Article Date: 2/1/2011

Adding the Right Technology Can Improve Efficiency

Adding the Right Technology Can Improve Efficiency

Investing in the right equipment can benefit your patients and your bottom line.

By Scot Morris, OD

Without question, technology will have a tremendous impact on our profession in the very near future and we must be deliberate in our technology integration to take advantage of its benefits. Many, myself included, argue that the technology of the next decade could have a greater impact on our profession than diagnostic or therapeutic privileges have had in the past. We have more information at our fingertips than ever before—the question is: What are we doing with it?

Within the last decade, technology has changed the way we view the retina, the optic nerve and the cornea by integrating digital photography, scanning laser ophthalmoscopes and topography, respectively, into our practices. Electronic health records (EHR) and various diagnostic technologies are also shaping the way we “see” our patients, in terms of both clinical efficiency and business intelligence. Due to changes in healthcare, optometrists will need to see more patients, more efficiently in order to survive on increasingly smaller reimbursement schedules.

Technology utilization will play a critical role in this survival process. Though many may consider this heresy, we, as optometrists, cannot afford to continue seeing a patient from the history-taking stage, through pre-testing, refraction and the remainder of the exam as we've done in the past. This way of operating is incredibly inefficient. It's time to face the reality that diagnostic refracting systems are more accurate than we are, give us more information in less time and take the guesswork out of many procedures, allowing us to delegate these tasks to capable staff members. Every task you can delegate leaves more time to do what you were trained to do: interpret and utilize data to treat your patients' visual and medical issues. For example, when was the last time your primary care doctor drew your blood or checked your weight and blood pressure?

I hear many people say, “I don't make more money by refracting faster or better.” That may be true but you may lose money by going slower. More efficient visual analysis leads to increased profit from one of two avenues: increased operational efficiency and increasing patient-based revenue. Increased efficiency means greater throughput (ie, you can see more patients) and more time to discuss personalized options for eye wear (ie, doctor-driven dispensing). This leads to a more effective use of your time and the patient's time, which leads to more effective education and more profitable selling.

Operational efficiency also relates to reducing human transcription error by utilizing an automated system that feeds your visual data directly into your EHR program. For example, what is the cost of one remake, both in terms of the actual physical remake costs and the loss of patient confidence?

In summary, the survival of each optometric practice will depend on how well the practice is run and how efficiently and effectively the patients' experiences within that practice are managed. To assess this, we evaluate workflow efficiency. You can improve your practice's workflow efficiency by conducting an in-depth study of each task and how much time it takes. Then evaluate each task to make it more efficient.

Many people feel that visual analysis technology doesn't create a profit so it should be made a low priority on the “acquisition line,” but I disagree. Remember that since approximately 50% of your office profits come from the optical department, visual satisfaction is crucial to the success of your practice. If newer diagnostic devices can help increase your operational workflow and provide a better visual analysis, then they have value. In other words, you should consider scrapping that old piece of equipment for a new “high tech” device. This purchase may even allow you to be more competitive in your local area, especially if you market your cutting-edge technology to your patients and the community.


Lensometers are an essential but overlooked piece of technology in the optometrist's office. This is especially true when that highly coveted, new patient that you just recruited away from your competitor comes in to complain about their eyeglasses. Without an accurate lensometry reading, you can't determine where your competitor erred and how you can improve upon their mistake. The new lensometers are user friendly, have ergonomic designs with small footprints and measure accurately everything from pupillary distance to prism and progressive designs. Some of them even feature a UV detection unit to assess and report how much UV protection patients are actually getting from their spectacles.


Now that you've determined which eyeglass prescription your patient is wearing, your staff can have them turn their chair ever so slightly and look into your new autorefractor. I must admit that I was not a fan of previous generations of autorefractors but newer versions have changed my mind. Marco's 3-D Wave combines refraction, topography, wavefront analysis and a host of other features all into one ergonomic package. Best of all, it feeds directly into my EHR, saving me time and decreasing costly transcription errors. New devices should allow you to evaluate each patient's total visual system thus allowing you to correctly diagnose and treat visual complaints.


Patients hate the series of questions “Which is better: 1 or 2?” even more than we do. Many people aren't great decision-makers and this forces them to make a choice. Let's not assume for a second that patients don't realize that they're doing the same exact test (on maybe the same piece of equipment) that they did 5, 10 or even 15 years ago. People expect and demand the most current technology. Aside from patient expectations, anything that can make this process more efficient and less stressful for you, your patient and your staff should be considered.

Many of the new automated phoropters allow you or a staff member to look at your patient's prescription, visual acuity and chart letters simultaneously. The best part is that they allow you to alternate very quickly between the patient's current prescription and the “new and improved” prescription you give them, helping them understand immediately that they need new lenses. Our practice's favorite phoropter is the Marco TRS-5100. Not only is it quiet, fast, efficient and comfortable, but it also has the “cool” factor. It allows us to evaluate, document and auto-populate (using our Exam Writer software) each patient's unaided visual acuity, lensometer reading, acuities with eyeglasses, auto-refraction, subjective refraction values, associated acuities, phorias and even the keratometer readings (if your keratometer or 3D Wave is synched up). You can even check and document phorias, near acuities, NPA, NPC, NRA and PRA. If the TRS-5100 could read and fit soft contact lenses, it might be able to examine patients without me!

Make the Change

So what are you waiting for? Acquire and integrate a more comprehensive vision analysis system and integrate it with EHR to improve patient satisfaction, increase your efficiency and improve your bottom line.

Dr. Morris opened his private practice, Eye Consultants of Colorado (, in 2004. He's operating partner of Morris Education and Consulting Associates ( and Ocular Technology Solutions, Inc. ( E-mail him at

Optometric Management, Issue: February 2011