Tag: trs

Efficiencies In The Refraction Process Improve Entire Patient Experience – And Sales – An Article From Women in Optometry

Original Article Published in Women in Optometry
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The refraction process has long been the “least favorite part of the exam for Loretta Seraly, OD, of Seraly Eye Care Associates in McMurray, Pennsylvania. After injuring her shoulder in a fall, the process became painful as well as dreary. “I would trade almost anything to not have to do the refraction,” she says, and when she heard that the Marco TRS-6100 automated refraction system could bring efficiencies and physical relief, she purchased one for each of two exam lanes and then added a third later.

The shift brought joy to her and her patients. “It’s much more enjoyable, and it’s faster. When she comes into the exam room, the pretest data has been transferred into the electronic medical record and she loves to show patients with a push of a button how the prescription today differs from the one that they’re currently wearing.

“I can choose whether I want to start with the new refraction or the patients’ old glasses. Then I can show them the improvement. It helps us avoid trying to answer that common question: ‘Do I need new glasses?’”

Dr. Seraly calls herself a low-key salesperson. “I’m not pushy, but we do have to sell ourselves. This feature lets patients determine if the 0.25D change is worth their time, money or energy. But I will always remind them that we have stylish frames, and a second pair or backup pair is a great option, too,” she says. Having no lag time between the before-and-after comparison does encourage many patients to opt for new eyewear.

REFRACTIONS IN THREE MINUTES OR LESS

Patients don’t like the traditional refraction process any more than she does. They worry about giving the wrong answer that might saddle them with eyeglasses that don’t work well for them. But the addition of this technology has improved her whole practice flow.

“Our goal is to provide the best patient experience – and that means efficiency. We aim to have patients greeted and through pretesting within 15 minutes of their arrival,” she says. This includes autorefraction, topography when called for, an optomap image and an OCT. Then the refraction and anterior segment evaluation and other elements of a comprehensive exam is another 15 minutes. She’ll instill dilating drops if needed.

She also likes the split prism function of the TRS-6100, which allows her to check astigmatism and show the patient simultaneous comparisons so that they can look at the right and left images and tell her which one is clear. It’s helpful in fine-tuning the prescription.

Most patients are done with the evaluation within 25 to 30 minutes of their arrival. “If doctors do not get the exam elements done in that time, patients are fatigued, and sales go down.”

More importantly, patients feel respected when the practice staff make their experience efficient. “It’s not about making money; it’s about serving the patient. They feel heard and appreciate our acknowledgement that their time is valuable.”

Dr. Seraly alerts opticians when she’s finishing the refraction. “By the time I’m done with the anterior segment exam, the optician will be in the room, and I can relay precisely what my recommendation are. I might say, ‘The patient has a high degree of near sightedness, so we discussed high-index lenses,’ for example. Introducing the patient to the optician and sharing a little information about them increases their satisfaction,” she says. The opticians will escort any patients who are dilated during this time back to the exam room after selecting eyewear. “Almost every patient is in and out of the office within 45 minutes to an hour. That drive sales and patient satisfaction.”

A LITTLE DISTANCE

TRS refraction system
Dr. Seraly can use the console in the hallway outside the exam room, allowing her to stand and creating a little distance during the refraction.
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Dr. Seraly purchased her first two Marco TRS-6100 systems in December 2019, with no real inkling of an upcoming pandemic. “When March 2020 rolled around, I realized that I was able to leave the room and conduct the refraction. I placed the controller outside the door, so I could step into the hallway and tell the patient he or she could pull down their mask for this part of the exam,” she says.

In fact, she still does it this way for a few reasons. First, it gives her the opportunity to stand up for a few moments. But more importantly, the practice is mask-optional and there are patients who prefer to wear masks. “They appreciate that I’ll step away and they can pull down their mask more comfortably. It also avoids fogging the equipment, which can add time to the process.”

At this point, Dr. Seraly conducts the refraction process still. “I’ve cut the most disliked part of my day down to nearly half of what it used to be,” she says. She has also gained so much confidence in the system that if she choses to delegate that process to a technician, she says that would add even more efficiency because she would simply review the findings.

Cambodia-Bound

Dr. Loretta Seraly will be heading to Cambodia this winter, joining a mission group, facilitated through the international Red Cross and founded to distribute wheelchairs to people in Vietnam and Cambodia. This will be her second trip with this group, having gone to Vietnam in 2019. “It’s such a cool thing to be able to experience this kind of mission trip and explore the world,” she says. She’s the only OD, but the group sees about 500 patients during the days she is there. She’ll be traveling with new eyeglasses that she acquired from donations of discontinued lines. “I bought 500 sunglasses, and we have single vision lenses from +4.00D to -6.00D with us. To see someone’s eyes literally open wide when they can see the world around them is so gratifying.”

