None of us want to spend money on equipment that will ultimately gather dust in a corner or be stuffed in a drawer. So, before we contact our favorite equipment rep, we would be well-served by first planning so that we are confident any new technology purchases meet the needs of our patients and our practices.
I have found that this can be achieved via these action steps:
INVENTORY EQUIPMENT
First, do an inventory of all the equipment and technology in your practice. Record what it is, how often it is used and when it was purchased. Additionally, don’t forget to include items such as computers, laptops, etc. (Those items need to be updated regularly too. The connected “high tech” isn’t good for much if the connected computer dies!)
Next, make a note of the current equipment you would like to upgrade or that is nearing end-of-life. To discern this: Ask your staff about the health of the equipment they use. For example, maybe the topography printer jams every time it is used. Perhaps they have to restart the autorefractor after every fifth patient.
Then, look at how the technology has improved since you purchased each type of equipment your practice uses. If you are still using the indirect ophthalmoscope you got in optometry school 30 years ago on every patient, you may love an upgrade. If you have a patient population who has mobility issues, you may want to consider a portable version of stand-based equipment, such as a hand-held slit lamp. (Note: Portable devices are frequently eligible for ADA tax credits, so consult your tax advisor.)
ASSESS FINANCES
Now, carefully look at your practice finances to get an idea of what you can afford to spend on equipment. Obviously, some equipment is revenue-generating, but I recommend you don’t count on this in your initial evaluation. If the equipment generates additional revenue and you can pay off the technology sooner than planned, that’s a bonus! If it happens that the equipment is not used as expected, or insurance reimbursement changes, you don’t want to be stuck in a situation where you can’t make payments. If you are looking at financing, talk to your banker and your accountant to get an idea on what amount you have to work with.
![WrightStudio/stock.adobe.com](https://res.cloudinary.com/broadcastmed/image/fetch/q_auto,f_auto/dpr_auto/https://optometricmanagement.com/media/fqsmijbr/om_jun_1701.jpg)
In general, spending money on equipment is a good decision — you are enhancing your practice, and your staff are excited about the new “toys.” Patients can sense that excitement. In my practice, most of my “extra” money, after making sure I have met my obligations and put some into savings, goes to equipment.
ALIGN WITH MISSION
Take time to look at your practice mission statement. (Note: If you don’t have one, work with your staff to write one!) This mission statement encapsulates your practice and what you stand for, so ensure that any purchases you plan to make are in line with that statement. For example, if your mission statement primarily involves providing vision therapy services to pediatric populations, computerized low vision devices may not be a good investment. My office’s tagline is “Small Town Values, World Class Care.” We obviously want our patients to know that they don’t have to travel to a big city to get high-quality care. This means that we need all our equipment to be current.
You also need to consider your practice’s reputation. Therefore, if your practice is known for always being on the cutting edge of technology, you need to make sure that you aren’t still using a Vis-à-vis marker and PD rule to measure progressive lenses.
In this evaluation, also consider not just where you are now, but where you would like to be. Is fitting specialty contact lenses a particular interest? If so, you may want to strongly consider anterior segment OCT.
PRIORITIZE THE LIST
Once you have a list of equipment that needs to be updated as well as new technology you would like to acquire, prioritize this list. As is the case with home maintenance, there will be big difference and small difference items.
Big difference items, small cost. If there are relatively small dollar items that will make a big difference to your staff (for example, replacing that finicky printer, mentioned as an example above), do that immediately. The reason: These items will have a big impact on the daily life of your staff, which will translate to a big impact on patient experience in your practice. Your staff will also appreciate that you listened to them and care about “the little things,” which can translate to staff loyalty and the desire to go above and beyond to help make the practice successful.
