EyeNet Magazine

/ October 2015

/ News, Tips, Resources

Academy Notebook

News, Tips, Resources

WHAT’S HAPPENING

Coming Soon: All-New Patient Education Videos

AVAILABLE IN NOVEMBER. Save 30% when you buy 4 or more of the video collections. The following subspecialties are available: cataract and refractive surgery, glaucoma, oculoplastics, pediatrics, and retina.

Next month, the Academy will launch 4 all-new patient education subspecialty video collections, a new video for the ophthalmic waiting room, and an upgraded version of the Digital-Eyes Ophthalmic Animations for Patients. These complete the Academy’s revamp of its entire suite of patient education materials, including redesigned and rewritten brochures and handouts, and a retina patient education video collection.

The waiting room video briefly discusses many common ophthalmic conditions along with informational and entertaining segments on eyes and vision.

Each subspecialty-focused patient education video collection (cataract/ refractive surgery, glaucoma, oculoplastics, and pediatrics) explains benefits, risks, and alternatives for many of today’s common procedures. The collections are intended to accomplish the following:

Educate patients through visual animations and easy-to-understand explanations that will improve patients’ comprehension
Put patients at ease while setting realistic expectations for their particular conditions
Deliver accurate, consistent information to strengthen your informed consent process and reduce malpractice risk

Features. All the patient education videos are concise and free of advertising. They are produced in high definition and include high-quality animations. The videos are available in both English and Spanish versions. You can play them on any platform, from desktops and tablets to smartphones. With the waiting room video, new topics, soundtracks, and Q&As have been added.

Add a personal touch. The videos are also customizable—you can add a personalized introduction to any video. While you’re attending AAO 2015, you can film an introduction in the Video Production Studio in the Resource Center (Booth 2632). Contact Daniel Porter at dporter@aao.org or 415-561-8549 before the meeting to make an appointment to schedule your shoot.

For more information about these new videos, visit www.aao.org/patientvideos.

TAKE NOTICE

PQRS—Oct. 31 Deadline to Sign Up for IRIS Registry Portal

You can use the IRIS Registry Web portal to report PQRS manually (no EHR required), provided you sign up by Oct. 31, submit a signed consent form by Dec. 1, and enter all the necessary data into the portal by Jan. 15, 2016.

What are your IRIS Registry options? You can use the IRIS Registry Web portal either as a Qualified Registry, which would involve reporting the standard PQRS measures, or as a Qualified Clinical Data Registry, which gives you access to additional eye care measures developed by the Academy.

This year’s deadlines have already passed to sign your practice up for automated EHR-based reporting via the IRIS Registry (June 1) and for manual reporting of the Cataracts Measures Group via the IRIS Registry Web portal (Aug. 1).

Why report PQRS? If you fail to successfully report PQRS this year, you will be subject to a 2% penalty on 2017 Medicare payments, plus a value-based payment modifier cut of up to 2% (for smaller practices) or 4% (larger practices). To learn more about PQRS reporting and penalties, visit www.aao.org/pqrs.

To sign up, visit www.aao.org/iris-registry/application-process.

Seeking Outstanding Ophthalmologists

Would you like to nominate a colleague for the 2016 Outstanding Humanitarian Service Award? The Academy must receive your nomination by March 17, 2016. The award recognizes Academy fellows and members who have made extraordinary contributions to humanitarian efforts, such as participation in charitable activities, care of the indigent, and community service.

To obtain a nomination form, visit www.aao.org/about/awards/humanitarian.

Ask the Ethicist: Use of Mobile Devices in Clinical Care

Q: I am a third-year resident and recently responded to a question from a second-year resident following up on a recently admitted patient. I knew exactly who he was asking about, and I replied by text, “She was admitted, DDX is filamentary fungal keratitis. Pretty rare. She’s in 517. Take a look.” I was using my personal cell phone, which is not encrypted. Later, I learned that this is considered a HIPAA breach because the text included enough information that the patient could possibly be identified by people in the community. Can patients ever be discussed via text without violating their privacy?

A: Although it is common for health care providers to access and relay protected health information (PHI) to other providers using mobile devices, doing so is risky. This is because the devices are small, portable, easily visible to others, unlikely to be password protected or encrypted, likely to connect with Wi-Fi (further risking interception), and highly vulnerable to being stolen.

If you choose to communicate this way, be sure to use an encrypted, password-protected device. When discussing patients, you must remove any information that could be used to identify them. Per HIPAA, there are 18 identifiers of PHI—they include everything from the patient’s social security number to the vehicle identification number of their automobile.

All communications with patients, the public, and colleagues, whether via social media or in more traditional frameworks, must adhere to appropriate standards of ethics and professionalism in order to maintain the public’s trust in the medical profession. Your training facility likely has a program for trainees about HIPAA and patient privacy. Take advantage of what information is available because you can’t plead ignorance once you’ve been the source of a leak.

