Category: Marco Blog

In New Practices, Patients Want to See New Technologies

Showing patients their new Rx also removes “awkward conversation”

There’s a conversation that Keri Dennis, OD, no longer has with most patients. She isn’t put on the spot to make a judgment whether a patient “needs” new eyewear. Since she joined Ridgeview Eye Care in Olathe, Kansas, in August 2019, that’s one of the fea­tures that makes having Marco TRS automated refraction systems most enjoyable. It’s also why the practice added TRS systems to the new loca­tion in Lenexa, Kansas, that recently opened.

“Being able to show patients the difference between their habitual prescription and the one from that day’s exam is one of the most valuable aspects. Being able to toggle back and forth between the two helps patients see for themselves if it’s valuable to purchase new eyewear,” she says.

It removes an “awkward conver­sation” from the patient encounter, but it also adds efficiency to the process. In the original Olathe office, two of the three exam lanes have the TRS system. The third is dedicated primarily to pediatric pa­tients. “When I’m working, I want one of the rooms with a TRS,” she says, laughing.

The technicians who conduct the pretesting insert a card into the TRS system that provides the data. There are no transcription errors or time spent dialing in refractions. “It saves our technicians time and reduces er­rors, and all of those factors add up to speed and efficiency. Patients love that,” she says.

It’s not that they’re necessarily in a rush to get through their exam, but most patients found the old refrac­tions – which is better? – frustrating.

“Patients want a modern practice to have modern technology. If they come here from an office that did not have it, they say, ‘Wow. I’ve never seen this before.’ We get that all the time.”

A little social distance

An unexpected benefit of having the TRS systems in place during and right after COVID-19 was the fact that she could complete her refractions with some social distancing. “The timing of having these systems in place then was have to lean right in and spin dials,” she says.

There are also ergonomic and efficiency advantages to this sys­tem. Because she can control the automated refraction system from a tabletop device, she can go home with no shoulder or neck pain at the end of the day. “It’s also a faster process because I don’t have to turn around from the phoropter and write down notes. In fact, I can do quite a bit of multitasking because I can pull up optical coherence to­mography scans and images. While I’m doing the refraction, I can look at data that can help me determine if there’s something else affecting their vision. It’s a more streamlined process because I’m not sitting in front of the patient spinning dials,” she says.

With three doctors working at the same time, each moment that the patient is in an exam lane is valuable. So being able to use the time that might otherwise be spent in the manual refrac­tion process to gather data that supports her clinical decisions is important.

Patients also appreciate being able to get through the process without the stress or extra time involved. With the added benefit of being able to show them their previous and new prescriptions, the practice
is capturing more eyewear sales. “It absolutely makes a difference because it’s difficult for patients to assess whether an updated prescription would be better if we need to dial the comparison in. We find that if patients detect an improvement of any sort in these TRS comparisons, it improves the capture rate tremendously.”

Growing practices

The practice opened its Lenexa location in an area of rapid com­mercial and residential growth. Having advanced technology that wows patients is an important part of the attraction, she says. Patients want a whole experience at their eye care provider’s office-from a beautiful location, friendly staff and the expectation that they are getting a thorough and efficient eye exam.

Being able to provide that from the start in both offices contributes to the culture of excellence and efficiency, evidenced through the practice’s nearly 5-star Google reviews.

Article originally published in Vision Source OD magazine. Learn more about Vision Source here.

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Automated Refraction System Was “Practice-Changing” – An Article From Women in Optometry

Original Article Published in Women in Optometry
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Of her three exam lanes at Vision Source of Brandon, in Brandon, Florida, owner Laura Vizzari, OD, avoided one. It was the only one of the three that didn’t have a Marco TRS automated refraction system in it. “I was embarrassed to bring patients into it because they were used to advanced technology. It would have felt like a less-than experience for them,” she says.

But using it as a dilation-only room or for consultations made her realize that was ineffective. “I realized I couldn’t avoid the room anymore,” so she added the TRS to it and now has three fully functional exam spaces that she and her associate can use.

Her focus on improving the patient experience and capabilities of this practice has been at the top of her list since she acquired it in 2004, when it was an optical shop. “There was nothing else to it, so I completely rebuilt it with a focus on high-end frames and high-tech instruments,” she says.

Components of the TRS automated refraction system - a table and automated phoropter
The TRS automated refraction system

She moved to a larger location in 2007, but she continued to work with a manual phoropter until 2012, when she added the TRS and the OPD-Scan III. Five years later, she added a second TRS system in a second lane.

“Even though we’ve been using this system for more than a decade, patients continue to be impressed with it,” she says. “I’m surprised at how often people say, ‘Remember when you used to have all those dials?’ It’s almost ancient history, but they remember that. The wow factor stays strong with this technology,” she says.

