• The standard of care provided to the patient must stay the same.
• Patients must be made aware of the limitation of telehealth services and should be given the option of in-person care.
• Eye doctors must abide by state licensure laws and regulations when delivering telehealth services.

LIVEonDemand doctors need to ensure they review this checklist to get ready for consultation:

• Consider a patient’s clinical & cognitive status – can the patient effectively participate?
• Is parent/guardian permission required? If so, obtain it.
• In the case of minors, determine where the adult will be within the location.
• Discuss the potential risks/benefits of telehealth sessions with the patient(s) whenever
  necessary.
• Verify the patient’s identity.
• Ensure the patient is comfortable with conducting the exam if there are any other
  individual(s) in the room.
• Ensure the room is well lit and you are able to review the eyes for an accurate diagnosis.
• Ensure to review the chief complaints prior to the call.

• Ensure to ask all relevant questions based on the chief complaint.
• Verify Medical & Ocular history.
• Review any current or past medications/ Allergies.
• Capture images when necessary (with appropriate consent.)
• Determine the type of consultation (Triage or Virtual Treatment)

Every successful encounter needs to have the documentation finalized within 24 hours of the virtual appointment’s completion. Any missing documentation will get flagged in the system and/or will be addressed during internal audits.

• Complete patient information
• Acknowledged Telehealth limitation consent
• CC
• ROS
• HPI
• Past medical/ocular history
• Family history
• Exam
• SPEED test review (when applicable)
• Imp & plan
• Photos/videos (when applicable)
• E-prescribe (when applicable)

• Minors without adult supervision
• Patient with impaired cognitive abilities
• Patient with any vision-threatening injury or sudden visual loss who will need in-office care
• Patients who have chronic eye conditions, like glaucoma, who haven’t seen an eye doctor for more than two years.
• Patients who are not comfortable with telehealth services after understanding the limitations.

Currently all states allow for the establishment of a provider-patient relationship via telemedicine as well as online prescriptions. However, Alabama and Texas have a requirement that the patient must be located in an “Established Medical site” which effectively restricts the practice of telehealth since the patient cannot be in their home or office for the encounter. Texas however has waived the requirement during the COVID-19 state of emergency.

 

We have relied on the American Medical Association 50 State survey- Establishment of a Physician-Patient relationship via Telemedicine as well as our own independent analysis to determine which States may have road blocks. The foregoing does not constitute legal advice and it is the responsibility of the practitioner to verify that participation in the Contact Lens renewal service is allowed in their state of licensure.

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