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Make Exams Faster and Easier

Rachel Tellez, OD, has been with Vision Source® since she started her career as an associate OD at one of the very first Vision Source practices in the San Antonio, Texas, area in 1990. Once she became a part of the Vision Source community, she says, it stuck with her, so when she opened her own location in 2003, she took advantage of all the benefits of membership for her new startup practice.

Since then, Dr. Tellez has moved her office into a newer location just a few hundred feet away, seen patients grow and bring in children of their own and added an associate OD. Something that has continually aided the practice’s growth, she says, has been the Marco technologies that bring efficiencies to the exam process.

For the first almost 30 years of her career, Dr. Tellez utilized an old-fashioned, bulky phoropter that required her to spend much of her days with her arms outstretched, spinning dials. Dr. Tellez—a regular at physical therapy with two bad shoulders— read about a piece of updated tech in an earlier issue of Vision Source OD magazine. A visit to The Exchange® in 2016, held in her hometown that year, solidified her decision to update her lanes with the Marco TRS-6100 Automated Refraction System with Infinity Remote Software.

“I only updated one lane and kept the old phoropter around in case we ever needed it,” Dr. Tellez says. “It didn’t take me long before I realized we needed the same equipment in our other two lanes. I was never going back.” Rather than relegating her other exam lanes to second-tier status because she didn’t want to use them, she added the Marco equipment to both. The advantages were immediate.

The wow factor

Patients who have been seeing Dr. Tellez for years are able to experience some of the high-tech instrumentation. Every patient sits at the Marco TRS, so they all appreciate the change from the stress of having to answer questions about clarity of numbers.

Faster refractions

With the process of obtaining the refractive correction more quickly, Dr. Tellez and the patient have more time to talk about other ocular health issues, the need for backup eyewear, dry eye treatments or other concerns the patient may have. Or the patient is able to get into the optical area faster to pick out their new eyewear.

More data, more quickly. With the OPD-Scan III Wavefront Aberrometer and the VisuALL virtual reality visual field perimeter, Dr. Tellez 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. She easily can find results that are automatically saved onto a data card and then transferred into the TRS. “We don’t have to input the data manually, which increases accuracy and definitely saves time,” she says.

Patient choice

It’s challenging or any doctor to determine whether a small refractive change means that the patient “needs” new eyeglasses. The OPD screen features side-by-side comparisons so patients can compare their current prescription to the one she derived that day. This puts the decision on whether new eyewear is worth it in the patient’s hands. Even small refractive changes can make a big difference to some patients, and if they decide that’s the case, they feel great about buying new eyewear.

Short learning curve

Dr. Tellez says that technology mastery is not one of her strongest suits, but within 15 minutes of sitting down with her Marco representative, she felt confident with the technology and
what it could do. Patients also appreciate how easy it is.

Goodbye, shoulder pain

Dr. Tellez can operate the autorefraction system by tabletop console, so she can relax her body. The shoulder pain that bothered her has completely disappeared, she says.

Advanced technology not only makes patients more confident in the care they receive, Dr. Tellez says, but it also ensures she is giving her patients the most appropriate options. “These patients are getting a more in-depth exam, and it’s easier on me and my team,” Dr. Tellez says.

Hearing about the experiences that her colleagues have had with products and technologies from Elite vendors like Marco gave Dr. Tellez the push she needed to learn more. She’s grateful she listened and cannot imagine still practicing the way she did just a few years ago.

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

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The Right Exam Lane Technology Can Make The Day Easier – And More Fun – An Article From Women in Optometry

Original Article Published in Women in Optometry
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Karen Wrigley, OD, with two practices, Wrigley Eye Associates and Visual Eyes, in the Philadelphia, Pennsylvania, area, has always tried to keep her practices updated with the latest technology. Yet when she brought in new exam lane equipment from Marco recently, she was impressed by not only how it sped up the refraction and exam process but also by how much patients are enjoying the experience.

Dr. Wrigley originally added an OPD-Scan III, and a Marco TRS automated refraction system to one of her two exam lanes in each office. She added a second TRS and a new slit lamp with the ION camera in June of this year. In the pretest area, technicians can capture wavefront aberrometry, topography and keratometry, among other features, with the OPD-Scan III. This data provides the doctors with more information about the surface of the patient’s eye before they are even in the exam room, which is particularly helpful with specialty lens fittings. Now, those patients with complex fitting needs can receive even more customized contact lens prescription, helping them see and feel better. The updated slit lamp has also allowed for a more precise patient examination.

WOW THE PATIENTS

Dr. Wrigley’s office serves as an internship site, and she says that while the manual phoropter provided interns a good learning experience, it was outdated and more difficult. It’s ergonomically stressful for the user, and the process can be stressful for the patients.