“HERE’S YOUR CHANGE”

One of the most helpful aspects of the TRS system in terms of patient flow is how easy it is to show patients the difference between their old prescription and the one from that day’s exam. “Patients want to know if there’s a change, so I can show them what the difference is. Now I can tell them, ‘If you can see a difference, then you can benefit from new eyeglasses.’ It’s amazing how much a 0.25D change can make for some people,” she says.

She knows that from personal experience. She just tweaked her own prescription for a 0.25 degree of astigmatism. “I’m really surprised by the impact. I can see so much more clearly, even with such a small numerical change,” she says.

By doing phoria testing and binocular balance with all patients, she can arrive at a more customized prescription, too. “All I do is hit one button and the chart changes. Overall, it takes less time to get to a precise prescription,” she says. It’s very helpful, she says, because “I’m ruling something out, or I’ll find new information because I chose that extra test. Patients routinely tell me they’ve never had such a thorough exam.”

These features helped increase her sales of eyewear, and it also helps get patients out of the exam lane more quickly and into the optical. If patients set aside a certain amount of time for their annual exam, the more quickly she can achieve an accurate prescription, the more time they can shift to picking out their new eyewear.

A GREAT STARTING POINT

OPD-Scan III instrument
Marco OPD-Scan III

As a part of every exam, patients stop at the Marco OPD-Scan III Visual System, a combination autorefractor, keratometer, corneal topographer, pupillometer and wavefront aberrometer. “I look at that data first,” Dr. Vizzari says. “Before I start the exam, I want to see data on their eyeglasses, their vision and their OPD. It helps me know whether I’m expecting a big change or if there’s something unusual and the data doesn’t match. It allows me to start thinking about keratoconus or know what other questions to ask,” she says.

This data is also very useful as a patient education tool. “I can show them a picture and say, ‘This is why I cannot make your vision perfect.’ Or it’s an opening to talk about specialty contact lenses,” for example, she says.

Dr. Vizzari says the amount of time that she saves with each patient compared to the days of using a manual phoropter are significant. For now, the doctors are doing the refractions, but she sees the opportunity for training a licensed optician to do the testing. “As I’m trying to expand the practice, that may be one way of increasing efficiency,” she says.

But she says she cannot imagine why some doctors are hesitant about adding the technology. “I’m surprised when I talk with a colleague who doesn’t have it. I tell them, ‘Just do it. It’s practice-changing.”

As someone who has changed the nature of an eye care business, from a generic optical shop to a full-service, high-tech primary eye care practice, she knows how much difference the right equipment can make.

Read other WO stories from Marco here.

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Fast, Efficient Refractions Allow Doctor Time for Deeper Discussions

One of the first investments that Michelle McReynolds, OD, made when she opened cold was with the Marco OPD Scan III Wavefront Aberrometer and TRS automated refraction system. “I was looking for anything that would make my work faster because I didn’t have a technician when I first opened. It was just me doing everything,” she recalls. She opened West County Vision Center in St. Louis, Missouri, in 2011.

Being able to have a system that could streamline everything from keratometry and refraction and transfer the data to her Revolution electronic health records system made everything easier. “In fact, I’m still using the same TRS and OPD that I purchased then. I’ve not had any issues with that equipment,” she says.

However, she has expanded the usage of it. As she got busier and equipped a second exam lane, she installed a second TRS system. “Once you have it, it would be hard to go back to a manual phoropter,” she says. “I knew that if I didn’t add the TRS to the second exam room, I wouldn’t want to use that room.”

Being streamlined is just as important now as it was in the beginning. When she opened, her mother worked her front desk, and she had an optician. Now she has two full-time front staff, a technician and optician, and she is looking to expand. “We’re busier than we’ve ever been, and I’m booking two months out,” she says.

Good data from the start

So she is grateful for the technology that helps her save time and provide excellent data on each patient. Patients interact with the Marco technology right at the start of their experience. In the pretest room, they sit at the OPD Scan III, which serves as a combination autorefractor, keratometer and topographer. “So many patients comment that they haven’t seen technology like this before,” she says.

Based on the data that Dr. McReynolds gains from the OPD, she can make decisions about the patient’s care plan. “I have detected a lot of early keratoconus, since we do a topography on every patient. The OPD obtains a topography automatically,” she says, noting that she can recommend crosslinking to help slow down the progression of keratoconus.

After those patients have been referred out for crosslinking treatment, she can fit them with scleral lenses if necessary. “I also love that I can show patients their cataracts with the retro illumination image. I can point to the dark opacities on the image and explain that I might not be able to correct their vision to 20/20 due to the opacities in the cataract,” for example, she says.

