• Academy Notebook

    News, Tips, Resources

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    New Member Benefit: Ophthalmology Retina

    Previously available only as a paid print subscription, Ophthalmology Retina will soon be free of charge to Academy members. Beginning in January 2021, online access to current and past issues of Ophthalmology Retina will be avail­able at aao.org/journals.

    Ophthalmology Retina helps readers stay on top of the growing volume of high-quality retina research and learn about advances in medical drug treat­ment, surgery, technology, and science. As a testament to the journal’s high cal­iber, Ophthalmology Retina is now fully indexed by Medline/PubMed.

    Accessing the journal online means you get the latest in-press content. You can also easily search across the entire journal database for the articles that in­terest you most. Recent articles include “Clinical Spectrum of Uveal Metastasis in Korean Patients Based on Primary Tumor Origin.”

    Print subscriptions will also be available for the cost of shipping beginning Nov. 12. See aao.org/retinajournal for more information.

    Visit the journals portal of the Acad­emy’s Ophthalmic News and Education (ONE) Network at aao.org/journals to start reading it in January 2021.


    Participate in the Academy Election

    The election for open positions on the Board of Trustees and voting on the proposed amendments to the Bylaws begins on Nov. 16 and closes on Dec. 15 at noon EST. Election materials were mailed or emailed to all voting Academy fellows and members. Results of the election will be posted on the Academy’s website at aao.org/about/governance/elections by Dec. 17, 2020.


    Wellness: How to Avoid a Musculoskeletal Disorder

    Why are ophthalmologists prone to musculoskeletal disorders of the neck, shoulders, back, and upper extremities? For many of them, it is because their working day involves a perfect storm of risk factors, such as tasks that require fine motor control and intense visual focus, often while maintaining an awk­ward body posture.

    Bookmark aao.org/wellness. This month, the Academy will highlight a range of ergonomic tips and resources in its wellness pages.

    Remember the Foundation on Giving Tuesday

    After your holiday shopping on Black Friday and Cyber Monday, kick off your year-end charitable donations on Giving Tuesday, Dec. 1. Entering its ninth year, this global day of philan­thropy encourages donating to initia­tives that are important to you. This year, consider supporting Academy programs such as the Ophthalmic News and Education (ONE) Network, EyeCare America, global outreach, and the Truhlsen-Marmor Museum of the Eye through a donation to the Academy Foundation. Your tax-deductible gift can be made in honor or memory of someone special.

    Give today at aao.org/foundation/giving-options.

    EyeCare America Is Seeking Volunteer Ophthalmologists

    The Academy’s EyeCare America program is the country’s leading public service program providing eye care. It provides access to eye care for seniors who have not had a medical eye exam in three or more years and for people at increased risk for glaucoma.

    With minimal time commitment and without leaving your office, you can make a difference in the lives of these patients. EyeCare America matches volunteers with eligible patients through the Seniors Program or the Glaucoma Program. Volunteers for the Seniors Program provide a comprehensive medical eye exam to eligible seniors (age 65 or older) and care for up to one year for any condition diagnosed during the initial exam at no out-of-pocket cost for the ophthalmologist’s services. Volunteers for the Glaucoma Program are asked to provide a one-time glaucoma eye exam at no cost to eligible patients. Volunteers for either program see an average of two to four patients a year. 

    Learn more at aao.org/volunteering, then choose Connect and Medical Eye Exams for Underserved Populations. (This is just one of many Academy vol­unteer opportunities.) 

    Submit Your Research to Ophthalmology Science

    Ophthalmology Science is a new online open-access journal focused on pub­lishing preclinical research, phase 1 and 2 clinical trials, laboratory-based work, ophthalmology informatics, and clinical science. Ophthalmology Science is the fourth of the Academy’s Ophthal­mology journals and its first open-access journal. Its inaugural issue will be available during the first quarter of 2021, and it will publish quarterly.

    Submit your research today at www.editorialmanager.com/xops.

