Georgia Public Policy Foundation: Keeping an Eye on Telehealth

Staff Report

Tuesday, August 31st, 2021

With the current surge of COVID-19 cases resulting from the Delta variant, and the probability of a continued strain on our healthcare system during the fall and winter, we face a renewed need to adapt the existing methods of healthcare delivery.

In August alone:

  • Medical staffers with the Georgia National Guard have been redeployed to support an overwhelmed and increasingly short-staffed healthcare workforce.

  • Hospitals have once again halted elective surgeriedue to a lack of bed capacity and resources.

  • And patients are sometimes spending hours in ambulances as hospitals lack not only the beds but even available space to accept them, and neighboring facilities within driving distance are also diverting patients.

Fortunately, innovative solutions to similar problems came to the forefront in 2020, and the landscape appears to be trending that way again.

One “new normal” out of the pandemic that should continue to be embraced is telehealth.

Notably during the first year of the pandemic, telemedicine visits would decline as new reported cases of COVID-19 declined, but would then level off as cases began to rise, according to research by the Centers for Disease Control and Prevention. Patients and providers adapted their behavior as necessary.

As other states rushed to loosen restrictions on practicing telehealth during the early stages of the pandemic, wisdom and foresight among Georgia’s policymakers meant the system was structurally sound and ready for the sudden surge in utilization. Only minor tweaks were needed to account for the new realities of life during a global pandemic.

However, one particular area of telehealth where the state lags behind is allowing optometrists and ophthalmologists to engage in telemedicine. In most states, patients can provide their current prescription information to an online vendor or take an online vision exam to purchase their glasses or contact lenses.

The result of this is that while Georgians can have a drug prescription refilled through a telemedicine appointment with their physician, they cannot renew an eyeglass or contact lens prescription without an in-person eye exam.

While some aspects of the in-person exam can never be fully replaced, providing patients with a reasonably safe and convenient option is worth pursuing.

As one doctor at the Cleveland Clinic observed, ““Seeing patients in person is still the gold standard for ophthalmology, but there’s quite a bit of information we can extract through virtual visits. That prevents some patients from coming to the office, supporting social distancing efforts. In critical situations, like we’re in today, we need to view virtual visits as a reasonable option.”

Legislation to address this lack of choice was introduced during the 2021 legislative session but failed to move out of committee.

The red tape that requires in-person exams for ocular prescription renewals is only one driver of the overall cost of healthcare, but it’s one that can be easily addressed and provide relief for patients.

As one speaker before the committee testified, “During Covid-19, it’s been laid bare how some parts of the healthcare system maintain barriers to access solely for revenue purposes. To reduce costs and improve access, we need to make it easier to access needed care — whether or not we are in a pandemic.”

It is important to remember that telehealth is an option for patients and providers alike and is not a requirement for all patients. Those who wish to pursue a more comprehensive exam are still within their prerogative to do so. However, mandating an in-person exam for this type of physician visit is a detriment for patients when it comes to both cost and access.