Refractions made easier

As patients move into the exam room, they continue to be impressed by the technology she has brought in. “Patients make comments about how high-tech everything is. I love being able to say to patients at the end of the exam, ‘This is the prescription you had, and this is what I’m getting today.’ Showing them is so much better than me trying to explain what a half diopter increase or decrease means.”

Toggling between the old and new prescription, patients can decide for themselves whether they want to purchase new eyewear. She can even use it to add validity to a complaint by a patient who says night driving is more challenging. The OPD will indicate if the patient needs a stronger prescription for night verses during the day.

Dr. McReynolds says that she enjoys the refractions process. “Optometry was founded on doing refractions, and I get a lot of satisfaction knowing that I am getting the best possible results for my patients. Plus, patients feel the refraction is an extremely important part of the exam.”

But because she relies on the technology to support her findings, she can also use that time to talk with patients about other concerns or conditions. “I’m talking to them throughout the refraction and listening to how they respond,” she says.

iON boosts education

More recently, Dr. McReynolds added the iON imaging system from Marco and has found that it helps her with her rigid gas permeable (RGP) fits and patient education. She can capture video of the RGP lens on the eye and upload it to her specialty lens consultant. “That helps a lot,” she says.

For patients with foreign bodies or oil gland dysfunction, she has also found that the video image helps them understand their condition better. “If they can see what I am looking at, they are more motivated to follow my treatment recommendations. Patients tell me, ‘No one has ever explained that to me.’”

The value of that comprehensive exam and customized solution is as important to her today as it was on the day she first opened.

Article originally published in Vision Source OD magazine. Learn more about Vision Source here.

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Automated Refraction System Allowed Practice To Grow Without Expanding – An Article From Women in Optometry

Original Article Published in Women in Optometry
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Since its founding in 2007, Northern Sight Vision Clinic in Phillips and Tomahawk, Wisconsin, has been growing. One of the original partners, Jessica Stromberg, OD, brought in Brittany Lemke, OD, in 2013. Dr. Lemke soon bought out Dr. Stromberg’s mother, who was one of the original owners.

Dr. Stromberg
Dr. Lemke
Dr. Treml

“These are Northern Wisconsin small towns,” says Dr. Lemke. Associate Lauren Treml, OD, works at the Tomahawk location, and the two partners each spend two different days each week at each location.

About 10 years ago, the doctors started feeling the pinch for space. “We added electronic health records in 2014,” Dr. Lemke says. That helped reclaim some of the space that had been dedicated to paper charts, but it still felt a little crowded. “We were considering purchasing another exam lane, but a Vision Source® colleague recommended that we install the TRS automated refraction system from Marco first,” she says.

The doctor did that – and it brought relief. “We were doing accurate refractions so much faster, and we were able to show patients with the click of a button what their current eyeglasses prescription was and what a new prescription would look like,” she says. The result was that patients were able to spend quality time in the exam lane, with the doctor discussing important ocular health issues, and get into the optical more quickly.

Marco automated refraction technology
Marco TRS

In fact, this measure allowed them to work in their small Tomahawk location for an additional three years before they moved to a larger space in 2017. The goal was to see more patients in a day – and it worked. The pretest technicians upload information to the TRS system, and the doctors finalize the refractions. “Usually, while I’m refracting, I can also work on the charting and talk with the patient. It’s a good time-saver,” she says

Today, both locations have two exam lanes, and all for are equipped with the Marco TRS-6100. “It helps with our efficiency. It was imperative to have the Marco technology in both lanes,” she says.

SMALL COMMUNITY, BIG CARE

It has been important to these providers that patients in these small communities have access to the same level of care that they could get in larger cities. Indeed, their mission statement says the practice is committed to improving “the quality of our patients’ lives by providing state-of-the-art eye health and vision care.” They do so by maintaining high standards, incorporating technology and pursuing education and the best products. “It’s exciting to see our mission statement come to life. Patients comment all the time on the technology.”

They appreciate that they don’t have to answer the old “which is better” questions that stressed them. “I attended a seminar where the speaker pointed out how many questions a patient is asked before the patient reaches the exam room. If we can make it faster and let the patient feel calmer, that’s a better experience. I can assure them that they will not give any wrong answers and that I’ll double- and triple-check the refraction,” she says.

GROWTH CONTINUES

Dr. Stromberg and Dr. Lemke at a Wisconsin Optometric Association meeting

The doctors and staff have by now used every nook and cranny of space in their Phillips location, so they’ll be remodeling. That plan includes adding the layout for a third exam lane if they need it in the future.

