OPTOMETRIC RECORD-KEEPING IN A COMPREHENSIVE HEALTH-CARE ENVIRONMENT

Optometric records which have evolved in private practice must be reco nsidered when included in a comprehensive care environment. These hosp ital, health maintenance organization (HMO), preferred provider organi zation, and similarly linked systems require a higher degree of commun ication among specialties than do self-standing practices. Furthermore , the administrative requirements of such a system require more standa rdization, cost sensitivity, medicolegal compliance, and other element s peculiar to a comprehensive facility. The expanded scope of care pro vided by optometrists within a hospital requires familiarity with a ne w range of procedures, languages, and reports. Information from labora tories, radiology, and other areas must be incorporated into the optom etric record. Continuity of care is more complex. Opportunities for st rong interprofessional synergies within the organization arise directl y from preactivity in optometric record keeping. New legal hot spots a rise from questions of records ownership, access, and privacy. Billing procedures are becoming extremely important, with significant effects on quality assurance audits, coding, doctor ''profiling'' against fra ud, and abuse; these priorities can interfere with clinical priorities . Driven primarily by the concerns and resources of large third-party payers, technology is making rapid changes in the form of optometric r ecord keeping in comprehensive systems. Electronic data management wil l change the face of medical records, although administrative data wil l be digitized much more quickly than clinical notes. Comprehensive ca re environments will be the ''test beds'' for these technologies. Opto metry is in a flood position to show its contribution to the health ca re team through leadership in the implementation of new record keeping models.