The AOA recently spotlighted the essentials of participating in comprehensive care teams, a growing necessity as ODs care for patients with more complex medical conditions. In her commentary, Dr. Nanette Curtis, chief of optometry for Northwest Permanente, outlined five foundational steps for success: relationships, communication, collaboration, coordination, and resources.
At Optometry 411, we’re taking it a step further to help you get something sustainable going. Understanding the “what” is only half the battle. The implementation is where things can get tricky.
Below, we unpack the essentials and explore which steps tend to be the biggest hurdle for most practices.
In terms of the required relationships, Dr. Curtis emphasizes that meaningful connections are the bedrock of integrated care. But you need to do more than exchange contact info. The best collaboration stems from mutual respect and regular engagement. How can you build that respect?
Action items:
- Personally reach out to local providers after co-managing a patient.
- Attend CE events to meet colleagues from other disciplines.
- Join your local AOA affiliate and stay active.
Next, communicating how your findings impact the patient’s broader care plan is a vital part of of co-managed care and integrated care models. Take diabetic retinopathy, for example — alerting a patient’s PCP could influence how they manage blood sugar or adjust medications.
Action items:
- Use a standardized summary sheet or EMR template to share relevant findings.
- Ask providers how they prefer to receive updates (email, EHR message, etc.).
- Keep communication focused by highlighting only the findings that inform the next steps in care.
To really succeed here, you need to recognize that this type of communication/collaboration might not be one-size-fits-all. Some specialists will want comprehensive notes; others will just need a heads up. A cardiologist may not change management based on amiodarone-related keratopathy, but still appreciates the info.
Action items:
- Ask your local referral partners what’s helpful for them.
- Maybe even create a quick-reference list of preferred contacts and their communication style.
- Encourage feedback about what worked, what didn’t, what could be better.
Coordination is the most difficult but the most crucial.
This is where things often fall apart. Coordinating referrals, lab work, follow-ups, and specialist care, especially across health systems, can be a logistical nightmare.
Different systems may not share EHRs; patients may be unsure how to follow up; small practices may not have dedicated care coordinators, so you need to be prepared to anticipate pain points and smooth the process where possible.
Action items:
- Identify key referral hubs in your area and build relationships with them.
- Train staff to understand referral procedures, insurance barriers, and follow-up timelines.
- Keep a shared spreadsheet or digital database of go-to specialists with their contact info, turnaround times, and insurance accepted.
Let’s hone in on the “train staff” bullet point. Knowing who to call and how to reach them is half the battle. But equally important is having a trained team who knows how to navigate referrals, request records, and explain next steps to patients. How can you begin to create this for your team?
Action items:
- Build a referral cheat sheet with up-to-date info (contacts, hours, insurances).
- Regularly review the list with your team to keep it current.
- Consider role-playing scenarios so your team feels confident explaining why a referral matters or how to prepare for it.
