Mass Eye and Ear’s Emergency Department launched a new service where patients can call into a hotline and request a virtual visit with an eye doctor for urgent conditions, which will be triaged by a nurse to make sure true emergencies still get seen in-person.
Mass Eye and Ear’s Emergency Department (ED) recently launched a virtual hotline program, a system where patients can call into the hospital with an eye (ocular) health question or concern and get connected to a virtual visit with an ophthalmologist. As part of the program, a nurse will speak to patients first and determine if they are appropriate for a virtual visit. If the caller does not have symptoms that suggest an emergency, they may qualify for a telemedicine appointment instead of having to visit Mass Eye and Ear’s busy 24/7 ED in person.
According to Grayson Armstrong, MD, MPH, medical director of the Ophthalmology Emergency Service at Mass Eye and Ear, the goal of the hotline is to provide patients with more convenient and timely eye care appointments, while helping minimize non-emergency visits to the ED.
“We are seeing a large increase in the number of patients coming to our ED,” shared Dr. Armstrong. “We are excited to offer a resource for patients to call before making the trip to our emergency room, giving them an alternative to traveling in. This helps give patients a clear understanding of the urgency of their condition and will ultimately help reduce wait times in the ED.”
A Dedicated Hotline for Emergency Eye Concerns
To use this new resource, a person with an eye concern can call 617-573-3880 at any hour of the day or night. A Mass Eye and Ear ED nurse will talk to the caller about their symptoms to determine if their situation is appropriate for a virtual visit or if they need to be seen in person. This optional program is only offered to people who have insurance coverage that is accepted by Mass Eye and Ear: The virtual visit is billed as an outpatient appointment, rather than an emergency room visit, which is typically more costly. Regular in-person ED visits, however, are not restricted to those with certain types of insurance.
The nurse who answers the hotline will screen for any severe symptoms that need immediate attention. If a person is calling with any of the following symptoms, they will be asked to seek in-person care at the Mass Eye and Ear ED:
- Severe eye trauma
- Sudden vision loss
- Severe eye pain
Dr. Armstrong adds that callers who experience flashing lights or floaters in their vision—which may indicate a retinal detachment or retinal tear—should also be seen in person at the ED, as these conditions cannot easily be assessed with a virtual visit.
If the nurse’s evaluation supports that the caller is experiencing non-emergency symptoms, the nurse will send the caller to speak with a scheduler who will make a telemedicine video appointment with one of the physicians who are a part of the virtual hotline program within one to three business days of their initial call.
All patients eligible for the virtual hotline will need to have access to a phone or computer that has video capabilities, as the program is through a video-based platform similar to Zoom.
Once the patient meets with the eye care physician virtually, there are a few different outcomes that may happen.
- The physician might feel comfortable treating their eye condition over telemedicine and the patient will not have to come into Mass Eye and Ear at all.
- If the patient’s condition seems to be ongoing or needs further care, then the first telemedical visit can be used to try to triage the condition and refer the patient to an appropriate subspecialist (such as a retina or cornea expert).
Telemedicine’s Growing Role in Emergency Care at Mass Eye and Ear
In December 2021, Mass Eye and Ear implemented telemedicine for ED follow-up appointments. This clinic was launched because Mass Eye and Ear’s ED sees patients from all over Massachusetts, meaning that some patients have to travel many hours each way for their follow-up care. The goal of this clinic was to minimize the burden of commuting and allow patients to check in with a physician from the comfort of their homes.
These virtual follow-up appointments were proven to be very successful, according to Dr. Armstrong. The ED team looked at the first six months of data from these visits, and not a single patient needed to go back to the ED for emergency care. The majority of patients’ symptoms were improving or completely resolved by the time they saw a doctor virtually for their follow-up visit.
“Patients told us they are very happy with using telemedicine for follow-up appointments and the data showed the program appeared to be very safe and effective,” said Dr. Armstrong.
The new virtual emergency hotline plans to build on the success of virtual follow-up appointments and hopes to continue the same pattern of positive patient satisfaction.
Many different medical specialties throughout Mass General Brigham have used telemedicine, which skyrocketed during COVID-19. However, Mass Eye and Ear’s ED is especially unique because it will be the first telemedical program in the system to triage and follow-up on emergency eye issues virtually.
In fact, Dr. Armstrong and his team were the first in the U.S. to create a curriculum to train eye doctors to conduct telemedical visits and train them about the benefits and drawbacks of ophthalmologic telemedicine. An assessment of the Mass Eye and Ear program was published nationally.
“The Mass Eye and Ear ED virtual hotline program is a groundbreaking concept, as we have many ophthalmologists who are ready and willing to use telemedicine to diagnose and treat an array of eye issues,” said Dr. Armstrong.
Virtual Care: Benefits and the Future
For patients who experiences unfamiliar or concerning eye issues, the virtual hotline offers many benefits for anyone in Massachusetts, not the least of which is avoiding Boston city traffic. Additionally, it will lead to decreased wait times for everyone.
Also, due to the COVID-19 pandemic, many people delayed care for routine visits or chronic illness, leaving appointment scheduling backed up for weeks or months. With this in mind, the virtual hotline program is significantly timelier and has the increased convenience of seeing a physician or subspecialist.
Dr. Armstrong encourages people to use this resource, but it’s important to remember this system is optional for patients and may not be right for everyone. The ophthalmology emergency services team wants to do what’s best for everyone’s eye and is happy to see people in person at the Mass Eye and Ear ED regardless of their type of insurance coverage.
According to Dr. Armstrong, this virtual hotline program is just one of several goals he and his colleagues have for telemedicine. His team is working on finding ways to use telemedicine and virtual care to conduct eye consults throughout the Mass General Brigham system.
He also shared that his team is working on rolling out telemedicine screening for diabetic retinopathy, a complication of diabetes where blood vessels in the eye are damaged. Physicians are using a camera equipped with artificial intelligence to help determine whether a person needs see an ophthalmologist or not.
“The future of virtual care within Mass Eye and Ear is extraordinary,” said Dr. Armstrong. “This virtual hotline program is just one of the novel examples of treating vision issues through telemedicine and we couldn’t be more proud.”
