Collaborative Care Breaks Down Patient Care Silos

This article first appeared in Women in Optometry and its corresponding “WO Voices” podcast.

Amy Moy, OD, FAAO, CPCO, FNAP, Senior Director of Health Center Initiatives and Optometric Compliance at New England College of Optometry (NECO), is leading efforts to integrate interprofessional collaborative care into optometry.

Interprofessional collaborative practice involves health care providers from different specialties working together beyond traditional referral models. “It’s not just referring someone out and saying you’re working with them. It involves actually working with those professions to bring the best outcome for the patient,” Dr. Moy explains.

Dr. Moy’s personal experience as a parent reinforced the value of this approach. Her daughter, who has Down syndrome, benefits from a clinic where developmental pediatricians, physical therapists, occupational therapists, audiologists and others collaborate in real time to address her needs. “They all come together in one place to examine my daughter and make their recommendations,” she says. Dr. Moy sees opportunities for optometrists to play a more active role in this sort of collaborative care.

Introducing Students to the Model

Dr. Moy says that it’s essential to introduce students to these ideas, too, and the Boston area does provide opportunities. The college has partnered with another university that has nursing, social work, physical therapy and occupational therapy programs. “We’ve been able to have lecture series together and have the students go into breakout groups to talk about scenarios such as trauma-based care, disability care and even gun control,” Dr. Moy says “It takes us outside of traditional conversations about optometry.”

The goal is to instill in students an understanding of how optometrists contribute to the whole of patient care, even when training outside of a campus setting.

“We have started this as an elective, and we’ve had some students go through the process. In their writing, we see how students have learned about dementia or the benefits of music therapy. It’s so enlightening because they’ve really taken a lot from learning from other professions and applying those skills. They’re thinking about how they can be better as an optometrist, how to communicate with these professions or what these professions might be able to do for their patients.”

Dr. Moy has already seen what collaborative care can do for her patients. A young boy presented with functional vision loss. His family doubted his symptoms, but after a comprehensive examination, Dr. Moy identified the condition and took action.

“I picked up the phone and called his behavioral health therapist, who he hadn’t seen since moving, and his pediatrician,” she says. By facilitating communication between providers, she ensured the patient received necessary adjustments to his medication and therapy. “Several months later, his vision returned to 20/20. But if I hadn’t coordinated that care, I don’t know how much longer he would have gone with worse than 20/400 vision. We’re a better link to the next step in care.”

Continuing to Expand

In order to more efficiently implement collaborative care in the clinic, NECO recently implemented EPIC, which all the local hospitals use. But she says that simply inputting notes into an electronic medical record (EMR) isn’t enough. True integration requires the ability to review and act on shared information. The EPIC system allows her to track patient history, treatments and referrals in real time.

For optometrists in private or small-group settings, forming relationships with local providers can foster collaboration. “Our school practice is right next to a primary care practice for a university, and there’s a psychiatric practice upstairs. We’re able to form relationships with them,” Dr. Moy says. She envisions similar partnerships in other communities, where optometrists proactively engage with specialists and primary care providers to create a more integrated health care model.

“When we share information, we can make more informed decisions and improve outcomes,” she says. By embracing collaboration, optometrists can move beyond siloed care and become key players in a broader healthcare network.