D.C. REPORT

Physician Pay Battle

The Academy is getting ready for the quickly approaching Nov. 1 publication of the 2016 Medicare Physician Fee Schedule—ophthalmology codes are being targeted by the Centers for Medicare & Medicaid Services (CMS) as potentially misvalued. We will see the final result of our fight to defend 2016 values for the major retinal detachment codes as well as trabeculectomy services. CMS, however, continues to target ophthalmology as misvalued with new challenges ahead for 2017 payments. CPT 92002, a code used for new patients during their first office visit, is one of several new codes being targeted or challenged as “misvalued.”

CPT 92002: The background. In the mid-1970s, the AMA decided that the existing office visit billing guidelines didn’t necessarily apply to ophthalmologists, especially considering how they perform examinations. To address this disparity, a new set of codes for ophthalmologists was established; since then, ophthalmology has experienced a lighter documentation burden thanks to the “eye visit” codes. In fact, codes like CPT 92002 through 92014 help Academy members to run a more efficient practice with greater focus on quality patient care.

CMS review of 92002. The CMS assessment of 92002 involves reviewing the valuation and, when codes are found to be misvalued, updating and revising the payment accordingly. Typically, CMS requires that all related codes also be reviewed, which could mean that services for both new and established eye exam visits would also be included. During the process, the agency seeks input from affected specialties through the AMA/Specialty Society Relative Value Scale Update Committee (RUC) regarding the most accurate valuation of services.

Where it stands today. The Academy believes that based on CMS’ own standards, the agency has inappropriately identified CPT 92002 as potentially misvalued. The Academy maintains that physicians are appropriately compensated for this service, and questions why it should even be under consideration. CMS has stated that their cost-saving efforts are focused on codes with significant increases in payment or volume. But consider the facts: in 2013, 222,037 Medicare patients were coded under CPT 92002, a decrease from 10 years prior. Additionally, the work value hasn’t changed for this service since 1996.

The Academy continues to press the RUC and CMS to recognize that CPT 92002 represents fair value for physicians and patients. If they don’t, we will work on next steps to preserve fair payment for physicians.

CANDIDATES’ VIEWS

Cynthia A. Bradford, MD

Board of Trustees Nominee for President-Elect

Professor of ophthalmology and full-time comprehensive ophthalmologist for 28 years, director of ophthalmology education for primary care physicians, director of medical student ophthalmology education, and resident cataract surgery instructor.
Professional society involvement for the Academy includes the Interspecialty Committee, Basic and Clinical Science Course Committee, Executive Editor for Basic Ophthalmology editions 8 and 9, Secretary for State Affairs, Senior Secretary for Advocacy, Membership Advisory Committee, Nominating Committee, Board of Trustees Executive Committee, Health Policy Committee, and the Leadership Development Program (LDP). State society involvement includes President of the Oklahoma Academy of Ophthalmology. International involvement includes Pan-American Association of Ophthalmology (PAAO) Board membership and interaction with LDP for the European Society of Ophthalmology, PAAO, and the Middle East Africa Council of Ophthalmology.
I am dedicated to upholding the profession of ophthalmology, which is founded on education and is well known for innovation. I recognize the stormy time of change ophthalmology faces on a state and federal level and view this as an opportunity to improve quality and efficiency of patient care.

Louis B. Cantor, MD

Board of Trustees Nominee for Senior Secretary for Clinical Education

Background. I serve as Director of the Glaucoma Service and Chair of the Indiana University Department of Ophthalmology. I have served as Residency Program Director, Chair of the Ophthalmology Residency Review Committee (RRC) of the Accreditation Council for Graduate Medical Education, and as Chair of the Council of RRC Chairs.
AAO education experience. I first served as a member, then as Chair, of the Basic and Clinical Science Course (BCSC) Glaucoma Committee before being elected Chair of the BCSC. I served as Secretary for Ophthalmic Knowledge before being elected as Senior Secretary. It is a privilege to be nominated for a second term as Senior Secretary for Clinical Education.
Goals. The Academy has a critical role in providing education as the pace and depth of new clinical information challenges physicians to incorporate the newest findings and discoveries into clinical practice. If elected to a second term as Senior Secretary, I will continue to seek to expand our educational programs, both within the United States and globally.

Michael F. Chiang, MD

Board of Trustees Nominee for Trustee-at-Large

Clinical experience. Specializes in pediatric ophthalmology, strabismus, and retinopathy of prematurity. Board certified in clinical informatics. Works at the Oregon Health & Science University (OHSU) Casey Eye Institute; was previously at Columbia University.
Research. Professor of ophthalmology and medical informatics at OHSU and a vice-chair for research in the ophthalmology department. Leads an NIH-funded research group studying telemedicine, EHRs, image analysis, and genotype-phenotype correlation to improve delivery of ophthalmic care. Previous Chair of the Academy’s Medical Information Technology Committee and current member of the IRIS Registry Executive Committee, Chair of the Task Force on IRIS Registry Analytics and Research, and member of the Academy’s Telemedicine workgroup.
Education. Previously worked as director of medical student education in ophthalmology at Columbia University and currently directs an NIH-funded training program in visual science for graduate students and postdoctoral fellows at OHSU.

Cynthia Mattox, MD, FACS