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    Coronavirus Impact: Practice Operations and Safety Considerations


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    The following are practice operations and safety problem-solving considerations shared by Academy and AAOE staff and members aimed at the challenges we face related to the coronavirus.

    Recommendations on Urgent and Nonurgent Care
    Due to the COVID-19 pandemic, the Academy finds it essential that all ophthalmologists cease providing any treatment other than urgent or emergent care immediately.

    Doctors: Here's what to do if you're exposed to COVID-19, from the American Medical Association.

    Operations, Communication and Security

    • Maintain an emergency management plan to address the impact of the coronavirus on your practice operations, physicians, staff and patients. See a sample of a Continuity of Operations Plan for Influenza Pandemic that can be customized for your practice.

    • Ensure continued access to information and communication by taking the following steps:
      • Test remote access to your practice server and email system in case you have limited or no access to the office.
      • If you don’t have a server that gives you access to files and email, upload your high-priority files to your laptop or to the cloud. Secure and cost-effective cloud options are Box or Dropbox.
      • Keep updated on COVID-19 Information for Healthcare Professionals, from the Centers for Disease Control and Prevention.  
    • Keep data security top of mind:
      • In a disaster, people may need to make do with what they have available to get the job done. However, potential data, IT and HIPAA security issues should never take a back seat to expediency when using personal mobile devices and computers.
      • During the COVID-19 emergency, follow HIPAA regulations although the regulations will not be enforced during this emergency.

    Appointments, Scheduling and Check-in

    • See only patients with emergent needs or those requiring frequent management, such as scheduled injections. This approach limits exposure, enables patients with urgent care needs to be seen and provides some continued income for the practice. 
    • Emphasize to patients that non-urgent appointments are being rescheduled but the practice is open should an emergency occur or when there are changes to their vision that require care.
    • Pick a “safe” date to reschedule based on your local or states guidelines.
    • Consider creating physician-staff teams and do not change team members. This makes it easier to monitor who tests positive within the team, curbs the spread to the other physician-staff teams and allows the practice operations to continue.
    • Patients can also be checked in by phone and wait in a parking area to be called in. 
    • Increase signage outside the practice warning sick or exposed patients and family members to reschedule their visits.
    • Use screening questions and require temperature check on all patients before bringing them into building.

     Social Distancing

    • Establish a protocol to verify if the patient should be recommended for telemedicine.
    • Only allow patients—no family members—inside the practice. If this restriction is not possible, allow only one person to accompany the patient. Specify that children should never come to the clinic unless it is a pediatric practice.
    • Create personal space of 6 feet by taping off or placing “No Sitting” signs on chairs in waiting areas.
    • Co-pay collection will create face-to-face interaction so must be considered as a health risk for both the employee and patient. Encourage online payment via patient portals to minimize the risk of infection.

    Cleaning Protocols 

    • Enforce standard use of hand sanitizer by ALL visitors to the practice.
    • If you cannot secure masks and gowns for protective wear, contact your local health department for availability.
    • Encourage frequent and thorough disinfecting of waiting rooms, restrooms and exam lanes to include chairs, desk surfaces, keyboards, mouse, slit lamps, occluders, tonopens, etc.
    • Install “sneeze guards” on all slit lamps and diagnostic equipment that requires close contact between patients and staff.
    • Review protocol with clinical staff for the use of gloves, masks, alcohol wipes, etc.
    • Increase signage in restrooms for proper hand hygiene.

    Patient Handouts