Last week's tip covered measuring the Rx capture rate for glasses and contact lenses. Today, let's look at a few of my other favorite practice metrics.

Measuring and tracking these on a monthly basis is a smart move. First, we know that the mere act of measuring something often causes it to improve because there is an increased awareness of the task by doctors and staff members. Secondly, you will find ways to influence the result in a positive way, possibly through a staff incentive program, a contest or more staff training.

**Gross revenue per exam**

This stat is very easy to gather and tells you so much about your practice. It is also referred to as average sale per patient. Every practice management system (PMS) provides some kind of monthly production report and I'm assuming you are reviewing this each month. To determine your average gross per exam, simply take the total collected gross revenue for the month (this is gross fees minus adjustments, discounts and returns) and divide by the number of comprehensive eye exams performed that month. We use comprehensive exams simply as a matter of convention; we need some definition in order to compare with other practices. To determine your comprehensive exams, you may have to add a few line items together from your production report, depending on how it is set up. You may need to add new patients, established patients, 99 codes, 92 codes and S-codes. The goal is to count all full exams and not count brief office visits or follow-ups.

The national median gross revenue per exam is $306 according to the Management and Business Academy, but I know many optometric practices where this figure is over $500. Realize that everything you sell affects this number, so if you often prescribe multiple pairs of glasses along with contact lenses and also order advanced diagnostic testing, your value will be higher. Charging higher fees also increases this metric.

It is helpful to calculate this data point for the whole practice and also for each doctor individually.

**Multiple eyeglass rate**

This metric is not easily seen on a production report, but it is very useful. If you implement a new program like 50% off on multiple complete pairs or if you hold a special sales training session, you can gauge the result.

Start by defining multiple pairs. I say they must be complete pairs of glasses and the orders must be placed at the same time, but you can make it any way you wish as long as you are consistent. You will have to design a simple method to count the additional eyeglasses. I find it easiest to have this occur at the place in the office where orders are sent to the optical labs. The staff members who process the eyeglass orders can easily see when two or more pairs are for the same patient. I have the staff make a notation in a simple notebook divided by dates. You can use hash marks or record the patient's name, but you end up with a count of all additional pairs of glasses for a month. You do not count the first pair of glasses for a patient, only the extra pairs.

Determine your additional pair percentage by getting the total number of frames sold for a month. Divide the additional pair total by the total frames to obtain a percentage. I have not seen any national data on this, but I can tell you my practice averages about 18%.

**A/R percentage**

This one is fairly easy. Do you know what percentage of all glasses sold in your practice have premium or standard antireflection lenses? Just use your monthly production report to determine the total number of lenses sold (be sure to know if this is in pairs or single lenses). You can also see the number of antireflective treatments sold, often broken down into premium and standard depending on your set up. Just divide the total number of AR treatments by the total number of lenses (pairs) and you have your percentage. The national mean is about 34% in the US, but it is 70% in Europe and 98% in Japan.

**Annual supplies of contact lenses**

You can track what percentage of patients buy full year supplies of contact lenses if you offer a small discount for the group purchase and set it up in your PMS program as a specific type of discount only to be used for that purpose. Most PMS software will count the number of these discounts on the monthly report. Divide the number of discounts given by the total number of contact lens evaluations and fittings and you can see your full year dispensing rate.

**Appointment fill rate**

Your PMS system can most likely provide this if you run a special report, or you can do it manually by counting the number of appointment slots available each day and counting the number of patients actually seen. For this, I would use all kinds of exam visits, but do not count eyeglass dispensings. Most offices do not use appointments for eyeglass dispensing, but some do. If you offer different exam lengths for different exam types, you will need to know the ratio of full exams to brief exams to determine your number of available slots. For example, if 75% of all exams are comprehensive and 25% are brief, then you should analyze each day of appointments with that ratio in mind, deduct the lunch period and make 75% of the time double slots and 25% of the time single slots. Divide your total number of all exams performed for the month by the total of all exam slots and you have your appointment fill rate.

Best wishes for continued success,

Neil B. Gailmard, OD, MBA, FAAO

Chief Optometric Editor,