The Cataract Pilot Project with Kellogg Eye Center reduced the use of low-value pre-operative physical exams before low-risk cataract surgery. The pilot project presented opportunities to expedite the pre-operative process, decrease in-person visits at the pre-op clinic, and save personal protective equipment.

Background: In 2019, the Centers for Medicare & Medicaid Services (CMS) implemented the Patients Over Paperwork initiative allowing ambulatory surgery centers (ASCs) to establish their pre-operative history and physical requirements. This allows tailoring of pre-operative care to case risk and need. The Kellogg Eye

Center & MPrOVE began collaborating to “right-size” pre-operative care. This project worked to reduce the use of low-value exams before cataract surgery, particularly during the Covid-19 pandemic.

MPrOVE Role: MPrOVE worked with clinical leaders to create and implement a new pre-op pathway that utilized a detailed virtual history to assess the risk level of cataract patients. Low-risk patients were triaged to receive pilot care (1 physical exam before surgery) and higher risk patients were triaged to receive usual care (2 physical exams before surgery).

Outcome: This project found that patients identified as low-risk for complications may safely proceed to cataract surgery without a separate pre-operative physical exam. The pilot project presented opportunities to expedite the pre-operative process, decrease in-person visits at the pre-op clinic, and save personal protective equipment.

These findings should encourage tailored pre-operative requirements for low-risk surgery cases, particularly cataract surgery.

Additional Links:

• Feasibility of a Risk-Based Approach to Cataract Surgery Preoperative Medical Evaluation