“If we’re going to update our technology, let’s wow our patients,” Dr. Wrigley says. The new slit lamps have updated camera software so that Dr. Wrigley and her team can show patients their images right there in the exam room. Plus, the new TRS technology lets doctors use a tabletop console to sit a distance back from the patient, supporting social distancing, which puts both parties more at ease.

The TRS and OPD systems in her two offices have created more efficiency while allowing the doctors to provide even better care to their patients. Dr. Wrigley has been able to minimize downtime in exam lanes, thanks to the updated technology in her offices. She or her technicians can complete the refraction faster, and she gains the measurements she needs accurately.

Leveraging her Vision Source member benefits, Marco brings doctors the “best bang for their buck” on upfront costs, lease programs and technical support, she says. Marco’s support is stellar; technician assistants will fix equipment on-site or remotely, which has also helped save the practice time and avoid downtime as, in many cases, they no longer have to ship equipment out for repairs or updates. She also appreciates that her representative is just a phone call away for pricing, advice, support and tech questions.

Dr. Wrigley has seen a positive return on investment and the intangible benefit of happier customers with the Marco systems. “Our vision statement at the practice is helping patients see well and look great. The new technology has helped us achieve this,” Dr. Wrigley says. “My goal is to always keep up and push forward.” She says her patients have even noticed the office updates. Those who have jumped to another practice for their eye care often come back to her because “they know we keep up with the latest and greatest in the industry,” she says. “It is so nice that they see what I’m trying to provide for them.”

Dr. Wrigley has been able to prioritize the best care for her patients without it burdening her team or herself; in fact, it actually makes her days easier.

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Post-Pandemic Safety Concerns Prompted Purchases That Have Yielded Far More Benefits – An Article From Women in Optometry

Original Article Published in Women in Optometry
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Like every doctor who purchased a practice in mid-2019, Nyssa d’Hedouville, OD, could not have anticipated that just seven months in the future, the COVID-19 pandemic would force her to close Mashpee Vision Care, the Mashpee, Massachusetts practice she acquired, for two-and-a-half months. But she sees some positive developments that came out of that time. “I updated every area of the practice while we were closed to routine patient care,” she says.

While the practice did have a visual field analyzer and older optical coherence tomography equipment, she wanted a higher-tech experience for her patients.

She added Marco diagnostic and lane equipment, include the TRS 6100 automated refraction system, the OPD-Scan III and iON imaging system. The advanced technology has been a benefit in a number of ways.

First, it has sped up the time it takes to get an accurate refraction. “The technician measures the patient’s current eyewear in the lensmeter and performs an OPD scan. That is all uploaded into the TRS when I come into the exam room,” she says. Patients love not being asked the old “1 or 2” question, and she sees an immense benefit to being able to toggle back and forth between their previous prescription and the new one. “Patients are much more likely to purchase new eyeglasses if they understand what the difference in their vision is going to be. It’s much faster than dialing the prescriptions in and going back and forth,” she says.

The simulator that generates a depiction of the patient’s visual acuity is great for patients – and parents of young patients. “I had a young man who came in with his father. The patient had been diagnosed with keratoconus and could not achieve clear vision with eyewear. I was able to use the simulator to show his father how higher order aberrations made his son’s vision so poor. Suddenly, the father understood why getting the son fit with specialty contact lenses became imperative. Because I had those measurements ahead of time, I could save time, instead of repeating what had happened so often before when doctors were unable to get him seeing clearly with eyeglasses.” Similarly, that strategy works well for parents of young children, too.

Best of all, she can conduct her exam with just as much personal attention – but at a great distance with the TRS and iON. “I’m able to sit further away than I could during earlier slit lamp examinations. Plus, it’s great for patient education,” she says. She can share the images with the patient and explain what she’s looking at, whether that’s blepharitis, dry eye, nevi or lid lesions. “It’s so much easier for the patient to understand what we can see when they look at the image. It helps show the value of what we do, especially when we can use the first day’s measures as a baseline and then show them the effectiveness of the treatment.”

Just as important as the physical distance – the feature that most attracted her when she was able to start welcoming patients back into the office – is the patient education aspect. The result is increased face time, where she’s talking directly to the patient about a refractive or ocular health issue.

The diagnostic instruments also provide her with a better idea of what she’s facing. For example, the patient may have said nothing about dry eye symptoms, but the OPD-Scan III data indicates that the patient might have dry eye. “So often, when I tease out whether the patients have symptoms, they tell me that they do, but they did not think it was significant or that I could do anything about it.”

Finally, the data from the TRS is uploaded directly into her electronic medical record, which means she doesn’t have to worry about transposition errors.

