Eye Care Communications, Part 2

Continued from Part 1 ... we are looking at the National Eye Care Communications Project, understanding what this project is and why we need it. We began on Monday looking at it through the eyes of a new and very important pilot project, the Comprehensive Primary Care (CPC) Initiative.


Two Levels of Involvement

There are two levels at which providers can participate in the CPC Initiative: direct involvement at the primary care level and indirect involvement at the secondary care level. The primary care level is, obviously for Primary Care Physicians. This is the participant role for which PCPs must apply, show eligibility and ultimately be selected. However, ECPs can also be involved indirectly. Indirect involvement means an interactive support role for the PCP, helping her or him understand DIRECT and becoming a partner with whom to exchange patient health information. We believe that by eye care providers being involved in the process from the very beginning, two things will occur.  First, the abilities the eye care provider brings to the primary care physician can actually make the physician a more qualified candidate for team delivery of care and, therefore, more likely to be accepted as a team participant.  Second, if the primary care physician is selected for participation, it will position the eye care office to be selected for inclusion in the care team, coordinated by the primary care practice.

Pilot Projects

The reason we see so many pilot projects throughout the transformation of  health care is that nobody knows how exactly the new connected-care and coordinated-care relationships should be structured. If we knew it already, there would be no need for pilot initiatives or incentives. Two things that we do know from the pilots to date are that, first a provider must be utilizing a certified EHR in order to be part of a team and, second, each provider must have the ability to share patient health information electronically.  Beyond this, there is a set of eligibility requirements that the primary care physician must meet in order to apply – and the local eye care provider can help!  

How can the ECP help the PCP? Many primary care physicians are using certified EHRs but have not been sharing patient health information electronically. So, the eye care provider can actually work with the physician to help implement that capability and serve as a test office once they have set up their communications.  This is an important issue as many local physicians are only aware of exchange communications capabilities within large local health systems. Many are not even aware that one of their communications alternatives is through DIRECT. Again, the eye care provider can actually assist the primary care physician in becoming more knowledgeable about this alternative. 

Additionally, pilot projects are put together with a lot of flexibility on the local level so they can be structured to meet the needs of the local community.  How they will be structured occurs largely at the local level.  Input of the local ECP is important early on as the individuals structuring the pilot may not even be aware of what an ECP can bring to the table, or the value that the ECP can add to the team.  The most effective time to be involved is in the formative stage where you can influence the process the most. The most important question you must ask yourself is whether or not the pilot project or the care team is going to be structured ideally for your office without your involvement.  If you think that may not or will not happen, then you know what you need to do. 


To be continued ...


Alistair Jackson, M.Ed.
Jim Grue, O.D.