    See Where You Stand on the Physician Well-Being Index

    The Academy is offering members free access to the Physician Well-Being Index, a brief online assessment developed by Mayo Clinic in partnership with Med­Ed Solutions.

    Goal. This tool is intended to help you better understand your overall well-being and areas of risk compared with other physicians across the nation.

    Fill out a short survey. If you answer just seven to nine questions, this tool will provide immediate individualized feedback.

    Anonymous and confidential. Your personalized data will not be shared with the Academy or any other individ­uals or companies.

    Free member benefit. To take the assessment, Academy members will need to create an account at https://app.mywellbeingindex.org/signup (use invitation code 2477026).

    Ask the Ethicist: A Racially Motivated Patient Demand

    Q: “I have a patient who repeatedly refuses to be worked up by Black tech­nicians. These refusals are becoming more disruptive. What is the best way to handle this patient’s refusal and the turmoil within the office?”

    A: Refusing to accede to this patient’s discriminatory demands shows your staff that you support them and stand with them, and it sends the message to the patient that you will not tolerate racial discrimination. You have an obli­gation to protect your employees from such behavior. Your practice policies should include a nondiscrimination policy and a clear statement that the practice will not tolerate discrimination in the workplace.

    Provided that you have a nondis­crimination policy in place, discuss with the patient how this behavior is affecting the practice and may affect his or her continuing ophthalmic care. If the patient refuses to comply with your policy, it is acceptable and reasonable to terminate the physician-patient relation­ship for nonadherence to your policies. The Ophthalmic Mutual Insurance Company (OMIC) offers sample form letters for terminating the physician-patient relationship at www.omic.com/terminating-the-physician-patient-relationship.

    In addition, complying with discrim­inatory staffing demands may expose your practice to liability. Consult with your malpractice carrier and legal counsel to fully understand the risk.

    For sample policies, the AAOE Practice Forms Library contains sample nondiscrimination policies at aao.org/practice-management/practice-forms-library/human-resources.

    To read the Code of Ethics, visit aao.org/ethics-detail/code-of-ethics.

    To submit a question, email ethics@aao.org.

    OMIC: The Importance of Documentation

    Ophthalmologists report learning many valuable lessons at the close of medical malpractice lawsuits. One of the most frequently cited is about the importance of documentation. The Ophthalmic Mutual Insurance Company (OMIC) conducted a study of two years’ worth of these lawsuits to understand the type of documentation issues that influ­enced the outcome of cases. An issue of the OMIC Risk Management Digest addresses the most common deficiencies. Visit www.omic.com/wp-content/uploads/2014/07/Digest-No-2-FINAL-7-14-141.pdf to read the issue.

    OMIC offers professional liability in­surance exclusively to Academy members, their employees, and their practices.

    MIPS: Does Your EHR Have 2015-Edition Certification?

    Are you participating in the Merit-Based Incentive Payment System (MIPS) with an electronic health record (EHR) system? If so, is it a 2015-edition Certified EHR Technology (CEHRT)? Like last year, if you don’t have a 2015-edition CEHRT, you won’t be able to report promoting interoperability (PI) mea­sures, your choice of quality measures will be limited to those that can be reported without an EHR, and you won’t be eligible for the quality mea­sure bonus for end-to-end-electronic reporting.

    How to check your EHR system’s certification. To check whether your EHR system is a 2015-edition CEHRT, visit https://chpl.healthit.gov/#/search. (When you do so, make a note of your CHPL ID#; you will need this when you report PI performance to CMS.)

    What if 2015-certificaton is pend­ing? CMS recognizes that some EHR vendors may have provided upgraded systems to practices while certification was still pending. If that is the case with your system, you may be able to report PI measures provided that your EHR system has 2015-edition functionality for all 90+ days of your PI performance period and CMS grants the system 2015-edition certification by the last day of that period.

    Did the pandemic prevent an upgrade? If COVID-19 prevented you from upgrading to a 2015-edition CEHRT, you may be eligible for a PI exception due to “extreme and un-controllable” circumstances. Submit your application no later than Dec. 31, 2020. For more information, visit aao.org/medicare/resources/MIPS-extreme-hardship-exceptions.