As these benefits revealed themselves, they reinforced the value of bringing this equipment it. “As business owners, we’re always worried about our return on investments. But rather than ask whether it’s something you can afford, take a look at how it can affect your practice. For me, this technology has halved the amount of time I need to do a refractive exam. My technician has already gathered good data, and I can finish that portion of the exam more quickly. The patient can see whether the new eyewear would help, so it has resulted in more sales and a higher capture rate,” she says.

“I got it because I was worried that I wasn’t going to be able to open without having this technology. But now I enjoy it for all the other benefits it brings.”

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Two Equipment Additions Provide OD With Efficiencies, More Data And Patient Wow Factor

Original Article Published in Women in Optometry
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After being shut down for two months at the start of the COVID-19 pandemic, Melissa Richard, OD, wanted to make some changes at Spectrum Vision Care in Chalfont, Pennsylvania, the practice she opened in March 2016.

Her first step was to furnish a second exam lane, which would allow her to bring on a second contact lens specialist one afternoon a week to help accommodate the growing patient load. She had her eyes on the Marco TRS automated refraction system, and the built-in social distancing features made it an obvious fit.

She moved her manual phoropter to her new second lane, but the Marco lane is by far her preferred exam room. “I use that second room more for medical services and consults,” she says. She wanted Marco anyway because that was the system she used in her previous setting and was already “sold” on its quality and benefits, “and it’ made a lot of sense coming back after COVID-19,” she says. “It’s faster, and I can hit one button that allows patients to compare what today’s prescription looks like compared to what their current prescription is. It’s been really great for sales of eyeglasses,” she says. Without having to dial in the changes and have patients try to compare those, “this feature provides an instant ‘oh wow’ from my patients,” she says.

However, the added benefit of being able to conduct this refraction process from a distance made her and her patients feel much more comfortable. “I can operate the TRS from six feet away, and patients love that.”

A SECOND UPGRADE

At the same time that she was making these changes in the summer of 2021, she also added the Phoenix Meibography Station from Marco. The unit has a topography workstation, and she wanted a topographer to help provide additional clinical data to her contact lens specialist. But she quickly realized that the Phoenix would help her with the dry eye patient management, too. “I remember thinking that the Phoenix dry eye module would be great once I could start my dry eye patients back,” she says.

The Phoenix provides her with a dynamic view of non-invasive tear film break-up time with tear meniscus height imaging and measurement. She can image the tear film dynamics as a video, too.

Dr. Richard began to realize how much more prevalent dry eye signs and symptoms were once she started screening all of her patients with the neurolens lifestyle questionnaire. “There’s a question on dry eye in there, and if dry eye is a patient’s primary issue, we will bring that patient back in for dry eye testing,” she says.

“Patients don’t always tell me about their dry eye symptoms unless we specifically ask,” she says. The lifestyle questionnaire has them grade their dry eye signs on a scale of 1 to 5. “If it’s a 3, 4 or 5, I’d call that significant,” she says.

As a result, she’s seeing about a three-fold increase in Meibomian gland dysfunction and blepharitis, much of it due to increased screen time and mask-wearing, as well as more chalazion and stye. “We’re able to do infrared meibography and start addressing tear volume,” she says.

She shares the report from the Phoenix, which “validates for the patient what they’re feeling and helps monitor improvement,” she says. It also helps improve compliance and patients’ willingness to return when they can see objective improvement that coincides with how much better they’re feeling.

EFFICIENCIES

Dr. Richard says that her Marco technology has added efficiency to her practice. The Phoenix Meibography Station with a topography workstation is in the pretesting area while the TRS is in the exam lane. Because the TRS is linked to her practice management system, there are fewer transcription errors and fast transmission of the results to whomever needs them. “Patients are impressed with the technology. I’d say that the TRS 6100 is the patient favorite,” she says.

That could be because nearly every patient interacts with it, unlike advanced equipment used to detect and monitor ocular diseases. Plus, patients love that they can skip the “1 or 2” questions that adds stress for so many.

Dr. Richard became a Vision Source® member when she opened, noting that the buying power helped her stretch her opening budget.

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Refraction System Provides Efficiency, Accuracy And A Little Distance – An Article From Women in Optometry

Original Article Published in Women in Optometry
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When Monica Brown, OD, purchased Baymeadows Vision Center in Jacksonville, Florida, one of the two exam rooms had a TRS refraction system from Marco, while the second had a manual phoropter. “I kept the manual for a while because I do a lot of orthoptics, and I was comfortable with the process. I didn’t know if the TRS would do it as well.” Dr. Brown earned a master’s degree in orthoptics before attending optometry school.