By making sure that they can provide patients with fast, accurate prescriptions, they can maximize the time they have with each patients and bring more patients into the practice. “We see patients from the surrounding area. Around here, patients are accustomed to traveling for health care. If they need a specialist, they’ll need to commute for an hour,” she says. So it’s important that they can bring patients in as quickly as possible. The ability to exceed patient expectations has been the major contributor to the practice’s growth in the past – and it will be in the future, too, Dr. Lemke says.

Let Me Walk You to the Optical

Dr. Brittany Lemke loves to style patients for their new eyes. First of all, it’s a great small-town touch, but it also provides another opportunity to make a connection with the patient. “I’m the one who has established what they do during the day and what their free-time activities are. I enjoy the retail experience, too,” she says.

Plus, it only takes a moment. “In just a few minutes, I can pull a few frames and make some comments, such as ‘I love this color on you.’ Hearing it from me is an invitation to find something fresh,” she says.

The optical staff can take over, but Dr. Lemke says the transition from exam room to the optical is enjoyable for both the doctor and the patient.

Read other stories from WO about women ODs using Marco technology to improve their efficiency and patient experience.

Visit Northern Sight Vision Clinic here.

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An Excellent Refraction Is The Pivotal Point In An Exam – An Article From Women in Optometry

Original Article Published in Women in Optometry
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Kathleen Joyce, OD, of EYECARE for You, makes a firm distinction between the different automated refraction systems out there. “My refractions are doctor-driven, but I love having the technology that helps me get to an accurate subjective refraction more quickly,” she says. That is important to her in her two practice locations where she focuses on medical services and custom fit contact lenses. “The refraction is a pivotal part of the exam, and my Marco TRS automated refraction system improves my overall efficiency,” she says.

In 2018, Dr. Joyce started her practice cold in Richboro, Pennsylvania, a northern suburb of Philadelphia. She had used the TRS system in a practice where she had been an associate, so getting her two exam lanes equipped with Marco technology in her new office was a priority.

Then she acquired a practice in Newtown from a retiring physician, who continues to work part-time. That location had a different brand of refraction system, “but I like the function of the Marco TRS system. I did look at a few others, but when it comes to the ease of use and integration with other technology, I liked this the best,” she says. She says that it’s also wonderful how supportive the selling optometrist was about making the switch to her preferred technology. She converted both of those lanes to the Marco TRS technology.

EFFICIENT PROCESS

Marco TRS-6100

“I saw the return on my investment,” she says. “The initial results are incredibly accurate. When I cross check my results with retinoscopy, my subjective refraction is very similar to the autorefraction. Allowing the patient to see side by side images results in greater patient confidence during the subjective refraction,” she says.

The system plays an important role whether it’s a routine comprehensive eye exam or a more medically-driven one. “By saving time during the refraction, I have more time to spend addressing a patient’s chief complaint in greater detail.  This allows my examinations to be more patient- and problem-focused.  It also affords me the opportunity to explain the need for follow up care beyond the comprehensive eye exam, ultimately resulting in greater patient satisfaction,” she says.

During more routine eye exams, Dr. Joyce estimates she can shave five minutes off the time the patient is in the exam room. “If I have several routine patients scheduled that day, it means I can see an extra one or two patients a day. If the average revenue is $300 a patient, one extra patient per day can be a $75,000 increase to my annual gross revenue,” she says.

MORE EXAM PATIENTS=MORE OPTICAL CUSTOMERS

It also means that these patients can spend those extra few minutes in the optical, where the message about second pairs of eyewear or backup eyeglasses is reinforced by the optical staff. In contrast, patients who feel like they’ve been challenged in the refraction or whose exam took longer than they expected are often the ones who want to rush out and delay buying their eyewear – or skipping the step altogether.

Plus, those extra one or two patients a day who can be seen each day also mean one or two additional customers passing through the optical. “The industry average for capture rate is around 50%. If I can bring two more patients in a day, that can translate to at least one more patient a day buying eyewear.”

SOLID STARTING POINT

In more complex cases, she appreciates having the data from the Marco pretest autorefractor  because it gives her a solid starting point. “I can make decisions about the data I’m getting from the autorefractor, and if results subjectively don’t make sense, I know I have to take another approach,” she says. She looks for the red flags that might indicate something is unusual – such as a dramatic prescription change—as she’s doing her own testing.

An automated refraction process never takes the place of her experience and knowledge. “But it can free up time that I can use on patient history or education, as well as discussing follow-up care,” she says.

With the two offices just a 15-minute drive apart, Dr. Joyce spends some time in each one every day, although she is full-time in the Richboro office. She also has an associate who covers there, and the retiring doctor continues to see his patients in the Newtown office. All three doctors see the technology as an enhancement to their exams as well as a positive return on investment.

