Tag: vision source

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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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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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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“Nearly Instantaneous” ROI on Marco Technology

Claudio Lagunas, OD, is a builder of practices. He has owned nine—with four at one time—but now has just two. One is his established practice in Woodlands, Texas. He and his wife Grisel Lagunas, OD, recently acquired an existing practice in Spring, Texas, when the opportunity was too good not to jump at it.

In order to grow a practice so that it becomes more profitable and efficient, Dr. Lagunas invests in technology. In his practice in Woodlands, there is an OPD3 wavefront system from Marco that he put in nearly 18 years ago. Then about seven years ago, he added the TRS refraction system. “I needed shoulder surgery, and I wanted to be proactive about protecting my other shoulder by being able to sit down and be comfortable versus reaching up and spinning the dial,” he says.

The surgery went well, and he regained full functionality. An associate, he jokes, “commandeered” the one exam lane he had converted to a fully digital system. He had been OK with that because he felt like he was completing exams efficiently with a manual phoropter. But as the doctors are building a new location to move that practice into, “all of our new lanes will be digital with the Marco systems as their quality and durability can’t be matched,” he says.

The six ODs in the larger Woodlands office cover the 50 hours a week that practice is open. In the smaller practice, there are four ODs. Creating efficiency and moving patients through the exam process more quickly result in additional time that patients can spend in the optical and help open the schedule for a few more patient exams.

In addition, the TRS includes what he calls “the money button” — a toggle switch that allows the patient to compare their current prescription with the one derived that day. “Patients can justify the purchase of their new eyewear more easily when they see that there’s a difference. It has increased our multiple pair sales and our capture rate,” he says.

Metrics he needs

What he most appreciates about the OPD-Scan III is its five-in-one functionality and space-saving design. It is an autorefractor, keratometer, pupillometer, corneal topographer and integrated wavefront aberrometer that captures diagnostic measurements in less than 10 seconds per eye.

That helps the doctors determine whether there are aberrations that might make a soft contact lens unsuitable. “Using the wavefront analysis, we can see right away if a soft lens isn’t going to work and can steer the patient to a specialty lens fit,” he says. And then they don’t have to rely on a series of empirical fittings to get to the final fit. “As doctors, we look really good when we can get the specialty lens fi t right from the start,” he says.

Exceeding expectations

For these two pieces of instrumentation, Dr. Lagunas says that the return on investment was “nearly instantaneous.” He justifies that by noting that they make the exams more efficient and quicker, allowing doctors to fit more patients into the day. They minimize transcription or other errors, virtually eliminating remakes due to this kind of mistake. They have helped increase the number of contact lens specialty fits and the capture rate.

With the remote control function now available that can allow doctors to operate the equipment remotely, the implications for being able to “see” patients in other locations or if the doctor is not onsite add to the appeal.

Dr. Lagunas has also added the Olleyes VisuALL from Marco, which helps him consolidate equipment into a single, portable headset. “We will be using this more extensively in our new location. It allows us to bring in virtual field testing without sacrificing floor space or efficiencies,” he says. He can also run these tests without having to dedicate a dark room to this testing. Since it’s so portable, the patient doesn’t have to be as mobile, or a test can be done in the exam room rather than taking the time to move the patient in and out of a special testing area. “In small locations, every square foot counts, so multifunction equipment is a benefit.”

These investments in technology are important to his patients, too. “They like to hear what we’ve added since their last visit,” he says. While some of the specialty instruments that he brings in are used only for patients with certain conditions, every patient sits at the OPD and many experience the TRS autorefraction system, too. They enjoy the experience and the knowledge that they are benefitting from technology that is going to help the doctor deliver the most customized visual solution for them.

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

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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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