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    Mid-Year Forum 2017

    In late April, more than 500 Academy members gathered in Washington, D.C., to discuss some of ophthalmology’s most critical issues with regulators, leg­islators, and Academy leaders. EyeNet summarizes 3 key Mid-Year Forum 2017 sessions below.

    Health Policy Direction of the New Administration. From the repeal of the Affordable Care Act to regulatory relief for physicians, the new administration has an opportunity to be transforma­tive. What do ophthalmologists and their patients need, and what is pos­sible? Can the Trump administration truly have an impact on spiking drug costs? Michael X. Repka, MD, MBA, Medical Director for the Academy’s Governmental Affairs division, covered the work ahead that could have a big payback for ophthalmic care.

    Telemedicine and Patient-Focused Digital Applications. Rapid innovation in health care technology and the grow­ing use of applications and platforms by patients and clinicians has funda­mentally altered the health care delivery landscape. The speed of this change has left policymakers struggling to identify how to harness this technology to improve patient access to care and curb growing health care costs. Participants discussed the latest developments in digital applications and telemedicine and assessed their impact on ophthal­mology. Panelists reviewed efforts at the federal level to alter policy in this arena and outlined regulatory issues relating to the development and imple­mentation of health care technologies.

    Thriving in a Solo or Small Practice Group. Despite the growing trend for consolidation in health care, a large percentage of Academy members work in a solo or small group practice. In an era of reimbursement challenges, rising office expenditures, a more complex regulatory environment, and high costs of new technology, ophthalmologists are trading the independence of solo and small group practice for the stabil­ity of a larger practice. Does this trend mean the end of the solo practitioner or small group practice? The expert panel debated the future of the small practice and offered valuable insights for those practicing in small and large practices alike.

    For more highlights, check out the Mid-Year Forum 2017 Report.

    Congressional Advocacy Day 2017
    CONGRESSIONAL ADVOCACY DAY 2017. OphthPAC Committee member Diana S. Shiba, MD, (left) and Young Ophthalmologist Advocacy Subcommittee member Jesse L. Berry, MD, (middle) met with Rep. Judy Chu (D-California) during Congressional Advocacy Day to advocate for relief from regulatory burdens and payments penalties in 2018. Rep. Chu serves on the House Ways and Means Committee and is a member of the subcommittees on Health and Human Resources. LEADERSHIP DEVELOPMENT PROGRAM. From left to right: Jeff S. Maltzman, MD, Academy OphthPAC Committee Chair; Derek Y. Kunimoto, MD, JD, a member of the Academy’s Leadership Development Program XIX, class of 2017; Rep. Kyrsten Sinema (D-Arizona); and Daniel J. Briceland, MD, Senior Secretary for Advocacy. Drs. Maltzman, Kunimoto, and Briceland presented a 2017 Academy Visionary Award to Rep. Sinema, who has provided critical support on issues affecting ophthalmology.


    MIPS—This Summer, the IRIS Registry Launches 2 Reporting Tools

    Use the IRIS Registry to streamline your MIPS reporting. You can use 2 reporting platforms.

    • Use IRIS Registry/EHR integration for automated reporting of quality measures and for earning credit under the improvement activity and advanc­ing care information (ACI) perfor­mance categories. Starting this summer, you can use an updated dashboard to gauge your progress.
    • Also, use the IRIS Registry’s MIPS-reporting web portal, which also launches this summer, for manual re­porting of quality measures, improve­ment activities, and ACI measures.

    Ask the Ethicist: Promoting Surgery With Vacation Discount Program

    Q: My partners and I are brainstorming ideas to increase our LASIK and photo­refractive keratectomy patient numbers. One idea is to offer all refractive surgery patients a chance to participate in a dis­counted vacation program. This vaca­tion program is offered by a third party and is not subsidized by the practice; rather, the practice simply provides pa­tient access to the program. None of our surgeons would ever operate on a poor surgical candidate simply because the patient was interested in the vacation deal, and the practice has no financial ties to the third party company. Are there potential ethical issues with marketing this type of promotion?

    A: Based on this description, there is no violation of the Academy’s Code of Ethics. To be on the safe side, however, we strongly advise that you check with the state medical board or someone who is knowledgeable about your state laws to ensure that there are no state-related advertising issues.

    While you are likely in the clear from an ethics perspective, it would be wise to consult with your malpractice carrier to assess the risk of the promo­tion being used against you in a mal­practice case. For example, an attorney may be able to show that patients were lured into your office by the offer of a vacation deal. In addition, as with any advertising, the wording of your ad (e.g., discussing success rates) could be misconstrued, or images in the ad could inadvertently imply a guaranteed successful surgery.