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More Data, More Quickly

With the Marco OPD-Scan III wavefront aberrometer and the VisuALL virtual reality visual field perimeter, Rachel Tellez, OD, of San Antonio, Texas, captures more information on each patient. The systems talk to each other, so staff members don’t have to load data manually. And Dr. Tellez has all the topography and perimetry data right on her screen.

Since the VisuALL system is portable and allows the user to perform several tests without having to move the patient from one machine to another, that system has also sped up the data-gathering process. “Within a minute or less, the refraction, keratometry and topography are all on one screen, showing both eyes, much faster than compared to performing these tests with three separate instruments,” Dr. Tellez says.

Article originally published in Vision Source OD magazine. Learn more about Vision Source here.

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The Power of the Current and New Prescription Toggle Switch

After about nine years of having an automated refraction system in the practice, Heavin Maier, OD, of Eyes for Life in Spokane, Washington, couldn’t imagine practicing without it. When she added another lane of equipment, the Marco TRS Refraction System was part of that. “It’s part of our standard operating protocol now. The flow works well,” she says. She has other Marco technology in her practice, and it adds to the overall efficiency when the equipment “speaks” through the card system that moves patient data from the lensmeter and OPD Scan III Wavefront Aberrometer to the TRS system.

Patients as decision-makers

What she loves about the process is the ease with which patients can make the decision on whether new eyewear will benefit them. “I hated having to dial in the prescription manually and show patients what the difference was between their current and new prescriptions. Keeping track of axis and cylinder and sphere shift was mind-boggling,” she says.

With the Marco equipment, it’s a simple toggle switch. “I can show them each eye individually, or I can show it as two eyes together,” she says.

She appreciates that it’s not up to her to make a judgment call or try to convince a patient that a prescription change is “big enough” to warrant new eyewear. “There have even been patients where I think they cannot possibly notice this change, but they immediately say, ‘Oh, that’s so much better.’”

When patients are assured that the new prescription will help them see more clearly or more comfortably, they’re happy to make the purchase.

The patient experience

It’s important, too, that patients see that the practice invests in the patient experience. Since nearly all patients engage with the OPD and TRS systems, new patients have the immediate perception that the practice isn’t outdated or old-fashioned with its technology.

Goodbye, shoulder pain

Dr. Maier has been in practice for 19 years. “Within the first year of practicing, my shoulder was killing me,” she recalls. She began wondering whether the cost of doing manual refractions was going to involve her own comfort and shoulder mobility. “After switching to the TRS system, I realized that I was no longer in pain at the end of the day, so that’s priceless. I cannot imagine why there are doctors wrecking their shoulders,” she says.

She has gotten good support from her Marco team, and she credits Marco President Jocelyn Hamilton as a true professional committed to helping doctors succeed.

Dr. Maier says that she would have a very difficult time going back to a manual system. The Marco equipment she has provides her with a solid starting point for her prescriptions, and she uses that to achieve her endpoint more quickly. It saves her time showing patients the difference between old and new prescriptions and improves patient engagement in their own care decisions when changes in the prescription are numerically small. And she can walk out of her building at the end of the day without her shoulder throbbing.

Article originally published in Vision Source OD magazine. Learn more about Vision Source here.

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Advancing Eyecare Announces Exclusive Distribution Agreement of Pure&Clean® Vision Hypochlorous Acid Products

Jacksonville, Florida, May 31, 2023 – Advancing Eyecare, a family of leading ophthalmic technology and equipment companies, has entered into an exclusive distribution agreement with Pure&Clean. Effective immediately, the group will add the Pure&Clean Vision hypochlorous acid product line, including Pure&Clean Vision’s Daily Lid Cleanse, Gel and Drops, Hand Prep, and Equipment & Surface Prep to complement their existing portfolio of ophthalmic solutions.

Eye care providers are leveraging Pure&Clean Vision in a myriad of ways by harnessing the powerful antimicrobial properties of hypochlorous acid to mitigate the harmful effects of bacteria, viruses, and other pathogens. With a shelf life of 24 months, it is one of the most stable hypochlorous acid products in the vision care market.

  • Pure&Clean Vision Daily Lid products offer natural, non-irritating non-pharmaceutical options topromote positive eyelid hygiene and overall eye health. They help to reduce symptoms of manycommon eye diseases such as dry eye, blepharitis, MGD, demodex and more.
  • Designed for contact lens wearers, Pure&Clean Vision Hand Prep is great for use prior to handling lenses in any environment and can also serve as a great substitute for alcohol-based hand gels.
  • Pure&Clean Vision Equipment & Surface Prep provides a non-toxic, effective and environmentally-friendly alternative to harsh surface cleaning solutions.

