Tips for reinforcing optometry’s role in the broader health care system

Interprofessional collaboration can lead to greater patient outcomes, better patient satisfaction and decreased preventable complications, so how can doctors of optometry ensure they are looped into the system at large?  

Well, take the case of diabetes care. 

The American Diabetes Association (ADA) estimates almost 12% of the U.S. population had diabetes in 2021—38.4 million Americans—while the Centers for Disease Control and Prevention (CDC) estimates 1 in 3 Americans will develop diabetes sometime in their lifetime. Taken together, the total annual cost of diabetes in the United States comes out to $413 billion—the most expensive chronic condition in the nation. That’s a staggering toll, but one further magnified by its potential impact on our nation’s children. 

Interprofessional care for diabetes leverages a multitude of provider types all working toward the common benefit of the patient, and optometry is a vital part of that care team.  

⏩ How optometry supports PCPs’ HEDIS scores for diabetes care. 

To discuss interprofessional collaboration and reinforcing optometry’s role among the broader health care team, the AOA caught up with two pediatric eye care experts, Stephanie Lyons, O.D., in Chicago, and Katherine Schuetz, O.D., in Carmel, Indiana. 

How can optometrists demonstrate their value to the full health care provider team? 

Dr. Schuetz: When we check the eyes of a diabetic patient and then discuss the ramifications of diabetes directly with that patient and caregivers, we are absolutely reinforcing the importance of blood sugar control, which is the goal of every one of that patient's providers. The conversation is always directed to the patient, but when it's a pediatric patient we certainly get reinforcement from mom or dad. Parents very much appreciate me having that conversation with their teenage diabetic who may act blasé about control at home but needs to have the understanding to limit future complications. Having the optometrist ask about their time in range and demonstrating that we as providers understand the systemic implications of diabetes can lead to better patient motivation to manage their diabetes. When I see a pediatric patient with diabetes, I always take time to help them understand why looking at their eye health is so important as an indicator of problems elsewhere, like their kidneys and toes. The goal is to make even our youngest patients with diabetes understand how diabetes works, and how they can prevent complications to help make their visits easier with their entire health care team. 

Dr. Lyons: I believe providing exceptional, collaborative patient care is the best way to showcase optometry’s importance among health care professions. This starts with communicating our exam results to a patient’s other health care professionals, thereby establishing our role as part of the interdisciplinary care team. 

Why is communication back to the primary care physician (PCP) so critical? 

Dr. Schuetz: It is critical that patients' primary care docs know we can competently look at the eye health features’ specific risk for our diabetic patients. If they do not know you are looking for diabetic complications and educating your patients, why would they refer to you, or not suggest that their patient see an ophthalmologist who they have more confidence in? Every single patient of mine who has diabetes gets a letter to their PCP and endocrinologist. It's important that their diabetes management team knows the ocular health status for their patient, as well as confirming to the health care team that the patients are taking the step of eye care that was recommended. Sending the pediatrician a note that their newly diagnosed patient has already established a baseline retinal exam and that you will consistently monitor for change is one less concern for them. You can only be a trusted resource by taking the time to become so! 

Dr. Lyons: Clear and open lines of communication help coordinate treatment plans, foster continuity of care, minimize medical errors and build patient trust. Interdisciplinary communication also helps establish referral networks, which can enhance continuity of care and practice profitability. 

How could optometry better reinforce the profession’s role in the broader health care team? 

Dr. Lyons: Optometrists need to actively seek out opportunities to engage with other health care professionals and educate them on the services we provide. This could be through networking events, joint education sessions or practice outreach. Our office utilizes a dedicated outreach coordinator to visit providers of various specialties and educate them about our services. 

Dr. Schuetz: Actions always speak louder than words, so volunteering for diabetes awareness/care events in your community or even doing school screenings shows a different level of care and expertise to other health care team members that may not have thought of optometry as a referral for their diabetic patients. When a school nurse knows you are caring and competent, or the dietician or nurse practitioner at the endocrinologist's office knows you well, they feel confident adding you to a patient's health care team. 

Access AOA resources for supporting your diabetic eye care 

The AOA offers several resources for AOA members to use in support of their role in the delivery of eye health and vision care services to patients with diabetes. 

• Diabetic Eye Exam Report. The AOA developed an easy-to-use, downloadable report optometrists can use to share their eye exam findings with a patient’s primary care provider or endocrinologist. 
• Eye Care Interprofessional Communication Protocol. The AOA, in collaboration with the ADA and other eye health care organizations, developed this digital resource outlining how eye care professionals and other providers can efficiently, routinely exchange information to increase patient co-management.
• Professional development courses on diabetes care. The AOA EyeLearn Professional Development Hub offers multiple on-demand webinar courses related to diabetes care, including three Para Speaker Series sessions tailored for optometric practice staff and an #AskAOA course focused on accurate coding for diabetic eye disease.
• Diabetes and Your Eyes infographics. The AOA offers several downloadable and customizable infographics, written at varying reading levels, that reinforce the importance of dilated, comprehensive eye examinations among patients with diabetes.