 30 minutes of clinic time that could have been effectively offered by video consultation.

For my practice, remote consultations are money saving, time saving, efficient and set us apart. They also make us appear much more modern and high-tech in a post-COVID era.

About the author
Brian Tompkins is a contact lens specialist, an optometrist and practice director of TK&S Optometrist in Northampton. He owns the practice alongside Nicky Tompkins, Keyur Patel and Andrew Oliver. He is also a BCLA past president. The practice is part of the Hakim Group family of independent practices.

• As told to Emily McCormick.