Article Date: 8/1/2011

Solving the Conundrum
management strategies

Solving the Conundrum

As reimbursements fall and demand increases, you can survive. Here's how.

Richard Edlow, O.D.

Today health care is faced with an economic conundrum: increasing demand for services, yet declining reimbursement. Assuming that our practices already provide superior clinical care and stellar customer service, the only solution to this conundrum is to generate productivity gains through technology.

Here, I identify four areas of opportunity:

Patient care

Sophisticated practice management software, electronic health records (EHR), digital capture and retrieval of diagnostic testing and patient education all enhance patient care. These allow patients to request appointments by e-mail, pay bills online and obtain clear instructions that are personalized and generated right in the exam room.

Eyecare professionals can examine a patient for an eyeglass prescription with accuracy never before available. Practitioners can then import the prescription into a patient's EHR, which sends an order electronically to the optical dispensary for custom-designed ophthalmic or contact lenses.

We can generate incredibly accurate images of the retina through imaging and photography systems and display these on monitors in any exam room, allowing the patient to better appreciate their condition and treatment options.

Medical charting experts can perform real-time prospective chart audits to assess the documentation and evaluate medical decisionmaking, which ensures the finest of patient care.


The click of a mouse (one-tenth the time of a paper system), sends prescriptions, legibly, to the patient's pharmacy through EHR. Practices can send referral letters immediately to primary care physicians. For example, in my practice every patient with a diagnosis of diabetes automatically has a letter sent to their primary care physician.

Patients can access educational material via their O.D.'s website or DVDs. A digital simulation can teach patients contact lens insertion and removal, saving you more than 60% of time. Patients can receive individualized e-mails that provide more information on their condition and treatment options.


With electronic systems, practices can receive most insurance payments in one-third the time. The practice can electronically request and receive authorizations for care and confirm a patient's copays and deductibles well in advance. And, practices can scan and save the patient's insurance card and photo ID to further ensure accurate billing.

EHR saves thousands of dollars per year on the management of paper and medical record folders. Now, imagine converting the chart room into three exam lanes — that's revenue-generating space.

Human resources

Our practice has hired more than 20 new staff members in the past 12 months, and only four had prior experience. These new staff members receive on-line training that is specific to one's job and includes testing and certification. Staff becomes skilled at diagnostic testing rapidly because many datacapture processes are automated and transferred seamlessly into EHR. Further, staff can receive daily e-mails that support and advance their education.

While I have listed only a handful of productivity gains, each can help us provide the best patient care in concert with making a decent living — something that in recent years has been challenging.

One last technology note: With EHR, you'll never lose or misplace a patient's chart. OM


Optometric Management, Issue: August 2011