I have always been known by my patients to implement the best technology to care for their ocular health, and almost every year patients see a new piece of instrumentation at my practice. I hold solidly to the belief that you bring in new instruments first to address your patients’ existing needs, not to “get paid.”
In this article, I discuss how, by focusing on the conditions troubling your current patient base, you can ensure you’re meeting their needs. I also talk about how to recoup your investment through analysis of patient records, as well as other factors that may influence purchase decisions, including efficiency, patient loyalty, and staff morale.
KEEP A TALLY
I have an easy way to determine the most effective new diagnostic and treatment equipment to implement at my clinic: First, I start with one quarter of reports (three months) from my EHR. Within the EHR, I can search for the diagnosis of, for example, ocular surface diseases, such as dry eye disease (e.g. meibomian gland dysfunction), and ocular rosacea, and allow that to populate the number of times these diagnoses have been made over a three-month period.
While this is obviously a retroactive tabulation, you can also keep an ongoing tally whenever you have such a diagnosis — I suggest using a dry erase board for this. Specifically, make yourself a table with these conditions at the top, and every time you see one of the conditions and diagnose it, make a tally. From there, it is easy math. You can figure out the cost of the instrumentation and the fees you would like to charge and make a schedule of how long it will take you to break even with the instrumentation cost.
At my practice, I have always kept a record of patients who have certain eye conditions. This way, when the opportunity to add a new treatment option becomes available, it is easy to pivot and determine which technologies will work best for my clinic. For example, recently, I had been able to identify 100 patients ready to benefit from a new instrumentation before I obtained it.
Even if you are not in a place to add new technology, these numbers can provide additional insights, such as you are not coding certain conditions as often as you should, and therefore, are missing out on possible reimbursement.
Either way, a breakdown and deeper dive into certain conditions may help you invest back into new technology or help you get to that point.
Another factor to consider when purchasing new equipment is efficiency. An efficient device means there’s more time to spend helping more patients, and less on testing.
To demonstrate this, let us look at the following example: With retinal imaging, my clinic’s exam process has been streamlined. Specifically, a staff member takes the images of the patient’s retina and loads them on a computer screen in the examination room for me to review with the patient. So, by the time I enter the room, all the data and information I need for the patient has already been obtained. This allows me to better listen, refine the case history with the patient, and most importantly, educate the patient with visual demonstrations.
Rewind just a few years ago, and we wouldn’t have had that extra time to spend with the patient. Instead, we would dilate our diabetic patients and spend time searching the retina for vascular anomalies. (As requirements vary from state to state, be sure to follow all your state’s specific requirements regarding dilation and testing.)
Some might even argue that many micro-aneurysms were being missed by simply doing a dilated fundus examination. What about subtle macular edema? This condition used to require fluorescein angiography. That meant a referral of the patient to a retinal specialist, possibly an unnecessary intravenous injection, and delay in treatment.
With the use of retinal imaging, both in digital ultra-widefield color imaging, as well as via OCT-A, we can detect such vascular anomalies in our own offices and properly direct treatment in a more efficient and effective manner.
When you’re deciding what equipment you want to introduce next in your practice, consider how much “busywork” it could save you. Those savings translate to time better spent with your patients.
My view on practice technology is that, if I do not have the proper diagnostic equipment and subsequent treatment, I am not serving my patients to the greatest extent to which I am trained. Second to that, these patients — sometimes even the most loyal — are going to seek another provider who does meet these equipment needs.
Patients love new technology, and they come to expect it from their doctors. I believe there is a sense of disappointment when they do not see it. Whenever I hear my patients say, “my other doctor never did this,” it sounds like they wonder whether something was missed on previous visits. This perpetuates other patients into coming and commenting that their friends were impressed with the technology and care presented to them.
The morale of the office is also impacted when your staff loves new technology and embraces it. It helps with delegation and lightens the burden on many mundane tasks. New technology helps with a smooth progression through the office from intake, to work up and diagnostic testing to finally, the explanation of the findings to the patient. OM
MORE ON INVESTING IN TECHNOLOGY
WHEN SHOULD I UPGRADE OR ADD TO MY DIAGNOSTIC TECHNOLOGY?
HOW CAN I TRAIN STAFF TO USE NEW EQUIPMENT?
WHAT ADMINISTRATIVE EQUIPMENT CAN HELP A PRACTICE?