“Pure&Clean Vision products represent a significant leap forward in the way eye care providers are helping their patients and staff alike. We are proud to offer a natural product that combines exceptional efficacy with unmatched safety. We aim to achieve healthier eyes and to provide safe, non-toxic, and environmentally friendly spaces.” said Trent Freeman, Chief Executive Officer of Pure&Clean. “We are excited to partner with Advancing Eyecare to provide even greater value to ECPs across North America.”

Pete Lothes, Chief Operating Officer for Advancing Eyecare, commented, “We are rapidly executing our strategy to provide innovative solutions to fulfill evolving market needs. Advancing Eyecare is excited to partner with this amazing group, and to build on Pure&Clean’s positive momentum to provide these great products to eye care professionals and their patients nationwide.”

Pure&Clean Vision products are now available across the United States through Advancing Eyecare companies, including Marco Healthcare, Lombart Healthcare, Veatch Ophthalmic Instruments, Santinelli International, and Enhanced Medical Services.

To get more information about Pure&Clean Vision, go to www.advancingeyecare.com/pureclean/.

About Advancing Eyecare

Advancing Eyecare™ is a partnership of leaders in the eyecare instrumentation marketplace established to offer the best products and service solutions in the ophthalmic equipment industry. Currently comprised of Marco Healthcare, Lombart Healthcare, Enhanced Medical Services (EMS), Veatch Ophthalmic Instruments, Santinelli International, S4OPTIK, and INNOVA Medical, the combined scope of the organization has the broadest product portfolio, the most knowledgeable people, and the most reliable service in the industry. Visit www.advancingeyecare.com for more information.

About Pure&Clean

Pure&Clean offers a number of healthcare, personal care, and infection control products that do not jeopardize human or environmental safety for effectiveness. The product line includes Wound Solutions, Hydrogel, Skin Defense, products for ophthalmology and optometry, as well as surface disinfecting products. The market reach of Pure&Clean expands from healthcare systems including long-term care facilities, home health and hospice, wound clinics, hospitals, surgery centers and profession clinics including optometry, to schools, sports programs, professional athletes, daycares and family use in the home.

Media Contact:
Kristen Tischler
ktischler@advancingeyecare.com

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I Don’t Have All Day… Increasing Efficiency Without Jeopardizing the Patient Experience

By Jennifer L. Stewart, OD

In optometry, we often think that more is better – bigger offices, larger staff, more frames in the dispensary – but when it comes to exam time, is longer really best?

Optometrists pride themselves on providing a great patient experience. We invest in beautiful offices, spend time training our staff members, invest in the latest technology, and proudly showcase the latest fashions in our opticals. We also want to make sure the patient leaves with no questions unanswered and fully understands their visit, which often leads to us believing that a longer time in the exam room is what patients want and expect. However, is this what is truly best for our practices and bottom line?

When I was practicing, my goal was to be as efficient and effective as possible in the exam room. But I also wanted to move the patient through the office in a timely manner in order to get them to spend the bulk of their time in the optical. Patients have set a time limit of how long they can spend with us in their day so I felt it was best that they had the time to choose glasses (and multiple pairs!) without feeling rushed or telling us they would come back (which they likely wouldn’t).

Improving Your Efficiency

One of my favorite exercises for doctors to learn how their office operates is to first have each staff member take a guess (doctors too!) at how long the patient spends at each part of their patient journey. This includes check-in, waiting room, pre-testing, waiting in the exam room for the doctor, the eye exam, optical time, and checkout. I call this the “Post-It Note” exercise, as we would write the time that the patient started and completed each step on a post-it note.

What were some of the discoveries? We had huge inefficiencies in each step, leaving the patient with too little time to spend in the optical. This is a great time to talk to each department about ways they can improve, and what they think the outcome will be.

Reception

Emailing paperwork ahead of time or using a patient portal to collect information can save significant time at check-in. Is it even possible to eliminate your waiting area and have a technician ready to bring the patient back as soon as they arrive?

Many patients also today prefer to book their appointments online at their convenience, freeing up the in-office staff from long phone calls or back and forth email conversations.  Two-way texting is also quick and efficient and the way that many of our patients prefer to communicate.

Pre-Test

If the patient has already filled out their ocular and medical history and it syncs directly to our EHR, you can shave off precious minutes for the technician in the pre-test routine. Thinking about technology can also save time from having the patient have to move to different stations. We now have amazing tools at our disposal that combine multiple instruments into one, reducing the need to move the patient from machine to machine. Virtual Reality (VR) devices are empowering ECPs to conduct a myriad of tests with more speed and flexibility than ever before. There are so many options available today to customize and speed up your pre-test patient flow.