However, the more she worked with the TRS system, the more she learned that she could use it for prism and binocular testing, as well as, if not better than, the manual system. Nearly three years after she bought the practice, she converted her second lane to include a TRS system, too.

She has found that adding the second automated refraction system helped her improve her efficiency, in large part because it allows her to look over other pretesting data and enter information into the chart from the patient’s history. “Patients have the wow factor while they’re going through this very easy refraction, and I am minutes ahead in my data collection and entry,” she says.

During her practice remodel in October, she also added the TruVue viewing system. “It’s a digital screen, and the clarity is unbelievable.”

For the past year, the added efficiency and speed, as well as the increased sales that result from using this system, “have been a godsend. Patients love seeing how clearly they would see with new eyeglasses. Even if it’s just an axis change, many patients can see the difference. And when I show them, saying, ‘Here’s how you could see with today’s new prescription,’ the majority say, ‘I want that.’”

PHYSICAL DISTANCE

Even as restrictions on physical distancing are lifted in some settings, providers and patients still expect and want some physical distance in a medical setting. “With the TRS, I’m not right there in the patient’s face for the whole exam. I’m at my desk; they’re in the chair. I barely have to get behind the slit lamp with the data I’m able to obtain now.”

OPD INSIGHTS

Adding the OPD-Scan III into the workup room routine has saved her even more time. The technicians run the process, and with the push of a button, that information is transferred to the exam lane. “I can show patients an unusual topography or tear film deficiency. It provides us with a quick and understandable explanation for why we might not get the vision to 20/20,” she says. Regularly, it saves her time because the OPD-Scan shows her a higher order aberration or other data point that will impact the final prescription. “I can explain to patients why, no matter how much we tweak the prescription, we are not going to be able to achieve 20/20,” she says.

For patients with tear film deficiency, however, she can also help them understand why compliance with a dry eye regimen she provides can help address their comfort and vision. Plus, on subsequent visits, she can compare the results from the most recent OPD-Scan.

Having the data on hand can help her describe her patient’s visual symptoms sometimes even before they do. “I might say, ‘Is this what you see at night?’ They are surprised and often tell me that I’m describing their exact experience,” another “wow” experience for those patients.

By staying current with technology, she meets the goals of her mission statement: to provide each and every patient a lifetime of healthy vision through superior comprehensive eye care thereby enhancing their quality of life.

ERGONOMIC BENEFITS

Dr. Monica Brown wants to avoid the physical pains that some ODs experience, so she has incorporated ergonomic features like a stand-up desk when she remodeled the practice. Her Marco TRS refraction system has also been helpful. “I can operate the console, and I don’t have to reach my arms up. I try to keep my elbows at my side as much as possible,” she says.

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Spend Money To Make Money – An Article From Women in Optometry

Original Article Published in Women in Optometry
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Shonda Achord, OD, of Achord Eye Clinic in Baton Rouge, Louisiana, hasn’t looked back since switching to the Marco Diagnostic Solutions TRS Refraction System. While she had already outgrown paper charts, she still found the switch expedited the whole process. “I can’t imagine the practice without it,” she says. The five-lane practice has a TRS in two lanes where Dr. Achord works, and her associates use the other lanes but can rotate through these two in her absence.

When she first brought in the TRS Refraction System, she found the refraction process to be so much faster that she felt her whole day could be restructured. “I felt like I could do four to five more exams per day—even before I added the OPD-Scan III wavefront aberrometer,” she says. “It’s just that efficient.” She has also found that with great technology comes a great reputation. “Patients were really impressed with it… so all that plays into the practice’s reputation. The wow factor is present, too. Patients always comment on it.”

GROWING, GROWING, GROWN
Part of Dr. Achord’s growth is attributed to an expansion she undertook. “I went from 1,600 square feet to 3,750 square feet, and I already wish I had more space,” she says. The practice has three doctors—Dr. Achord and two associates. While there are only two of them at a time there daily, the five exam lanes plus workup room/exam lane are always in use. She has seen a major change in patient flow already, with 30 percent of her patients currently being new to the practice. “I couldn’t do that before because we didn’t have the space or capacity for more patients,” she says. Despite her initial reluctance to move to a larger space, the lesson is the same one she passes on to doctors about equipment and technology: “If you don’t spend money, you won’t make more.”

“When I first added Marco technology, growth was the point,” she says. “Being able to fit in more patients and do it well was what I wanted. Now my goal is efficiency. I’m not trying to see a huge number of patients per day, but it frees up time that I can use in conversation and communication.”

