Steve Kelley
Here's a troubling statistic--Vision Serve Alliance (VSA) reports that only 3% of individuals who might benefit from vision rehab services actually receive these services. Think about that for a moment… only 3 people out of every 100 people needing vision rehab services, receive it.
The reasons for this are complicated, and nearly everyone agrees there is a shortage of vision rehab professionals and low vision doctors to serve the growing need. Imagine for a moment a virtual house call was available, with a vision rehab professional, someone who was trained to do a low vision assessment and make some suggestions for devices that might be useful with low vision—magnifiers, reading glasses, glare filters, video magnifiers, etc. And what if, after the assessment, these devices could be demonstrated, right in the home or workplace, where they could be tried out to see if they'd be useful, before buying them.
Now that's really dreaming, isn't it? Maybe not... Eschenbach's new Haus Call Telelowvision Program is designed to make this a reality—enable the professional to meet with a client virtually—someone who might live a great distance away or be unable to get into the office or clinic, provide a virtual assessment, and introduce them to aids and appliances useful with vision loss.
How does it work?
Haus Call can be set up with a vision rehab professional through Eschenbach. If a client or patient wants to find a doctor or vision rehab provider that supports Haus Call Eschenbach customer service can get them connected. Each virtual house call will include two kits—one for the initial assessment, and the second with recommended devices to try. Both kits have the option of including an iPad with a preset, HIPA compliant meeting software to be used for videoconferencing to enable the patient or client to work virtually with the vision rehab professional.
The Assessment Kit
My assessment kit arrived, by UPS, in a hardcover case, with handle, and an accessible lock. Directions for the lock were emailed with a link to a YouTube video on how to unlock the case. The case included:
- Near vision acuity test
- Distance acuity test
- 4 glare filters
- iPad which opened to video-conferencing app
- hands-free iPad stand
- Patient instructions
Both near and distance acuity tests contained a premeasured cord to establish the correct viewing distance—16 inches for the near viewing assessment, and 10 feet for the distance viewing acuity chart.
By using the large print instructions provided in the kit, and a pre appointment phone call with the vision professional, the client is prepared to work through each one of the assessments with the guidance of a vision professional connected and observing through the camera on the iPad. A stand for the iPad is included in the kit, so the iPad can be positioned Hands free to allow the professional guiding the assessment to observe and make suggestions with the various assessment tools.
For Haus Call clients that may be unfamiliar with an iPad a preliminary call before the meeting will help get oriented to the iPad and meeting software. The iPad powered up to a home screen with the Eschenbach logo and an icon of a video camera. Touching the camera provided two tabs—one to Start a Meeting, and the other to Join a Meeting. Although the home screen was simple and the icon fairly large, there was no additional accessibility incorporated into the software, like Zoom or VoiceOver. Siri could then be turned on following visual prompts, and with it enabled, VoiceOver could be turned on, if necessary, for a client or practitioner accessing the iPad with a screen reader.
With the assessments completed—near vision, distance vision, and glare filters, the practitioner uses the assessment results as a guide to order devices that will be useful vision aids. Eschenbach has a wide range of devices that can be ordered for the client to try in the home—readers, handheld magnifiers, monoculars, portable and desktop video magnifiers, glare filters, and more. The client packs up the Haus Call assessment kit, when finished, locks the case, attaches the enclosed shipping label and calls Eschenbach to arrange for UPS pickup.
The practitioner uses the findings of the assessment to order aids and appliances appropriate for the client, directly from Eschenbach, to be shipped to the client's home for a trial period.
From the results of this writer's assessments, the following items were requested from Eschenbach for a trial in the home. These included the following devices:
- 5X handheld magnifier with light
- 6D reading glasses
- Yellow glare filter
- Handheld video magnifier
My request was followed up with a clarification for the handheld magnifiers, and a suggestion that both the readers and handheld magnifier requested be 'bracketed', meaning that in addition to the ones requested, additional devices in a size or magnification power above and below the one requested also be included. For example, not only was the 5X handheld magnifier ordered, a 4x and 6X were also ordered so each could be tried to fine tune the best match. This is what a client or patient might experience during a clinic evaluation—the option to try several similar devices, for the best match.
Haus Call Demo Devices
Like the initial Haus Call assessment kit, the trial devices were shipped in a hard plastic case with an accessible padlock. Instructions were forwarded by email, prior to the kit's arrival for unlocking the padlock.
Carefully packed within the case were the following items:
- 4X, 5X, and 6X handheld magnifiers
- 7D and 9D readers
- 2 yellow glare filters (size small and large)
- 1 handheld video magnifier, the Eschenbach Smartlux Digital)
Also included in the kit was an iPad and hands-free stand, like the one included in the initial assessment kit, set up for a video conference for any questions or instructions related to the devices sent. In addition, the near acuity chart, instructions, and a return shipping label were also included in the case.
The addition of the bracketed items really made this experience similar to what might be expected in an office or clinic, with different items to try of various powers and sizes. Although the vision rehab professional is available virtually, rather than in person for both the assessment and the device trials, one of the benefits of the virtual Haus Call is that these devices are tried out in the home environment where they will be used. It is not uncommon for a client to try something in a clinical environment, only to find that when they use it in their home environment with different lighting conditions, it may not be as effective, or perhaps another power would be the better choice.
Once the in-home trial is complete, the devices are packaged back up in the case, the packing label put on the case, and Eschenbach called to arrange pickup. Any of the devices the client found helpful may be purchased directly through the practitioner.
Wrapping it Up
Eschenbach's Haus Call was convenient and provided the tools necessary for both a virtual assessment and then to try beneficial products, hands-on, after the assessment. The iPad used during the assessment provided appropriate support for a functional assessment and to determine some devices that might be helpful aids. Shipping the devices directly to the client's home for a trial, in many ways, is a better alternative than just trying them out in a clinical environment, because conditions in the home will be different, and that is where they ultimately need to work well for the client.
After trying out the devices, clients have the option of keeping any of the devices in the kit by purchasing them through their doctor or vision rehab professional. The devices may be kept from the kit or returning them in the kit and placing an order for later delivery. It's important to note that Eschenbach does not sell directly to the client, or patient, this is done through the vision professional. For more information contact Eschenbach customer service at (800) 487-5389 or email info@eschanbach.com.
This article is made possible in part by generous funding from the James H. and Alice Teubert Charitable Trust, Huntington, West Virginia.
