Assessing optometric care delivered by telehealth during the COVID-19 public health emergency

Background: The emergence of coronavirus disease 2019 (COVID-19) forced many eye care providers to implement telehealth services while in-person visits were reserved for essential and/or emergency eye care. Objective: This study documents how an optometry group successfully implemented telehealth to care for patients during the outbreak of the COVID-19 pandemic in the United States. Design: Retrospective, comparative case series. Methods: Records were reviewed for patients seen in an academic optometry clinic from 23 March through 7 April 2020, the period of the Massachusetts stay-at-home advisory issued in response to COVID-19. Patients who completed telehealth visits were compared with those who received in-person care. Services delivered by telehealth included a check of symptoms, medication refills, health education, and assurance of future follow up. The study took into account the reason for each visit, as well as the rate of scheduled and completed follow-up appointments. Patient satisfaction with in-person care was evaluated by Press Ganey patient experience surveys. Results: Out of 855 patients scheduled, 421 patients completed telehealth encounters (49%), and 46 patients completed in-clinic visits (5.4%). A further 272 patients canceled appointments (32%), 123 patients were unable to be contacted (14%), and 8 patients declined care offered by telehealth (0.94%). Most patients who were cared for by telehealth returned to see optometrists (88%). By contrast, most patients who required in-person visits during this period were subsequently seen by ophthalmologists (58%, p<0.001). Patient satisfaction remained high for in-person visits that took place during the COVID-19-related emergency, with improvements noted in patient satisfaction regarding 'information about delays' (47 versus 100%, p = 0.007) and 'concern for questions or worries' (76% versus 100%, p = 0.037) compared with the same period 1 year prior. Conclusion: Optometrists rapidly embraced telehealth to deliver eye care to their patients during the COVID-19 public health emergency. Most eye issues were able to be addressed through telehealth; urgent eye problems were triaged and referred to the optometry clinic, when appropriate.