As we prepare for the challenges ahead amidst the ongoing COVID-19 crisis, one of the single biggest determinant of preventing the transmission of the virus is "SOCIAL DISTANCING". This new term that the world did not even expect to experience is now become ever more important to control outbreaks and prevent lock-downs that have brought life to a grinding halt. How is this important to us as eye care providers to adapt to this NEW NORMAL? In the current practice, it is become more evident to focus on the following factors in the delivery of eye care services to our patients.

It is even more important now to decrease the time spent by the patients in the hospital and balance the processes. Knowledge about the status of the patient is crucial to be able to efficiently deliver eye care service without compromising on the quality of care. EMR systems help to track the time spent at each interaction and thereby help to effectively monitor and also help resolve bottle necks if any in patient flow in the hospital. The use of automated medical reports being sent to the patient mobile devices also helps to reduce the time of interaction with the patient staff. Online checkins will also decrease interaction with the front desk personnel and help provide safety to this workforce that has the highest rate of interactions with the patients. Because of the challenges of social distancing, the full capacity of the hospital cannot be reached. This is linked to the possibility of still enabling care through Telemedicine. The ability to understand the spectrum of patients presenting to the hospital is crucial to take the decisions to decide who needs to follow-up and who can be managed remotely with a teleconsult. The All India Ophthalmology Society (AIOS) and the Indian Journal of Ophthalmology (IJO) have published National Guidelines for patient triage that serves as a wonderful tool that can be utilized to understand the clinical presentation of patients presenting to the hospital. They divided the clinical and surgical spectrum into the following three segments for every ocular specialty. The guidelines can be downloaded here - https://pubmed.ncbi.nlm.nih.gov/32317433/

The ability to TRIAGE the patients into the above categories with the use of EMR systems enables to understand the footfalls of the patients to the hospital and also enable to better plan human resource and also decide which segment of patients can be managed remotely as well. Routine patients who are wanting to visit after a long follow up and surgical follow ups are some of the possible group of patients that can be managed remotely. The guidelines clearly mention the various criteria as shown in the sample below. However, the full list of the criteria is available in the main article in the link mentioned above.

We published the experience of using this TRIAGE guidelines to guide decisions on the delivery of patient care services over the past 3 months since the lock-down began on March 23rd, 2020. Knowledge from EMR systems on these crucial insights will enable organizations to plan their care better and also increase the efficiency of services being provide to the patients. In our experience in the first one month of the lock-down we have seen a steady decline in the percentage of routine cases while the percentage of emergency cases steadily climbed.

You can download and read the full article at the following link - https://pubmed.ncbi.nlm.nih.gov/32587174/

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