Exam Room

Once the patient is in the exam room, scribes could help the doctor be more efficient in their charting.  Additionally, technology advances that import pre-testing information directly into the exam room and EHR system exist, allowing the doctor to use that time to educate and communicate with the patient instead of manually entering data. For example, leveraging a digital refractor can speed up the exam by yielding faster testing and immediate data transfers to the EHR system. This automation provides a high-end patient experience, leaving you more time to educate and connect with your patient. The cumulative time spent in the exam room is less, but the quality time spent with your patient is more. It’s a win-win!

Optical & Checkout

Once the patient is done in the exam room, streamlining the handoff to optical can expedite the process.  Can you directly send all relevant information to your opticians, including prescription(s), lens recommendations, and treatments so they automatically have that information when the patient arrives?

Consider in-office finishing to deliver eyewear to your patients faster while also lowering your lab costs and controlling the quality of your finished product.  Providing more convenient optical services will not only help increase your capture rate, but also your patient satisfaction.

Finally, giving the optical staff the flexibility to check the patient out and collect payment information, can streamline the checkout process and eliminate a step in the patient journey.  Further, emailing receipts and prescriptions or using a patient portal allows the patient to be on their way quicker.

Multiple Benefits to Your Practice

What is the benefit of increasing your office efficiency?  There are many and it all goes back to your practice goals.

  • Do you want to increase revenue by seeing more patients? Shaving off 1-2 minutes (or more!) from each exam will allow you to see more patients in the same number of hours.
  • Looking to increase your per-patient revenue? Leverage technology to increase your billable tests, obtain valuable clinical data for a more thorough exam, and provide a high-end experience for patients (and without adding additional time to the overall time spent in your practice!). Getting patients to the optical more quickly also gives them more time to shop and browse.
  • Looking to increase staff happiness and morale? Giving them a stake in making office decisions and making them responsible for outcomes makes them feel more connected and part of the team.
  • Want to provide more quality time with your patients? Refining your office workflow allows you to spend more time communicating and educating your patients.
  • Want to cut back on the hours spent charting and in the exam room? Those precious minutes that are freed up become yours to do what you’d like – take a break, work on staff training, grab a coffee, or continue to work to build a super-efficient, effective, productive practice. Take it a step further and leverage remote refraction. Refract your patients from anywhere—your home, on vacation, anywhere!

Interested in learning more on maximizing your practice efficiency? Be sure to register for the webinar, “Technology and the Modern Practice: The Link Between Efficiency and Productivity” on Tuesday, June 20 at 8pm EST.

About the author:

Dr. Jennifer Stewart is an optometrist, internationally recognized speaker, writer, consultant, and entrepreneur.

She has a passion for helping optometrists and organizations with operations, sales success, practice management and sales team training through her advisory and consulting firm, OD Perspectives. She is the Professional Editor of Independent Strong, is an Adjunct Assistant Professor at the New England College of Optometry and a consultant for Coopervision, MacuHealth, GPN and Zyloware. She is also the recipient of the 2022 Emerging Leader Award from the Optical Women’s Association.

With a deep interest in sports vision, Dr. Stewart is the Co-Founder and Chief Vision Officer for Performance 20/20, which provides services for sports and performance vision training. She is a recipient of the Theia Award for Innovation by Women in Optometry and serves on the Executive Board for the International Sports Vision Association.

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VisuALL: The Future of Visual Testing is Here

Time is money, and factors like staffing and available workspace can significantly impact both. For example, if you’ve felt the effects of the great resignation or bottlenecked testing rooms plague your technicians, your practice might be missing out on its earning potential. A virtual reality testing platform could provide the much-needed performance boost you seek.

Olleyes VisuALL ETS and VisuALL S Virtual Reality Platforms are multi-function systems that can consolidate a roomful of equipment into a single headset that patients wear for reliable, fast, and easy testing. Tests include:

  • Visual field (adult and pediatric)
  • Visual acuity (near and far)
  • Color vision (D-15)
  • Contrast sensitivity
  • Pupillometry
  • Extraocular motility
  • And more

One of the most significant factors in establishing a productive, profitable business is your ability to cycle patients from the waiting area to the exam room and out as efficiently as possible while still providing a quality exam. With all of their capabilities in one headset, here are a few ways virtual reality platforms like VisuALL can help revolutionize your practice’s productivity.

