A: Advances in diagnostic and therapeutic technologies provide optometrists with great opportunities to expand their scope-of-service offerings. But what specific technology do O.D.s need, aside from standard devices, such as the slit lamp and phoropter? The answer is based on this information:

LOCAL DEMOGRAPHIC DATA

Optometrists should have an understanding of the area in which they practice: What are the demographics of the surrounding community? What referral patterns are possible? Certain ocular diseases are more prevalent in specific age and ethnic groups.

For example, if O.D.s practice in an area comprised mostly of elderly individuals, it makes sense for them to acquire technology, such as OCT, which is associated with age-related eye diseases, such as AMD.

To acquire local demographic data, optometrists can visit American Fact Finder, a U.S. Census Bureau website that enables users to enter a state, county, city, town or zip code to find facts, such as age, income and race. The site can be accessed at bit.ly/CensusFactFinder .

CURRENT PATIENT POPULATION DATA

Having a pulse on current patient population data, in terms of patient age and the prevalence of ocular disease and the one or more popular optometric services ensures patient satisfaction, which translates to practice loyalty.

For example, if a great number of patients have been diagnosed with dry eye disease, O.D.s should add in-office treatment technology, such as thermal pulsation, to increase patient satisfaction in the care the practice provides.

To obtain this data, optometrists can use their EHRs or practice management software to create a report of their current patient population.

TECHNOLOGY DATA

Once O.D.s determine what technology is necessary for the practice, research should be conducted on the technology itself, in terms of:

• Space. Does office space allow for the technology? Office space is often at a premium, so optometrists must factor in the size of the technology.

At my practice, for example, we found that we needed to provide treatment for meibomian gland disease. Through research, we discovered that some devices had too large a footprint for the office space. Recently, however, we acquired a small, more portable device that satisfies our space requirements.

To determine office space, optometrists can take measurements of the specific area they plan to house the device, and use these measurements as a guide. (When taking measurements, O.D.s should be sure to account for the space needed for the tech and the patient to move in and out of the technology.)

• Features. Does the technology enable better care for patients? It should enhance the monitoring, treatment and referral process for the prevalent conditions in the current patient population and local demographic.

For example, if optometrists are seeing a lot of cataract patients, they may want to purchase an A-Scan ultrasound or an optical biometry device to aid in ensuring an accurate refraction pre-cataract surgery.

To find out what recent technologies are available and whether their features meet patient need, O.D.s can conduct research online, contact the technology vendors to ask questions and reach out to colleagues for their thoughts as well.

• Cost. What payment plans, if any, are available? Optometrists should consult vendors to determine how much they’ll have to pay up front, whether they can afford it and whether they can incur the required additional payments at the required due dates. When can a return on investment be expected? Vendors often provide ways (e.g. online calculators) to estimate this. That said, O.D.s should also evaluate their insurance contracts and fee schedules to compare reimbursement for a technology to its cost and also estimate how many procedures they will do per month or per year to cover the cost of the technology. For non-covered services, what will the patient base be willing to pay for the technology? This depends on patient demographics. For example, my friend practices in silicon valley, where price is rarely an issue for patients.

• Ease of operation. Is the operation of the technology complex and time-consuming? If the technology is going to negatively affect patient flow or increase the likelihood of possible mistakes, its purchase is likely not a good idea. Will current staff be able to handle the added responsibility of its operation? This may not be an issue if it is worth hiring additional staff to take on the operation of the technology, from a patient care and practice-cost perspective. That said, the projected use of the device should more than pay for the cost of adding additional staff members.

• Equipment review. Once optometrists decide on the needed technology, they should speak with colleagues on the pros and cons of the model and manufacturer they use.

When I’m considering a new technology, for example, I arrange for an on-site demonstration at a colleague’s practice. The reason: It allows for a no cost, low-pressure assessment. I can see the technology in action, review the results, measure the footprint and decide whether it’s a good fit for my practice.

O.D.s can find colleagues who use the technology in which they’re interested via reaching out to their inner circle, posting in a well-known Facebook group of optometrists or in an optometric advice and education website or contacting the one or more vendors themselves and asking them for the name of an optometrist client. Regarding the latter, it’s important to be aware that the vendor is, obviously, going to provide the interested optometrist with the name of a very satisfied user.

• Vendor customer service. Is the vendor willing and able to train staff on the device’s operation? A representative should be amenable and eager to show staff a technology’s operation. Does the service contract look fair?

The vendor should be willing to send a representative to the practice when requested and actively trouble-shoot any issues. Also, there should be room to negotiate the length and coverage of the contract.

Follow Your Bliss (If Possible)

NOTED PRACTICE MANAGEMENT EXPERT, CHUCK BROWNLOW, O.D., F.A.A.O., said during a presentation at an AOA advocacy meeting: “The most valuable patients are those that match the doctor’s skill set and interests.” One of the best things about being an optometrist is the broad scope of practice. O.D.s can focus on an ever-growing list of options, such as specialty contact lenses, sports vision and vision therapy.

If an optometrist’s greatest interest aligns with local demographic and current patient population data, he should add related technology that will allow him to provide cutting edge care at the highest level possible as well.

For example, if O.D.s are interested in seeing specialty contact lens patients, corneal mapping technology makes sense.

Develop your practice such that it fulfills you professionally and personally and, ultimately, your patients will benefit.

THE ANSWER!

Taken together, this information should help O.D.s decide what technology makes the most sense for patients and their practices. The litmus test for technology must be that O.D.s have all the necessary tools to confidently and competently manage prevalent conditions. A “shoot first, ask questions later approach” can increase the likelihood of little-used and costly technology. OM

DR. MONTAQUILA practices at West Bay Eye Associates in Warwick, R.I. He is a past president of the Rhode Island Optometric Association, has served as Chair of the AOA’s Third-Party Executive Committee and currently serves on the AOA Federal Relations Committee. Dr. Montaquila is active in clinical research in the areas of dry eye disease, contact lenses and lens care solutions, and he lectures nationally on topics relating to eye health, contact lenses and health care delivery reform. Disclosures: Bausch + Lomb.