Patients prefer it, too. “Refractions make people nervous,” says Dr. Achord. “When I have to dial it into a manual phoropter, it’s not as impressive as showing them their earlier prescription and the new one with the push of a button.” She has found that patients being able to see the differences for themselves has translated into the sale of more eyewear. “I didn’t like being the one to say, ‘Well, it changed this much so you should get new eyeglasses.’ If the Rx change didn’t make enough of a difference to them but I had told them they should buy new eyewear, then they may not trust me as much.” With the new system, Dr. Achord and her associates are able to let the patient decide for themselves with all the information in hand. Dr. Achord also has found few to no transcription errors, which has led to fewer remakes of eyeglasses.

The new system has proven to be useful in making up for closings and reduced volume during the pandemic. “We want to get patients in and out as fast as we can,” she says. At the same time, “We have to see people and catch up for the time we were closed, so we have to be efficient.” When it comes to the OPD, Dr. Achord praises its efficiency in helping her assess the issue. “It gives us topography, so right away I can see if there’s a reason that the patient might not achieve 20/20,” she says. “It’s an amazing instrument, and it saves me and the patient time and frustration.” She finds that the more information she has, the better she can advise the patient moving forward. “I can explain that the topography shows what issues we can’t overcome easily and what the options and/or compromises might be.”

She’s happy to share with her colleagues inside and outside of the Vision Source network how much more efficient the Marco technology has made her practice, and she emphasizes how even small time-savings with each patient add up. “I feel like if you don’t invest back in the practice, it’s not going to be successful.”

Ergonomic Benefits
For herself and her future well-being, Dr. Shonda Achord is also thankful she added the TRS Refraction System. “I’m only 5’3”, and I would rest my wrists and hands on the top of the manual phoropter because my arms got so tired,” she says. “I developed pleurisy, and it would hurt to breathe. My doctor asked if I did exercises that kept my arms and shoulders up—but it was my work.” She also notes that the new autorefraction system allows her to sit more throughout the day rather than standing all day like she was before. Another perk? “In the days of pandemic and flu, I’m five to six feet away from people,” using the tabletop controller.

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Replicate A Model That Works – An Article From Women in Optometry

Original Article Published in Women in Optometry
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Dora Sudarsky, OD, had been considering the right time to equip a second exam room at her practice, Chroma Optics, in Burlington, Vermont. Her son will be graduating from optometry school in May 2021 and will join her in the office, so she knew the change was on the horizon. “I knew I needed to add another lane, and with COVID, I decided now was the time to do it,” Dr. Sudarsky says. She added a second TRS system from Marco as well as the ION slit lamp earlier this year, and working between two systems is allowing her to be more efficient seeing patients. She can alternate from room to room, which leaves more time for cleaning between each visitor. “It’s been awesome.”

TECHNOLOGY IS A TOP PRIORITY

Dr. Sudarsky opened the practice in 2015, renovating and redesigning the space that was a former video store. She did most of the interior design and decorating herself to allot more of her funds to her instrumentation. Marco was on her wishlist from the start, and she opened her doors with one TRS system and the OPD III in her pretesting area. “The OPD III was above and beyond what anybody else had, and that was a big appeal,” she recalls.

Many patients followed Dr. Sudarsky from the optical where she had previously offered her optometry services, and in that space, she did not have any advanced technology. So the impression on patients has been huge and continues to be when new patients come to her office. “They tell me they’ve never seen so much technology, and while it may not all be brand-new, not every eye care practitioners embraces it the way that I have.” She recalls as she was preparing to open the practice that a colleague told her to wait and add automated refraction technology in five years. “I wanted to have it now so patients would tell their friends; that word of mouth makes a huge difference,” she says. “Some people say that they can’t afford to do it, but I say you can’t afford not to.”

BENEFITS FOR PATIENTS AND PRACTICE

Dr. Sudarsky says the staff adapted well to learning how to use the technology from Marco, and the data transfers automatically to her exam rooms so she can discuss the results with patients. “One of the things I love about the TRS system is that it’s a lot easier on my body—doctors don’t always think about that,” she says of the repetitive movement of traditional refracting. After experience her new, upgraded TRS in the second exam lane, Dr. Sudarsky is a fan of the improvements Marco has made, such as a bigger touch screen and even more intuitive software. It’s easier for her, but the experience is also simplified for patients. “Being able to press a button and show their old prescription vs. new prescription has a big impact, and I do think it has helped with upgrading and updating eyeglasses,” she adds.

The new ION Slit lamp in her exam room has become a great patient education tool in just a few months. “I can take pictures, put them on my computer screen and share with the patients.” Dr. Sudarsky was recently recommending a switch to wear daily disposable contact lenses to a patient. “I was trying to convince her, and with the picture, I could show her that her current contact lenses were dirty, even when she said they were clean. A picture is worth a thousand words.”