1. Make Better Use of Office Space

Simply a headset and controller, not big, bulky tabletop equipment like traditional units, VisuALL doesn’t require a dedicated space with specific lighting. “I like to tell doctors that (with VisuALL) they could run their visual field tests in their lobby if they wanted to,” says Jeff Morris, an Area Manager with Marco. “The equipment goes where you are without any special tech or space requirements.”

The gold standard for visual field perimetry has always been a large, standalone device. But Claudio Lagunas, OD, of Lifetime Eyecare Associates, explains how the VisuALL has been a better fit for his practice. “We’re growing, so space is limited. VisuALL’s portability has been great for us. Being able to move it from room to room has helped eliminate logjams in our pre-test area. Plus, our patients have really embraced the technology and the kids love it!”

2. Free Up Your Staff

Team members delegated to perform visual field testing often feel like they drew the short straw. It’s time-consuming, and they’re usually at the mercy of the patient’s ability to perform the test. Fortunately, Olleyes has equipped its VisuALL platforms with an interactive virtual assistant named Annie. Annie walks patients through the testing process step-by-step. Practices can also create test bundles with groups of their most commonly used tests and Annie will take the patient from one to the next until they are all complete.

“With our VisuALL, the technician is not tethered to the test. Once they get started, Annie will go ahead and walk the patient through with instructions and keep them going, while our assistants can go over and start the next patient or get going on something else. It’s really made us much more efficient.” For most common protocols, the testing process only takes about three to four minutes total.

“The biggest thing for me is that it’s so consistent,” says Emily Coles, OD, owner and operator of Big Rapids Family Eyecare. “I have four technicians, and now they’re all delivering a uniform exam. With our previous machine, someone had to sit with the patient and ensure their eyeball was lined up with a camera. Now, they just have to help them with the mask, and the virtual assistant delivers the same instruction every time.”

3. Provide a Better Patient Experience

Virtual reality platforms like VisuALL also create a significantly less stressful testing experience for patients. “My patients tell me they are much more comfortable with the VisuALL system,” Coles says. “They don’t have to sit leaning forward on a chin rest, and we don’t need to finagle trial lenses. Patients dreaded the old way of testing so much that some would just decline it. It’s so much better now.”

VisuALL is also much more comfortable for elderly patients and less stressful for testing children, ultimately resulting in happier patients and more accurate test results. There’s no need to prop kids up at a big machine built for an adult.

Children will sit still longer with a virtual reality headset than a traditional device, and Olleyes even went one step further by creating a pediatric version of the visual field test that’s more like a game. In fact, a recent study conducted by Vanderbilt University Medical Center found that VisuALL’s game-based VRP can be used to effectively map out the peripheral vision of pediatric patients and has a higher patient satisfaction than that of a traditional HFA. Patients found the headset more engaging and were more willing to complete the requested testing.

In addition to comfort, having the latest technology shows patients that you’re invested in their vision care. Lagunas says his patients appreciate the technology and it keeps them coming back to his practice. “One of the best compliments I get from my patients is when they ask me, ‘What’s new this year, doc?’ That’s a culture we’ve built over the years that keeps patients engaged with the process and their experience.”

4. Improve Testing Data

When compared to traditional methods, one of the distinguishing features of the VisuALL ETS is the Dynamic Matrix, a proprietary algorithm that significantly reduces fixation loss, many times to zero. Patients and technicians can relax because the VisuALL automatically tracks their gaze, yielding more accurate test results than traditional perimeters.

“A traditional visual field test is thrown off when a patient ‘cheats’ by not staring at the target,” says Morris. “If the stimulus is to the right, and you’re looking to the right, you’re going to say you can see it. But the VisuALL ETS will account for your movement and move the stimulus proportionally to your gaze.”

The VisuALL virtual assistant also has the ability to speak more than 30 languages, so test results are not influenced by communication barriers.

5. Lower Costs

It may seem a bit salesy to say that a piece of equipment pays for itself, but when compared to the cost of traditional devices, a VisuALL unit can represent significant savings, especially if you’re starting or expanding a practice.

“Imagine you’re just starting out and you don’t have a visual field machine,” Coles says. “Are you going to want to spend $30,000 or $3,000? It’s a huge price difference to get the same result. If you’re a multi-doctor practice, you will want to buy two of these. It’s a Captain Obvious moment.”

Using VisuALL for Glaucoma testing alone, Lagunas says his practice saw a return on its investment in the first year, outperforming some of the other technology in his office. However, he says the patient experience the device provides is priceless. “It’s just a wow factor that we can give our patients,” he says. “They can’t believe how cool the technology is. So in that respect, it paid for itself right away.”

If you’re interested in learning more about how a virtual reality platform can help your practice, click here or reach out to your local Marco Area Manager.

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