GlobeChek: A Comprehensive Virtual Eye Exam

COVID-19 has changed the way we go about our days, and it has impacted how we interact with our patients. We now include telemedicine visits as part of our patients’ care, and we manage patient flow in our practices so that patients are socially distant and safe. Even in this modified health care environment, the eye care we deliver has to be without compromise. Our patients still require tests that evaluate both vision and ocular health, with a depth of information we need to detect eye disease. So, how can we incorporate telemedicine without compromise?

A solution to this question is GlobeChek (GlobeChek), a comprehensive tele-eye care platform that detects glaucoma, diabetic retinopathy, macular degeneration, and cataracts, as well as other eye and systemic diseases (Figure). The technology is a state-of-the-art mobile, single kiosk that consists of the same high-quality instrumentation found in our offices to evaluate vision and ocular health. With GlobeChek, we can minimize risks to patients by keeping them socially distant and deliver eye care without compromise.

Addressing an Unmet need

Regardless of the circumstances they may face—whether it’s the COVID-19 pandemic, chronic disease, or other issues—patients need quality eye care, says Mohammed Rafieetary, OD, FAAO, FORS, Dipl ABO & ABCMO, an optometric physician at the Charles Retina Institute and advisor to GlobeChek on education for optometrists. “Access to eye care is critical. Whether it’s doctors’ access to patients or vice versa, access and quality care are essential,” says Dr. Rafieetary. Dr. Rafieetary sees GlobeChek as technology that can allow practices to “gain a business” they did not have before by providing easy, convenient eye care to patients who may not have had access to eye exams previously.

Dr. Rafieetary considers GlobeChek to be a vital part of integrated eye care. “We can identify eye disease timely, if patients have access to regular eye exams, and we can refer patients at the point they need treatment.” Additionally, he believes GlobeChek is a technology that should be embraced as a way of the future, and he does not see it as a replacement for primary eye care providers. The technology simply allows doctors to utilize an increased level of information from the GlobeChek eye exam to make the best management decision for their patients.

How it works

GlobeChek accomplishes a complete, comprehensive eye exam in 10 minutes or less, and patients do not require dilation. A technician guides patients through the exam process. Testing begins with a visual acuity evaluation, both near and far, followed by an auto-refraction. Eye pressure is measured, and high-definition photos of both the external eye and the retina are acquired. OCT is used to evaluate the optic nerve and the macula for signs of glaucoma and macular degeneration. Finally, corneal topography and an anterior segment OCT are taken.

A certified GlobeChek doctor reviews each patient’s test results. Primary eye care doctors view their patients’ results in a single-page report and, after evaluation, devise a management or treatment plan for patients. Patients are then sent a report with diagnoses and recommendations for follow-up care and can schedule a telemedicine consult to review the findings.

Ophthalmologists and optometrists can join the GlobeChek network free of charge. They will become part of a searchable database and can then be found by patients looking for an eye care provider in their area. Doctors in the network are also listed on patient reports.

ACCESSIBILITY and TIME SAVINGS

GlobeChek can be used in the waiting room or lobby of a traditional office, as well as in a mobile office setting delivering access to eye care in remote areas. Ruchi Gandhi, OD, an optometrist with the Tackle Eye Group, says their office has placed GlobeChek just outside the waiting room at their Locust Grove location in Georgia. Patients undergoing a GlobeChek eye exam at Tackle Eye Group check in first at reception to have their temperature taken. Then a technician briefly explains the exam to the patient and guides them through the GlobeChek exam in less than 10 minutes, with no dilation required. “It’s revolutionary and a huge time saver,” says Dr. Gandhi. “The technology helps us to streamline our practice more efficiently with less chair time and provide great eye care with a depth of information that is important.” Patient feedback has also been positive, as GlobeChek is a time-saver for them as well. Dr. Gandhi always points out the benefits to her patients, who generally feel they spend at least half their day at an eye appointment, between traditional tests that can take 45 minutes or more and moving from room to room for each test until their consult with their doctor. This is time missed from work, family, etc., and if their eyes need to be dilated, they require someone to accompany them to an appointment. With GlobeChek, patients are able to complete a comprehensive eye exam in less than 10 minutes. Dr. Rafieetary calls GlobeChek “a number of exam rooms in one globe.”

Dr. Gandhi explains that their practice maintains a separate schedule for GlobeChek, and the scheduling department reviews charts for upcoming eye exam appointments to transition those patients to a GlobeChek exam. She says that 9 out of 10 of her patients are willing to undergo a GlobeChek eye exam. Dr. Gandhi feels the ideal candidate for GlobeChek is any patient requiring an eye exam, such as patients who are new or existing to the practice, routine diabetic patients, and those who have their eye disease well managed.

“Expanding outreach with GlobeChek is part of our plan,” explains Dr. Gandhi. Tackle Eye Group is looking at mobile placement of GlobeChek in nearby nursing homes, assisted-living facilities, and surrounding retirement homes to provide quality eye care to these communities.

TelE-Eye CAre Coverage

During COVID-19, and for the foreseeable future, GlobeChek exams can be billed in the usual fashion as in-office exams using the customary Eye Codes 92004/92014 or Evaluation and Management Codes 99204/99214 for new and established patients. All codes should be submitted with a 95 modifier. Documentation of informed consent is required, such as: “Consent was obtained from the patient. Performed telemedicine visit during COVID-19 with audio and/or video face-to-face interaction with patient.” Practices interested in purchasing or leasing a globe can contact GlobeChek directly.

CONCLUSION

Tele-eye care is now an integral part of our eye care practices. While in today’s health care environment we need to limit physical interactions with our patients, the quality of care can’t be compromised. GlobeChek is significantly minimizing the risk of exposure and contamination while achieving a comprehensive eye exam for patients. Patients no longer need to sit in a room with others while waiting to be examined.

GlobeChek strikes the right balance between opportunities for a practice and delivering quality care to patients. A reduction in chair time, improved testing workflow, and expanded mobile footprint are all important benefits to a practice. In addition, GlobeChek elevates patients’ experiences, keeps them safe, and provides access for more people to regular eye exams. GlobeChek is truly revolutionizing the way we deliver quality eye care.