    Avoid Claim Denials

    The Academy’s coding education resources provide an expansive mix of personal instruction and the essential coding tools you trust most. These include the newly developed course for conquering E/M changes, the annual Coding Camp seminar, and updated editions of ICD-10, Coding Coach, and other popular reference books.

    Visit aao.org/codingtools.


    Dr. Crandall Dies at 73

    Alan S. Crandall, MD, senior vice chair and director of glaucoma and cataract at the John A. Moran Eye Center, died Oct. 2 following a sudden illness. He was 73. Dr. Crandall founded and directed Moran’s Global Outreach Di­vision, training hundreds of surgeons and performing countless free surgeries to restore sight to patients in Utah, the Navajo Nation, and more than 20 countries. He was a past president of the American Society of Cataract and Refractive Surgery (ASCRS) and the recipient of numerous prestigious awards for his humanitarian contribu­tions. “Alan’s passing will be mourned by thousands of patients around the globe,” said Academy CEO David W. Parke II, MD. “He was kind, gracious, and genuine. He embodied the best in our profession.”

    An award winner. Dr. Crandall received many accolades for his work, including four internationally recog­nized humanitarian awards in oph­thalmology: the American Glaucoma Society Humanitarian Award, the American Academy of Ophthalmolo­gy Humanitarian Award, the ASCRS Humanitarian Award, and the inaugu­ral ASCRS Foundation Chang Humanitarian Award.

    A masterful surgeon. At the Moran Eye Center in Salt Lake City, Dr. Crandall focused on the medical and surgical management of glaucoma and cataract, as well as complicated anterior segment surgery. In an obituary, John A. Moran Eye Center CEO Randall J. Olson, MD, spoke to Dr. Crandall’s prowess: “He skillfully handled the most challenging cases, and his surgical skills were legendary … He invented several surgical techniques and was involved in many clinical re­search studies that led to better surgical outcomes and improved care.”

    A humanitarian and friend. After Dr. Crandall’s passing, his friend, Ronald L. Fellman, MD, OCS, of Glaucoma Asso­ciates of Texas said this: “He wore his heart on his necktie bolo, exposed to all, as a sign of willing­ness to lend a help­ing hand, especially to children in need on different continents. Today, I’m wearing my bolo, a small way to carry on the spirit of a great teacher who will be missed and whose footprints estab­lished a path for eye care worldwide.”


    Complying With the New FTC Contact Lens Rule

    Ophthalmic practices that sell contact lenses had until Oct. 16 to comply with an addendum to the Federal Trade Commission’s (FTC) Contact Lens Rule. The rule change requires prescribers to request that their patients confirm receipt of their contact lens prescriptions, and that prescribers keep a record of the confirmation for at least three years. Prescribers must note if a patient refuses to sign a confir­mation and save it to record their compliance.

    The FTC has implemented the policy despite strong Academy objections that such revisions were unjustified. In changing the rule, the FTC exempted prescribers who lack a financial interest in the sale of contact lenses. The purpose of the exemption was to “reduce the burden on prescribers who do not sell lenses,” according to the FTC. In response to Academy recommendations, the FTC has imposed new requirements on online sellers of contact lenses, including changes to automated prescription verification calls.

    The new rule has broad implications for ophthalmologists, optome­trists, and others who prescribe and sell contact lenses. If you haven’t done so already, here is how you can comply:

    • Request that the patient acknowledge receipt of the contact lens prescription by signing a separate statement confirming receipt.
    • Request that the patient sign a prescriber-retained copy of a con­tact lens prescription that contains a statement confirming receipt.
    • Request that the patient sign a prescriber-retained copy of the sales receipt for the examination that contains a statement confirm­ing receipt.

    If a digital copy of the prescription was provided to the patient (via an online portal, email, or text message), retain evidence that such prescription was sent, received, or made accessible, downloadable, and printable.

    If you have questions, contact Scott Haber, Academy manager of federal affairs and public health, at shaber@aao.org.