Tag: trs

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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With Marco, You’re Guaranteed to Succeed

Our 67-year-old Tennessee practice, Vision Source of Newport, recently opened a 9,500-square-foot facility, operating with three physicians and 18 staff members. We see roughly 350 patients each week, and we’re well on our way toward reaching our goal of becoming a $2 million practice. For the past 5 years, we’ve been using an OPD-Scan III integrated aberrometer and three TRS-5100 digital refractors in our office. Both have greatly contributed to our success.

Easier on Patients and Optometrists
As an optometrist, what’s good for my patients is also good for me. I can hit two buttons on the TRS-5100 and seamlessly compare their current refraction to their previous prescription. It makes it much easier to show the patient the difference, which increases Rx satisfaction and eyewear sales. In particular, the “night vision” refraction feature is helpful; I always perform this test on patients who complain that they just can’t see well at night. With only one machine, the OPD-Scan III, we can measure higher-order aberrations, detect corneal dystrophies and degenerations, show patients their cataracts, use images to explain why they’re having trouble seeing at night — and even find a floater. Also, the ability to measure phorias and tropias (both horizontal and vertical) in 0.1 steps using the TRS-5100 system helps uncover problems that manual refraction cannot catch. It is amazing how a vertical heterophoria even as low as 0.5 diopters can cause severe issues, especially in children and others still in school. I prescribe eyeglasses for these patients and refer them to our vision therapy specialist. This technology truly sets us apart from other offices.

Increased Efficiency
As someone who travels and lectures throughout the United States, being efficient in the office means a great deal to me. Between working with the OPD-Scan III
and the TRS-5100, I simply don’t have the words to describe how much efficiency has improved since we implemented these two technologies. Instead, I’ll let the numbers do the talking: Before I began using the Marco technologies, I was averaging collections of $3,400 per day. Now, with the OPD-Scan III and TRS-5100, I
average $4,500 per day (>32% increase). Utilizing scribes and the Marco technology has resulted in $200,000 more in revenue per year than we were achieving with manual equipment and without a scribe. This does not take into account additional savings from avoiding lens remakes, or the value of patient retention.

Training and Customer Service
One significant perk of purchasing Marco’s technology is that the company can train several members of your team at their Technology Vision Institute, in Jacksonville, FL., by teaching staff how to use the products and about the refraction process, various optometric terms, visual issues, and eyeglass prescription terms (phorias, vergences, binocular testing, etc). Marco also makes online courses available 24/7 to you and your staff.

Guaranteed to Succeed
In summary, Marco’s OPD-Scan III and integrated TRS-5100 provide an amazing array of diagnostic testing that a regular autorefractor does not. They make the patient’s experience easy and enjoyable. The improved efficiency has led to greater profitability, all while delivering educational and emotional “wow” factor for patients. With all this, your practice is guaranteed to succeed.

– Kurt Steele, OD is an optometrist with Vision Source of Newport in Newport, TN.

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Speed and Precision: Marco Helps Bring Both to Your Practice

I first had the opportunity to use Marco autorefractors in the 1990s while serving in the U.S. Army at Fort Jackson, SC. There, I witnessed firsthand how Marco’s technology helped us swiftly and efficiently process the eyecare needs of 100 or more troops on any given day. I also appreciated the ability to transmit data directly to the lab with no need for data entry or writing out prescriptions. Having experienced the benefits of this technology, I knew that I would want the same technology in my own practice one day.

Technology I Can Trust
After completing my 3-year commitment to the Army, I moved to San Antonio and began looking for practice opportunities. I purchased my practice, Stone Oak Vision Source, in 2004 and began outfitting it with Marco’s automated technology as quickly as I could.

I started Stone Oak with one associate; we now have three associates and a staff of 20. We expect to gross more than $3 million this year. To this day, we still run an ARK-1 autorefractor and LM-1200 lensometer in our primary prescreening room, and an AR-510A autorefractor and an LM-1000 lensometer in our secondary prescreening room. Exam rooms 1, 2, and 3 each have an older generation RT-900 autorefractor, while exam room 4 has an RT-2100 autorefractor and exam room 5 has the latest TRS-5100 digital autorefractor that we acquired when we moved into our new building in 2016. Marco technology is clearly a part of the fabric of this practice.

Quick and Accurate
Today, just as when I was in the Army, one of the things I appreciate most about Marco’s technology is how easy it is to quickly and accurately transfer autorefraction and lensometry data. Indeed, I have no doubt this reduces prescription mistakes and remakes. The autorefractors and the lensometers seamlessly network into our phoropters and ExamWRITER software. We use the new manifest-to-old-Rx toggle feature at the end of the refraction to show our patients the difference between their new prescription and their old one. This allows them to more accurately appreciate the change they will see in ways they can understand.

In addition, the ability to transmit data with the touch of a button is a huge time-saver. Anything that can help improve accuracy and efficiency in our clinic is a win for us. In fact, spending less time on data entry and the refraction process as a whole gives us more time to discuss each patient’s condition and the solutions we can offer. For example, it’s easier to get patients on board with multiple pairs of eyeglasses when our doctors have enough time to discuss how each one will meet specific needs, and when patients are able to quickly assess the Rx differences themselves.

The “Wow” Factor
The technology is also a “wow” factor for our patients; they appreciate that our office doesn’t have the same old equipment they’ve seen for decades in other offices. We offer high-tech lenses and diagnostic options throughout our clinic. Performing examinations with anything less than state-of-the-art equipment simply wouldn’t correspond with our mission to deliver high-tech, cutting-edge service.

As fond as I am of our older RT-900s, I am looking to upgrade them to TRS-5100 digital refractors this year. They have served us well these past 14 years, so it almost pains me to let them go. Still, I know exactly where to turn to receive the same high-quality technology that I’ve come to trust for so many years.

– Monica Allison, OD, MBA, FIAO

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