The OPD III has been a great asset for fitting contact lenses, and in particular, multifocal contact lenses. “It has a lot of great tools,” Dr. Sudarsky says. “I can tell if the patient’s visual axis is not the same as the center of the pupil, and I will know if multifocal contact lenses will work for them or not.” That can save her and the patient some frustration, especially compared to a system where she may have tried multiple lenses before reaching this conclusion.

Dr. Sudarsky says her efficiency has improved working with this technology, and she’s able to spend more time with each patient. “I have fewer remakes and better refractions,” she says. “I wonder how I practiced before it.”

Dr. Sudarsky didn’t know any colleagues who had technology from Marco when she took the leap, so she’s relied on the support of its team who have helped her with any question or issue that arises. She’s particularly thankful to her Marco support representative, who is a master at the OPD III and who helped Dr. Sudarsky understand how to utilize the many features and functions that the instrumentation has to offer. “They are just a text away and always willing to help,” she says.

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High-Tech Exam At A Personable But Appropriate Distance – An Article From Women in Optometry

Original Article Published in Women in Optometry
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When Patricia Haller, OD, added Marco technology to her Chillicothe, Ohio, practice in 2015, physical distancing was not even a thought. But when she closed her office to routine care for four weeks during the stay-home orders in the state, she realized how this same technology allowed her to see emergency and urgent cases and still maintain some distance. Dr. Haller’s practice reopened at a lighter schedule to routine eye care in early May. She discovered that Marco was a “hidden gem” in the post-COVID era.

REFRACTIONS AT A DISTANCE

With the tabletop controller for her Marco 5100, she is able to conduct her refractions and sit about six feet away from the patients. “It’s also very easy to sterilize because all mechanisms are housed inside, so we wipe down the exterior casing without worrying,” she says.

She already knew its value. “I purchased my first TRS in 2015 when I built the new office. I left a manual phoropter in one of my exam lanes,” she says. However, she quickly realized she didn’t want to use that room for patient exams. So now she has three units—one in each exam lane.

“It helps to keep the process streamlined. I can control the speed at which the refraction takes place,” she says—an even more important factor in the post-COVID opening. “We want patients moving through the office efficiently so that we do not have any backup in the reception area. With the TRS, it’s quick to arrive at a final refraction, and patients can see and justify their decision to buy new eyewear.”

READY TO BUY

That’s helpful because every practice is faced now with trying to make up time and lost revenue from being closed to routine care. Happily for her, she says that patients are returning, ready and eager to buy. “I was prepared for the fact that patients might not be ready to make purchases. The staff and I discussed ways in which we could help patients with their essential needs if their finances were tight,” she says. She’s not finding that to be a hindrance, however.

“They’re excited to be back and have been updating their prescription eyewear without any of the hesitation I thought that we’d see.” Dr. Haller says that it is helpful that patients can see the steps that she and the staff members are taking to keep the practice and optical clean and sanitized. “We have a UVC wand that we are using to sterilize every frame that a patient tries on before those frames are placed back on the boards. We used to wipe down our frames on a regular basis, but now they’re sterilized.”

The practice staff works on maintaining physical distancing, and opticians are masked. Patients who don’t wear a mask are offered one—and patients who would like to wait before coming in are rescheduled.

UNEXPECTED SURPRISE WITH iON

Dr. Haller added the iON imaging system to her slit lamps, allowing her to take an anterior segment image and immediately pull it up on the computer screen. She can pivot the screen toward the patient or toward an attending family member so that she can explain what she’s seeing.“I purchased the iON because I thought it would be terrific to do anterior segment documentation in the exam room where I could enhance details. The unexpected surprise is the physical distancing that I gain with this—while still providing patients with a comprehensive exam,” she says.

Dr. Haller uses Marco’s autolensmeter and autorefractor, appreciating how quickly information can be downloaded into the electronic health record. “Even before the patient is escorted to the optical, the opticians already know the lens designs and recommendations,” she says.

She knew the equipment she has been purchasing would bring her speed, accuracy and efficiency. “But the help it provides in this time is something no one could have foreseen,” she says. The combination of a high-tech, highly efficient exam process and the sanitization and safety protocols that are on display are raising the likelihood that patients are talking about the practice to their friends. “Patients are saying, ‘I had my exam there, and it’s safe to go in.’”

That feedback makes Dr. Haller happy. She says that she missed her patients. “Nothing replaces that feeling of seeing the smile on a patient’s face, knowing that you helped. It’s been challenging, as I’m a hand-shaker and hugger, but we’re managing. It’s great to see my patients back.”