    Finally, you may run the risk of an implied endorsement of the vacation program. If a patient has a less-than-acceptable vacation experience, there may be resentment toward your prac­tice as a result.

    For more information, see Rule 13 of the Code of Ethics.


    New Features Added to Practicing Ophthalmologists Learning System

    Written by leading ophthalmologists, the Practicing Ophthalmologists Learn­ing System, 2017-2019, offers more than 4,000 self-assessment questions cover­ing 1,400 topics. Select content has recently been reviewed and updated; also, a highlighting feature is now avail­able, allowing you to easily reference key phrases. If you have already purchased this product, it will be upgraded to include these new features. This online resource enables you to work at your own pace or create timed exams to mimic the test-taking experience.

    To purchase, visit the Academy Store.

    Sign Up for Ophthalmology Retina eTOC Alerts

    Ophthalmology Retina, a peer-reviewed journal focused exclusively on the latest advances in retina, is now available for order. Ophthalmology Retina will be issued bimonthly during 2017 and monthly thereafter. To subscribe, visit the Academy Store. To receive eTable of Contents alerts, visit the Ophthalmology Retina website.

    New! The Lean Practice: A Step-by-Step Guide

    Transform your practice through Lean, a methodology for improving patient experience and satisfaction. Lean in­creases patient throughput and revenue and re-engages physicians and staff. The Academy’s brand-new e-toolkit, The Lean Practice: A Step-by-Step Guide to Running an Efficient and Profitable Practice, contains activities and printable forms to help you and your team observe and assess your practice process from the patient’s perspective and helps to root out waste in the clinic in order to in­crease efficiency and profitability.

    To order, visit the Academy Store.


    “A Chance to See Again”

    Helena Ndume, MD, a volunteer for SEE International, was featured in “A Chance to See Again,” an award-win­ning short film by Blue Chalk Media. Dr. Ndume has performed free eye sur­gery on more than 35,000 Namibians. In 2015, she was the first recipient of the United Nations Nelson Rolihlahla Mandela Prize, which honors a dedi­cation to serving humanity, upholding the principles of the United Nations and Nelson Mandela.

    Young MD-Scientist Award

    Rajesh C. Rao, MD, received the American Society of Clinical Investiga­tion Young Physician-Scientist Award. The award recognizes young physi­cian-scientists supported by research career development awards who are early in their first faculty appoint­ment and have made notable research achievements. Dr. Rao is receiving this award for his paper, “Next Generation Sequencing of Vitreo­retinal Lymphomas from Small-Vol­ume Intraocular Liquid Biopsies: New Routes to Targeted Thera­pies” (published in Oncotarget, January 2017).


    The Push to Preserve Access to Compounded Biologics Continues

    The Academy is making it a priority to inform new members of Congress and new leadership at the U.S. Food and Drug Administra­tion about the importance of access to compounded drugs for our patients. The Academy’s Congressional Advocacy Day 2017 in April included 400-plus ophthalmologists lobbying for the preservation of access to drugs like Avastin. The momentum is carrying over to stake­holder meetings to further the message.

    Beyond-use dates. In January, the FDA scrapped its draft guidance restricting the use of repackaged biologics and replaced it with a new policy allowing longer beyond-use dates that would ensure patients have timely access to biological treatments. The FDA would allow expanded beyond-use dates for repackaged biologics by putting the onus on the facilities that provide these drugs to perform necessary quality testing. The Academy views this proposal as an improved, more nuanced approach to the critical access issue, and we are urg­ing the FDA to adopt it.

    Patient-specific prescriptions. Meanwhile, the Academy is one of the strongest supporters of a congressional effort led by Reps. Buddy Carter (R-Georgia) and Chris Stewart (R-Utah). The effort urges the FDA to reconsider a policy that would bar traditional, 503A com­pounding pharmacies from distributing compounded drugs for office use without a patient-specific prescription. While the FDA guidance does not impact Avastin, it limits timely access to other in-office-use drugs that eye care patients need but larger outsourcing com­pounding facilities do not offer. Advocacy on this issue dates to last July, when the Academy pressed the FDA to let 503A compounding pharmacies do office-use compounding. At that time, we reiterated our skepticism that outsourcing facilities would be willing to meet all of ophthalmology’s compounding needs.

    Other tactics. The Academy also is partnering with other stake­holders to identify possible legislative and regulatory fixes to this issue, which puts patients at significant risk.