At Press Time

The Insured Seek Far More Eye Care

Demand almost certain to climb under ACA.

■ A recent study conducted by researchers at the University of Miami Miller School of Medicine has found that individuals with insurance are far more likely to actively seek eye care than those who are uninsured. The researchers say this fact has great implications for future eyecare demand, as the implementation of the Affordable Care Act will lead to millions of newly insured people.

The researchers set out to evaluate the relationship between demographic factors and eyecare expenditures and to assess the level of ocular expenditures as compared to total healthcare expenditures.

The researchers began by conducting a retrospective analysis of ocular expenditures by more than 20,000 individuals age 18 and over who had participated in a national survey of medical spending. The main outcome measure was eyecare expenditures by demographic characteristics.

The researchers found that 22% of the studied population had eyecare expenditures in the year studied. Demographic factors significantly associated with the probability of having eyecare expenditures included older age, female gender, higher educational attainment, having insurance and visual impairment.

Older age, female gender and the presence of insurance were also significantly associated with the probability of having overall medical expenditures.

The researchers concluded that demographic factors affect the probability of eye care spending. Of all the factors examined, they found that insurance status has the most potential for changing eyecare spending levels. They postulate that the lower eye and medical care expenditures in patients without insurance are mainly due to access issues. Healthcare reform has the potential of improving access and utilization by increasing the number of individuals covered.

The research was presented at ARVO 2012.

Reference:

Fernandez, C.A. et al: Influence of Demographic Characteristics on Eyecare Expenditures. ARVO 2012 (abstract).

EHR Doesn't Decrease Patient Volume

Despite concerns, evidence shows steady or increased numbers.

■ Impending EHR implementation may have some worried. Will the electronic learning curve add time to recordkeeping and ultimately result in decreased patient volume? Not according to a study presented at the 2012 ARVO meeting. The study set out to measure the effects of EHR systems on ophthalmology practices. It took place over the course of three years at Oregon Health & Science University.

Using the EHR electronic scheduling system to gather clinical volume data, the study found ophthalmologists can implement EHR without significantly affecting clinical volume. In some cases, the study suggests, ophthalmologists could even increase volume after EHR implementation.

Starting in 2006, 21 ophthalmologists and two optometrists who worked at OHSU for five months before and after the 3-year study period were evaluated. Of the practices studied, the average quarterly clinical volume after implementation was 93% in the first year, 97% in the second and 96% in the third, when compared with the baseline quarterly average clinical volume. Five other medical and surgical specialties at OHSU were taken into account as well to determine the baseline. The ophthalmology departments as well as the five other departments all showed overall clinical volume increases.

The study was supported by Research to Prevent Blindness, New York, and was authored by Sarah Read-Brown of OHSU.

Reference:

Read-Brown S., et al. Implementation of Electronic Health Record Systems In Ophthalmology: Impact On Outpatient Clinical Volume. ARVO 2012 (abstract).

How EHR Effects Patient Satisfaction

Some features are seen as added benefits.

■ A study to gauge patients' perceptions of service quality using electronic health records in an ophthalmology clinic shows the new technology has not negatively impacted patient satisfaction. Although it doesn't show a positive impact either, overall, most patients view some of the ancillary features of the EHR system as added benefits.

Among patients favorite EHR features, the study suggested, are the electronic prescription function and the MyChart function. Of those surveyed, 48% said electronic prescription functions facilitated in obtaining medications. The MyChart function was also well-liked, but only 54% reported being aware of it. MyChart is a patient-accessible Internet portal that allows patients to access and review medical records, communicate online with caregivers, schedule and view appointments and order medications. MyChart also features customizable apps. Of the 54% aware of MyChart, 58% felt it was a useful feature.

While the vast majority of patients (95%) noticed the EHR changes, only 35% felt that it improved their healthcare. Forty-six percent of patients agree the physician-patient relationship was not affected. Press-Ganey patient satisfaction scores were unchanged. The 75 patients surveyed had a mean age of 63-years-old with 53% female and 47% male. Half of them said they were familiar with computers.

Bina Patel at the University of Virginia conducted the study.

Reference:

Patel B., et al. Patient Perception of Electronic Medical Records In The University of Virgina Ophthalmology Clinic. ARVO 2012 (abstract).

Glaucoma Medications and Dry Eye

Study finds an association with severe dry eye symptoms.

■ Patients taking glaucoma medications are more likely to suffer from both severe dry eye symptoms and an accompanying decline in emotional well-being, according to a study. The study, which received support from the Department of Veteran Affairs, used data gleaned from responses to a questionnaire. Of the patients questioned, 35% of those using glaucoma medication reported severe dry eye symptoms. Only 24% not using glaucoma medication reported severe dry eye symptoms. The research also indicated an association between glaucoma medication and an increased percentage of severe dry eye symptoms with 28% of patients reporting severe symptoms after taking one drop of glaucoma medication, 31% after two drops, 30% after three drops, and 48% after four drops.

Questionnaire scores suggested a significant decrease in emotional well-being for those using glaucoma medication, although the medication was not reported to have an impact on the ability to work or perform other activities.

Sarah R. Wellik led the study at the Miami Veterans Affairs Medical Center from June until August 2010. Four hundred eighty-nine patients elected to fill out the questionnaire. The response rate was 36%. The findings were presented at the 2012 ARVO meeting.

Reference:

Wellik S., Impact of Ocular Surface Disease on Quality of Life In Glaucoma Patients. ARVO 2012 (abstract).