XFRACTIONSM PROCESS
Improving Patient Experience
Speed, accuracy and efficiency can be quantified, but some other benefits of XFRACTIONSM have immeasurable value.
Brett M. Paepke, OD
FirstView Eye Care Associates, Plattsburgh, N.Y.
Anyone involved with the business of eye care knows the value of metrics. Whether you add functionality to your website, change your recall system or add new equipment, you want tangible evidence that these changes have had a positive impact on your practice. When optometrist Brett M. Paepke, OD, started looking at new equipment for FirstView Eye Care Associates in Plattsburgh, N.Y., he knew exactly where he wanted to see improvement. “First, I was looking for a way to make the flow of refractive data more efficient,” he says. “Second, I was looking for greater accuracy in refractions.”
Dr. Paepke’s third objective, however, was not so easily quantified. “I also wanted to improve the patient’s experience,” he says. “Knowing that patients don’t really like refractions, I wanted to provide them with something different, superior and, ideally, more enjoyable.”
Since adding the OPD-Scan III wavefront aberrometer and the TRS-5100 digital autorefractor — the key components of Marco’s XFRACTIONSM system — along with the LM-600 auto lensmeter last fall, Dr. Paepke is realizing the measurable and immeasurable benefits he was seeking.
Speed, Accuracy, Efficiency
The OPD-Scan III combines numerous functions — autorefraction, keratometry, pupillometry, corneal topography, wavefront aberrometry, retroillumination and day/night measurements — to produce more than 20 diagnostics in 10 seconds per eye. In less than 1 minute, it provides a wavefront-optimized refraction that demonstrates whether or not a patient requires a full refraction to achieve optimal visual acuity. Data transfers to the TRS-5100 completing the required refraction with digital speed and accuracy.
“I like the accuracy and comprehensive nature of the data I receive from the XFRACTION process,” Dr. Paepke says. “When I enter the examination room, the results are on my screen. At a quick glance, I have a feel for what the patient’s optical path looks like and what his best-corrected vision should be.”
The LM-600 auto lensmeter reads the patient’s current correction, which is transferred to the TRS 5100 via smart card and is seamlessly uploaded into the practice’s EHR system. “All refractive data are available on one touchscreen-based control unit on the TRS-5100,” Dr. Paepke says. “I can effortlessly and immediately show the patient differences between his habitual correction and today’s refractive result, which allows for an easier justification of the investment in new eyeglasses.”
The Point Spread Function (PSF) shows what a point of light looks like when imaged through the patient’s optical system; in this case it explains his night-time glare shaped “like a cross.”
Making the Comprehensive Eye Exam More Comprehensive
Being able to acquire so much data in so little time with the XFRACTION process broadens the range of a comprehensive eye examination, and in at least one case at Dr. Paepke’s practice, it restored a patient’s credibility with his wife.
“All of my patients have technician-guided topography and OPD-Scan III performed as part of a comprehensive eye examination,” he says. “I then review the data with the patient in the examination room, making sure to connect any anomalies to his complaints. Having topography data available for every patient has shown me many cases of corneal conditions that I might not have detected otherwise.”
“I’ve even saved marriages with it,” Dr. Paepke says with a smile. He is quick to explain: “A 60-year-old truck driver had a chief complaint of nighttime glare that was shaped like a cross. His wife thought he was making it up, but I was able to show her a point-spread function map that clearly demonstrated the cross-shaped glare that was being generated by the patient’s cataracts.”
The beach scene on the left is the uncorrected view, with the corrected view on the right. Utilizing this display from the OPD viewing software allows you to show patients, or parents, the effect of the prescription on their vision.
Improvements in efficiency and accuracy have been noticeable. “Having all refractive pretest data flow into the examination room and then having the final data flow into the EHR has saved time and eliminated the potential for transcription errors,” Dr. Paepke says. “Considering the time needed for printing and transcribing the data, I estimate I’m saving 3 to 5 minutes per encounter. That’s significant found time each day.”
An Experience Patients Appreciate
In his 12 years of practice, Dr. Paepke has come to realize what many patients won’t admit. “Most patients don’t enjoy the refraction process,” he says, “so having a faster, better defined, more accurate starting point, which in many cases might be the final prescription, interested me.”
The XFRACTION process did not disappoint. “In traditional setups, a technician might perform an autorefraction and manually enter data in the record,” Dr. Paepke says. “With XFRACTION, everything is at my fingertips with minimal effort and capable of being uploaded to our EHR with the same ease.”
Patients have noticed the difference, too. “Feedback has been great,” Dr. Paepke says. “Patients love the XFRACTION experience, because it’s different. It looks cool to them, and it helps me solve their problems. If I can be more efficient and accurate while providing a better patient experience, that’s a solid technology.”
Dr. Paepke has also realized a financial benefit since introducing the XFRACTION process. “We’ve restructured our professional fee schedule to account for the technology and done so in a way that more than covers the monthly payment on the equipment,” he says. “This makes increased efficiency and sales of multiple pairs of eyeglasses icing on the cake.”
Added Value: Patient Education
Dr. Paepke’s expectations for the XFRACTIONSM process were well grounded and realistic: accuracy, speed and efficiency topped his list. He was surprised by an unexpected benefit.
“I didn’t anticipate the system would be so valuable from a patient-education perspective,” he says. “For example, being able to demonstrate to a patient why a certain contact lens option is better for him based on his corneal topography has been a welcome benefit.”
Dr. Paepke reviews topographic data with all contact lens patients and with any patients who show issues in need of discussion. “I use the uncorrected/corrected beach scenes to show parents how their children see versus how they should see,” he says. “I use the retroillumination views to demonstrate to people who have cataracts why they’re having trouble with their vision and how surgery will help. Pretty much anything refractive that I would need to discuss with a patient can be done using the array of OPD maps and the examination room viewing software of the XFRACTION process.”
Differentiate Your Practice
“There’s no question that high-tech systems such as the XFRACTION process helps to differentiate my practice,” Dr. Paepke says. “I think patients get tired of the same eye care experience over and over, and I think they’re savvy enough to know when a practice is investing in technology to enhance their care. Anything I can do to elevate the patient’s experience interests me.” ■
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