By David Geffen, OD
Dec. 13, 2017
Technology is ever-changing, with new opportunities presented every year to better serve patients and build revenues. In that pursuit, in my shared OD-MD practice we are considering adding three new instruments over the next few years. As with all practice investment decisions, we are projecting cost, benefit to our patients and practice growth, and how much revenue will be added to our bottom line as a result of upgrading technology.
This technology will enable us to better follow our diabetic and retinal patients, and it will allow us to manage these and other disorders in the office instead of referring them to specialists.
Acquire: Lease with a buyout at the end over three years.
Break-Even: Three years. However, this technology will also add the ability to bill for many other office visits, and would even make a two-year break-even possible.
An OCT pays about $36 from insurance, which means that billing two uses of this instrument per day will pay off the machine in the three-year term. This does not include the generous depreciation the practice will get from the purchase. Also, if you do not have the technology you will need to refer out many patients and lose much more income. The anterior segment scans will not yield direct revenue, but will greatly assist you in fitting specialty contact lenses, which are high-profit items in a practice.
Decision: We are evaluating the ability to make the payments for this instrument within our budget for next year.
HIPAA-Secure Telemedicine Platform
Telemedicine technology is in its infancy, but it offers great promise to assist us with minor office visits and follow-up visits.
This technology will allow your office to become much more efficient, and help save your patients time. It often takes a patient 2-3 hours of their time to come to the practice when a telephone consultation with photos may be sufficient.
The patient is appreciative of this, and it also frees up office time. This technology also can allow for secure HIPPA-compliant communication with patients and doctors. The apps can also allow for patients to make appointments to your office securely. Many think of telemedicine as the devil, and think only of remote refractions, but it is much more than that, and when used properly, adds a powerful technology to the practice.
Cost: $1,000, or less, annually. The costs will probably be minimal, as they will be billed as we use it.
Acquire: We will likely use CoolDoctors, which is HIPAA-compliant and designed specifically for eyecare providers with its eyecarelive platform.
Break-Even: Most states, including California where my practice is based, allow us to bill for telemedicine appointments. With the minimal cost, we anticipate breaking even, and possibly profiting, immediately.
Decision: We will add this to our office in the next year because the demand is already there for access to our doctors and staff via computer and mobile devices.
The Pentacam is a rotating Scheimpflug camera system for anterior segment analysis. It measures topography and elevation of the anterior and posterior corneal surface and the corneal thickness.
The Pentacam is used in our practice for a variety of functions. It screens for possible irregular corneas, which is vital knowledge in referring a patient for refractive procedures. It shows the posterior corneal surface, which will often show irregularity before regular topography does. It is of great assistance in my specialty contact lens fitting. New software will allow us to fit contacts in the future.
We already have one Pentacam in our office, but with our patient volume and flow, a second would be helpful in reducing the chance of patient bottlenecks, allowing us to be more efficient.
As a corneal refractive cataract practice, we often utilize this technology. The second pentacam we acquire would offer new software upgrades, including contact lens assistance. We would use this for all of our refractive surgery consults and all of our patients with irregular corneas.
We would also utilize this technology to help screen for keratoconus, as the incidence appears to be much higher than previously thought.
Practices should consider screening the posterior cornea of our young patients to detect this disorder before it becomes visually significant, and cross-link them, to prevent poor vision.
Acquire: A lease-to-buy payment plan.
Break-Even: The break-even for this device cannot be measured in direct billings because use of it will be part of surgery and contact lens fitting fees. My projection is it will take about three years to pay for itself.
Editor’s Note: Click HERE to view coding and billing instructions for the Penticam from the Corcoran Consulting Group.
Decision: We are still deciding whether the break-even and ROI is there to add it to next year’s budget.