A Critical Time for Optometry

Christopher Colburn, O.D. is the past president of the New York State Optometric Association (NYSOA).  His letter dated 25 April 2011 speaks a timeless message that every optometrist needs to hear, regardless of your home state. We have removed occasional content to help with brevity (as indicated by an ellipsis ...) but invite you to read the whole letter here on the NYSOA website.

A Critical Time for Optometry -- We Need Your Help 
The Patient Protection and Affordable Care Act, better known as The Health Care Law, will likely be modified over time. While news outlets focus on hot button issues, there is consensus that the law will not be entirely repealed. Overhaul of healthcare delivery infrastructure has already begun here in New York and elsewhere ... Health Information Exchange projects in New York have made significant progress, but little has been done with respect to developing a Health Insurance Exchange. Insurers in New York however have started to implement coverage requirements prior to deadlines specified in the Affordable Care Act.

This is a critical time to establish optometry as the primary eye care profession. We have the opportunity to participate in the development of Health Information Exchanges, Health Insurance Exchanges, Medical Home projects and the policy entities that will govern them. Our success depends upon broad participation by individual optometrists. Failure will require decades of fighting for inclusion.

While the presidents of your local societies and ... executive committee[s] are diligently monitoring and identifying opportunities to participate, we need individual optometrists to develop the relationships necessary for success. There are many opportunities to participate, often requiring little effort and minimal time ... 

Health Information Exchanges are up and running across the state. They are currently variable in their scope of information processing. Most are providing access to clinical laboratory results; some have access to radiological reports, and a few have access to actual images.

Optometrists' role in managing diabetes is of particular interest to Health Information Exchanges. Every optometrist should register with his or her regional Health Information Exchange. Doing so provides you with reliable clinical information, establishes optometry as a resource for future clinical information, and demonstrates optometry's integral role in the delivery of efficient quality care  ...   

Optometry has been conspicuously absent from most third party administrative structures. While we have successfully defined optometry to our patients and our legislators, we have permitted ophthalmology to define optometry for insurers. Optometrists must develop relationships within the administrative structure of insurers as well as entities that emerge to develop the Health Insurance Exchange ...

The Health Insurance Exchange will be impacted by, and will have impact on, all medical and routine healthcare services provided in the state. Rules defining primary care services and essential benefits will permeate through government and private insurance programs. Requiring access to comprehensive optometric services will secure our position as primary eye care providers. Allowing the exchange to be developed without our consultation will surely limit our participation within these programs. ... 

Medical Home demonstration projects are underway in many states including New York. Most have a very limited definition of primary care services within the Medical Home, but some have a more extensive definition. Ohio for example has included optometric services as a primary care component of the Medical Home. By doing so, patients serviced within a Medical Home in Ohio have direct access to optometric services.

Obviously if the Medical Home becomes a viable means of medical care, delivery it will be imperative that optometric services are defined as primary care services. Established relationships between optometrists and the primary care physicians charged with administering Medical Homes will provide the means to inclusion. ...
Now is the time to establish optometry as the primary eye care profession. Our success will be proportionate to the number of individual optometrists that choose to actively participate in the overhaul of our healthcare delivery system.  

Christopher Colburn, OD