MAY 2016

FASTER, MORE EFFICIENT EXAMS

WITH A SPEEDY TEST TIME AND NO MANUAL DATA TRANSFER, PHOROPTOR^® VRx CUTS EXAM TIMES SIGNIFICANTLY

Vadim Guy, OD, FAAO

As I completed my optometric training in Florida, I planned a move back to my hometown of Rochester, NY to be close to my family. After 2 years, the right opportunity came along: I purchased a solo family practice from an optometrist who was relocating and who helped transition his patients to me.

The process of buying an existing practice is very different from starting from scratch. The new optometrist already has a patient base of people who, hopefully, will stay with the practice. There are staff members who may stay as well. Sometimes, cosmetic updates are needed, or the optical area is ready for some changes. Since I have been at my practice, I have added two full-time staff members, renovated two exam rooms, and added more quality frames to the optical area.

And then there are the equipment and software systems that enable us to do our jobs well and profitably. Initially, unless the equipment is seriously outdated, a practitioner can get to work and make changes gradually without any disruption to the practice. (Closing the practice for any length of time doesn’t help when you’re trying to retain patients.)

Phoroptor VRx Digital Refraction System

In my case, the practice’s only noteworthy deficit was an EHR system, so I knew I’d make that change in the near future. The existing diagnostic equipment was not outdated, but I spent time seeing patients and using the equipment, evaluating whether I saw a need to purchase any new devices to improve accuracy or efficiency.

To date, I’ve made one major equipment purchase — the Phoroptor VRx (Reichert). The results: less manual data transfer and faster exams.

Seamless EHR Transfer

Two years ago, we implemented an EHR system in the practice. In the following months, it was easy to see where I was spending time transferring data from device to device and into the EHR. For example, I had to transfer data from the autorefractor to the manual refractor, and then to the EHR system, along with the old prescription from the lensometer.

In 2014, I was able to try out the Phoroptor VRx at a meeting. I then had a Phoroptor VRx brought to my office for a few days as a trial. I really fell in love with it during that time, and about 15 months ago, I had one delivered and installed. It resides in my main exam room, and my other exam room houses the manual refractor.

Making the Transition

I had worked with an automated refractor system during my training, so I did not have any issues trusting the Phoroptor VRx or getting used to the technology. I enjoy using it.

Although there is a cost involved in any equipment purchase, some equipment requires additional investment in exam room space or creates a need to rearrange the existing setup. In contrast, the Phoroptor VRx was an easy device to introduce to our existing exam lane. It has a very compact design, and I use it while seated next to my patients.

Because I had a suite of equipment to work with, it was very important to me that the Phoroptor VRx could be integrated with other manufacturers’ devices, as well as the EHR. The Phoroptor VRx is able to seamlessly share data with my autolensometer, autokeratometer, and autorefractor, which are manufactured by Topcon, a competitive manufacturer. I also use another Reichert product, the ClearChart 3P Polarized Digital Acuity System, and I can pull that data into the Phoroptor VRx and control my acuity chart with a touch of the screen.

When I use the Phoroptor VRx, it automatically gathers data from the autorefractor and lensometer, adds the refraction data, and sends it to the EHR system. It is a much more efficient process, and I don’t spend time transferring data manually. In fact, because the Phoroptor VRx eliminates manual transfer and tests patients faster than a manual refractor, refraction for an existing patient now takes 2 or 3 minutes — about half the time required for a manual refractor and transfer.

Faster Exams

To cut examination time in half, the Phoroptor VRx does not just save data transfer time; it also saves time in performing refractions.

The Phoroptor VRx features a compact digital head that allows for greater patient visibility.

The Phoroptor VRx is much easier to control compared with the manual refractor. Sitting next to the patient, I select and control testing with an easy-to-use, portable touch screen display and keypad unit. I can avoid all of the reaching and adjusting that is necessary when using a manual device.

With a manual refractor, I have to switch lens powers and change targets manually, whereas the Phoroptor VRx (integrated with the ClearChart 3P) allows me to choose from a set of automated tests (prism, astigmatism, phoria, vergences, or binocular balance). Once I choose a test, the target on the acuity chart seamlessly changes, and the appropriate lens power goes into the Phoroptor VRx. For example, in vergence and phoria testing, with the push of a button, the prism is set up and the fixation target switches automatically. It allows me to efficiently measure the phorias and vergences and move on to the next test.

Using the Jackson Cross Cylinder (JCC) method, the device narrows down the cylinder and axis powers very quickly. When I use a manual refractor, I usually work on sphere, then axis, then cylinder. JCC uses smart differences — 5, 10, or 15 degrees — and I switch as I’m refining the prescription, doing both the axis and cylinder in three steps. I go from one power to the next fairly quickly, rather than going in circles having patients compare one and two.

With the click of a button, patients can instantly see the difference between their old and new prescriptions, so they don’t have to come out of the Phoroptor VRx to compare. That instantaneous comparison has increased sales in the optical. Before I know it, we’re done and ready for dilation.

Because the Phoroptor VRx requires half the time, I am able to see more patients. In the past, I could perform one comprehensive exam and a follow-up in an hour. Today, I see two comprehensive exams in that same hour. That amounts to a significant increase in patient capacity and revenue.

Refinement of cylinder power and axis can be accomplished using the split cylinder feature.

Future Changes

Today, I work solo with a staff of four employees. We’re in the process of hiring technicians who will perform testing, and I am considering adding another doctor part-time as the patient base increases. With another doctor, it would be best to have another Phoroptor VRx in the other exam room, so that the rooms mirror each other.

I am also aware that in some practices, technicians operate the Phoroptor VRx, and I am keeping an open mind about that possibility. As I continue to grow my practice, I know that investments in efficiency will pay off well, and I continue to seek out changes to build a healthy business and an enjoyable career.

Vadim Guy, OD, FAAO, is in independent private practice at Family Vision Center in Rochester, NY. A graduate of Nova Southeastern University College of Optometry in Fort Lauderdale, Fla., Dr. Guy trained on ocular disease and pediatric optometry at Bascom Palmer Eye Institute in Miami.

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