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TRS-5100: A Win-Win

In using a manual refractor, I was facing two major and increasingly burdensome challenges. First, the technology was simply outdated compared to all the other technology I have in my practice, such as the OPD-Scan III (Marco), digital retinal photography, OCT, osmolarity testing, Visioffice, and my EMR system. Simply put, the refractor did not complement the level of care and patient experience I was providing throughout the rest of the examination and beyond, including the various touch points I have with patients through electronic media.

The second major challenge I faced was the inefficiency associated with manual refraction. I work just 3 days a week, so I need to maximize efficiencies to best serve my patients and my practice. The several extra minutes it takes for a traditional refraction really adds up, especially in a practice with patient volume averaging about 15 to 20 patients per day. I would prefer to spend that valuable time educating patients and making recommendations about eyewear and ocular health.

I reviewed auto-refractor systems from other companies, but I ultimately went with Marco’s digital technology because of their established success and consistency. Further, I received many strong recommendations from other doctors who successfully use Marco refractive technology in their own practices.

My selection of the TRS-5100 has proven successful in addressing my issues of compatibility, consistency, and efficiency. The system has improved the overall efficiency of the practice, and its compatibility with the OPD-Scan III wavefront aberrometer has proven to be invaluable. Combined and integrated with the OPD-Scan III, the TRS-5100 gives me a much better idea of a patient’s likelihood of achieving 20/20 vision, and a far more comprehensive picture of the patient’s complete optical pathway.

The OPD system delivers a statistical indicator (RMS, or root mean square), which gives the practitioner an idea of potential best-corrected outcome. This statistic is obtained via aberration measurements, topography, pupil sizes, and day and night refraction differences, among other data points. As a result, I know about how long I should spend refracting my patient with the TRS if his potential visual outcome is limited. I generally save several minutes per patient, and several minutes more on patients with more complex refractive errors (i.e., patients with moderate to advanced cataracts and corneal irregularities).

Positive Staff and Doctor Impact
My staff quickly embraced the system. They appreciate its ability to free them up for other tasks. The automated data transfer through the IC card-loading system minimizes staff involvement, as the patient’s refractive data is loaded onto a data card in the pre-test area, and the card is inserted into the TRS module in the exam lane, loading all data instantaneously. Staff members no longer have to enter refractive data, which saves time and reduces costly transcription errors.

As for myself, I really appreciate the system’s customizable ergonomic preferences. Although I see patients only three days per week, the upper shoulder and back strain I suffered prior to acquiring the TRS-5100 was nearly
constant. I’m sure other ODs who have used manual refractors can relate. Today, I have far less upper shoulder pain and back issues, thanks to the system’s ergonomics — ergonomics that may actually lengthen my career.

Positive Patient Response
The patient response to the new system has been overwhelmingly positive, both within and outside our practice. New patients and those unfamiliar with the system hear the TRS-5100 uploading data as they sit in the exam chair and are excited to see how it works, even before I start refracting. Patients who pay attention to medical technology can immediately appreciate how advanced our practice is compared to others.

Indeed, the system provides a true wow factor with patients. The TRS-5100 allows for a one-touch comparison of the patient’s current eyeglass prescription with the new prescription. Patients can immediately see for
themselves — in vivid detail — the impact of updating their prescription. While the previous processes left a fair number of patients uncertain about whether or not to purchase new eyewear — even with doctors’ recommendations — the TRS gives them far more confidence in their purchasing decisions, and applies more value to our practice.

Outside the office, my practice is enjoying many more positive online reviews, and our online referral stats are up by about 100% compared to the year prior, when we didn’t have the TRS. In addition, the comments from patient surveys now cite our technology, our professionalism, and the comprehensive, thorough nature of our eye exams as positive attributes in the patient experience.

Positive Financial Impact
In all honesty, except for the refraction, our exam flow hasn’t changed dramatically, so the transition was painless. I believe it’s the additional time I get to spend with and educate patients — enabled by the automation of the TRS-5100 — that is responsible for the favorable patient impressions. Thanks to this technology, I have more time to prescribe and recommend eyewear and contact lenses, and discuss treatment plans and general eye health with patients. All of this, of course, benefits our practice’s bottom line. Revenues-per-patient are already up about $50 over the previous year, and our capture rate in optical is up 10% since purchasing the TRS-5100. This automation further delivers a reduction in manual transcription errors and the cost of prescription remakes.

Bottom Line
With respect to improving exam flow efficiency and patient care, competitive standing among local optometry practices, and practice profitability, there’s simply no reason not to consider improving your practice with the TRS-5100. We are told to make purchasing decisions based on the goals of enhancing data, knowledge, profitability, and our care of patients. Marco’s TRS-5100 not only helps us meet all of these goals, it also makes our workday easier and far more pleasant. It’s a win-win for ODs and patients.

– Gina Wesley, OD, owns and operates Complete Eye Care of Medina, Medina, MN.

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