Computers. The next item on your list is likely computers. I recommend you plan to replace 20% of the desktop computers in your practice and 30% of the laptops in your practice each year. The reason: Doing so will ensure your desktops are no more than five years old and your laptops no more than three years old, ensuring they continue to function as desired and are compatible with diagnostic technology. Of course, computers can last longer, but this will give you peace of mind. If you have an IT professional, I suggest working with them on a plan for computer replacement. By planning to replace computers on a rolling basis, you won’t have to replace all of the office computers at once.
Diagnostic technology. Look at the inventory list that you gathered in step 1, the financial information gathered in step 2, and your practice alignment from step 3. You will likely find that your list has narrowed to a few key items. If your list is still overwhelming, I recommend prioritizing based on what you use (or expect to use) the most. You will get more “value” from a piece of equipment used on every patient than a piece of equipment that is only used on every 50th patient. (See “Nuts and Bolts of Acquiring Diagnostic Technology,” left.)
Nuts and Bolts of Diagnostic Technology
DIAGNOSTIC TECHNOLOGY can be a large expense. I’ve found that doing some research, knowing how to shop and avoiding some installation quagmires can help to make the expense worth it.
RESEARCH
Do some homework on technology options: Browse manufacturer websites, talk to colleagues, read articles or (when possible) attend exhibit halls. Once you have an idea of what you are looking for, contact sales reps or distributors. Ask as many questions as you can think of. How big is the instrument’s footprint? What is included in the price? What about service and upgrades? Who will do the installation? Is this included? The more you know before a piece of equipment is in your practice, the better.
If your staff will be using the equipment, make sure they are an integral part of the process as well. Ask your staff what features would help them facilitate patient care. If you are having an in-office demo, make sure your staff is present and involved. If you are looking at equipment at a trade show, try to have a staff member who will be using the equipment come along. At the very least, have your staff look at online information for the equipment you are considering. The best way to make sure that equipment won’t be used is to buy it and “force” staff to use it! The more your staff knows, the better they will serve your patients.
SHOPPING
When speaking to equipment reps, be up front about what you are looking for and your budget. It isn’t in anyone’s interest to spend time on a $100,000 piece of equipment if your budget is $25,000 (no matter how cool it is). If you feel pressured, stand up for yourself. You have done your homework, so you know your practice better than anyone else. Don’t be afraid to say “no.” You won’t hurt the reps’ feelings.
I have found that manufacturers seem to always have “savings” of some sort — rebates or specials for a show or a season. Just ask. The worst that can happen is they say nothing is available. If you know of a major event at a specific time of year (for example, Optometry’s Meeting or Vision Expo), ask about discounts associated with that event. If you are a member of an optometric alliance/buying group, make sure you mention that as well to see whether you qualify for special pricing. Finally, make sure you get any quote in writing (including rebate information), so that if there is confusion later, you have documentation.
INSTALLATION
Before you sign the contract for the new technology, make sure everyone is clear on the timeline of installation and who will do it. Know when to expect the new equipment, especially if it is ordered near the end of the year. In such a case, the equipment has to be placed in service before December 31 to be claimed on that year’s taxes. If the distributor is backed up for three months, you need to know that before ordering. Additionally, ask about backup installers if the original individual is suddenly unavailable. If you have to arrange your patient schedule around installation of a new piece of equipment, you don’t want to have to reschedule that!
You may think that once the equipment is successfully installed, you are done. Not quite! Virtually every piece of diagnostic equipment, in particular, is utilized on patients. This means that you need to determine how the new technology is presented to patients. I recommend initial scripting and role-playing with staff members. Even small pieces of technology can be very impressive to patients with the proper presentation. For example, my optician presents a digital measuring device by saying, “This device gives us many different digital measurements for this particular frame on your face, so that your lenses are fully customized to you.” Therefore, the patient is immediately educated that this is something our practice provides that obviously cannot be obtained online.
PREPARATION IS KEY
New technology is an exciting part of our practices. The key is preparation. Go into the process knowing what you have, what you have to spend, who you are and what you want. In keeping those criteria in mind, you’ll have a successful experience growing your practice with technology! OM