Practice Management

Lag Time: The High Cost of Slow Adoption

By Roger Mummert
Content Director, ROB

Nov. 7, 2018

At my annual physical, I schmooze with my primary physician about health-care reform, his billing and management network, and my patient portal.

The one he has yet to provide.

Now, I like my doctor and value the continuity of care he provides. But I am frustrated to be writing about how a patient portal promotes engagement and improved outcomes while not yet benefitting from a patient portal of my own.

My doctor lags behind the health-care curve, and sooner than later I may seek another doctor who reviews my dashboard with me during my exam instead of shuffling through a thick folder of tattered papers.

This is hardly an isolated case: The delivery of healthcare is riddled with lag times in the adoption of

innovations that can help us meet the stated goals of health-care reform: wider access, better outcomes, greater efficiencies and lower costs.

So, why are we stuck? Why the “lag time” between idea and implementation? Don’t look to Washington; they practically invented lag time.

There are signs of hope within our optical community.

At the recent Vision Expo West, ROB hosted a symposium “Future of Optometry: Telehealth & Eyecare.” There, a panel of ODs showed a host of ways that telehealth expands optometric care.

Larry Macapagal, OD, of Kaiser Permanente shared specifics on how Kaiser employs telehealth in 52 percent of all doctor/patient transactions. The Kaiser system saw 110 million people in 2017–with 59 million of them connecting through online portals, online visits or via a Kaiser app. And satisfaction is high: 93 percent said that their online encounter met their needs.

Dr. Macapagal also played videos of patients using telehealth to maintain wellness in their homes, communities and families. It was a major wow.

Across the country, health-care systems and employee-based plans are gung ho on telehealth. Our own health plan at Jobson Optical Group sends us e-mails encouraging us to go online for a doctor visit for common problems–like red eye.

A 2018 survey by the National Business Group on Health shows that 96 percent of major employers offer some type of telemedicine benefit as part of their health plan, compared to 46 percent in 2015. But adoption? Less than 10 percent of employees had a telehealth visit last year, the NBGH survey reported.

Again, this kind of major lag time is not an isolated case.

In our “Future of Optometry” symposium in 2017, Richard Edlow, OD, The Eyeconomist, presented an insight with tremendous import to optometry practices looking for growth opportunities: Medical model optometry services are growing at a pace 2.5-times faster than refractive care services. Both are important, he stressed, but one offers far greater growth opportunities for practices.

Dr. Edlow then looked into CMS Medicare data on medical model adoption: He found that only 28 percent of ODs were billing for Visual Field Testing & Interpretation and just 26 percent were billing for OCT testing for glaucoma and retinal issues. In other words, with all of the growth in medical model, only about one-in-four ODs are pursuing it.

Again, why the lag time? And what is the cost of lag time in the business world?

Examples abound of companies lagging behind the adoption curve and paying a heavy price. Did Walmart hold onto its store-based model too long and lose much of its franchise to Amazon? Did Sears rely too long on heritage brands? Are “fast fashion” stores H&M and Zara failing to heed the disruption to their customer base posed by Rent the Runway, which offers $150 monthly subscriptions to rent four work outfits per month?

So back to my primary physician and the patient portal that I continue to wait for. Will he continue to lag behind the curve? Why do ODs lag behind in embracing medical model or in offering patient portals?

This is a question ODs themselves need to answer and soon. In doing so, the decision tree on this centers around a few basic questions:

  • Am I satisfied with my practice and the services I provide?
  • Are my patients satisfied with the patient experience I offer?
  • Can I build my practice as I plan, exit profitably, and retire well with my current plan?
  • What new technology must I adopt to offer needs-based and growth-driven services?
  • Can I do this myself, or do I need to find new associates, consultants and partnerships that can help me?

Finally, while the adoption of telehealth is today’s hot topic, several other issues loom on the horizon:

  • Myopia Control: Will it emerge as mainstream eyecare?
  • Blockchain: Will it be essential in telehealth encounters?
  • Patient Portals: Are they a must-have to satisfy and retain patients?
  • Privacy: And how will I make communications HIPAA-secure and retain control of patient data?

These issues challenge ODs to ask: Will I be an early adopter? Or will I fall prey to lag time?

 

Roger Mummert is Content Director for Review of Optometric Business. Contact: Rmummert@jobson.com.

 

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