Diagnostic Instrumentation

OCT: Add Value to Your Eye Exam in the Age of Online Refractions

By R. Aaron Werner, OD

Sept. 9, 2015

SYNOPSIS

The higher level of care that you can provide with an OCT adds value to your comprehensive exams. That is a powerful differentiator as online refractions become a reality.

ACTION POINTS

DELIVER IN-DEPTH CARE. Use the OCT to screen all patients age 18 and over for evidence of retinal disease.

EDUCATE PATIENTS. Point out what the OCT helps to monitor about the health oftheir eyes, and why their eye exam is more than just refraction.

ESTABLISH MEDICAL EYECARE IDENTITY. Market the full comprehensive exam you provide, including your use of advanced instrumentation like the OCT.

Now that patients can obtain a refraction online, as well as from one of your many competitors, the advanced technology of the OCT allows you to elevate the care you provide, add value to the patient’s exam, and differentiate your practice.

Adding value to the comprehensive exam is essential because patients often fail to appreciate all that goes into one. According to Jobson Optical Research, over 60 percent of U.S. ODs don’t believe their patients perceive a difference between a refraction and a comprehensive eye exam, and 97 percent of ODs are concerned, or very concerned, that the capacity for patients to do arefraction “at home” via Opternative will cause patients to miss out on their annual eye exam.

We have an Optovue iVue OCT with the iWellnessExam, and we charge $39 for a screening scan produced by that technology. Our office has determined that the information we get by utilizing iWellness is invaluable. This test is a set part of our pre-testing for patients 18 and over. We are not comfortable presenting this test as an “option” because we believe it enables us to provide a more comprehensive exam. We do not add revenue per exam by utilizing the technology, but because we are able to detect retinal structural changes earlier than before, we see an increase in subsequent medical visits to further evaluate and treat the changes.

Try Out DifferentOCTs

At the end of 2013, we brought in different models of OCTs to evaluate. We wanted to make sure that the doctors were comfortable with the data that was being collected, and that our technicians were comfortable taking good images. Quality images are key, and making sure that everyone using the instrument is comfortable with it, was important to us. We were profitable with the OCT immediately, as it allowed us to screen for more pathology and follow-up with further testing if warranted.

It takes years to pay off a loan for an OCT, however the instrument was profitable immediately in that it allows us to diagnose and treat retinal disease earlier. The profitability is accounted for in the additional office visits and diagnostic testing (OCT, as well as others). The additional visits and tests, including the OCT scans, generate more than the monthly note, which is why it is a profitable investment.

Optovue’s iVue OCT in Dr. Werner’s office. Dr. Werner notes that while an OCT can take years to pay off, it is immediately profitable by enabling an OD to diagnose and treat retinal disease earlier.

Deliver In-Depth, Efficient Care

We believe technology should be used to help us perform a more comprehensive eye exam in a more efficient manner. We also are strong believers in preventative medicine. The OCT is a wonderful tool to accomplish these goals. As noted, we have every patient 18 years old and over screened with iWellness during a comprehensive eye exam.

The technicians have the images open on the computer monitors in the exam rooms when we enter, and in a matter of seconds, we can quickly review the scans and get an excellent idea of the health of the macula. We also look at the Ganglion Cell Complex scan (GCC) as an additional glaucoma screening evaluation.

Educate Patients About Value of Exam

Too often patients do not understand what they cannot see, especially when we are discussing early signs of retinal structural changes that are painless and generally asymptomatic. The ability to show a patient scans of their own eyes is very powerful. For example, a patient with early macular drusen who sees 20/20 may not fully understand the doctor’s concern. But when the patient can see the structural changes on the OCT images, it becomes “real” for them.

Understanding of the disease deepens, and patients are much more compliant with treatment recommendations. When taking the OCT scans, our technicians explain what the test is doing and the importance of the results. In the exam room, the doctor takes a minute to “guide” the patient through their scans and provides the opportunity for the patient to ask questions. This approach has helped our practice to demonstrate the value of a comprehensive eye health exam while educating patients on the difference between a refraction and an eye exam.

Earn Patient Loyalty

We believe that the right technology will improve the quality of exam the patient receives while at the same time improving a patient’s experience in our practice. As such, patients have come to appreciate and expect new technologies to enter the practice. They are loyal because we strive to meet and exceed their expectations. We see referrals from existing patients because they value the experience they receive, which includes OCT screenings, as well as other equipment not found in all eyecare facilities.

Affirm Practice Identity as Technologically Advanced

Successful practices understand that their practice personality may not suit every patient. Maybe they are too expensive, not expensive enough, spend too much time with patients, or spend too little time with patients. I sometimes come across practices that are proud of the fact they still do things “old school.” There is nothing wrong with some “old-school” philosophies, but technological advances in quality of care, like the OCT, have improved, and as practitioners, we must keep up to date in order to provide quality care.

R. Aaron Werner, OD, is a partner at Werner Optometry in El Cajon, Calif. To contact: aaron@wernerod.com

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