Article Date: 11/1/2003

Take a Tour of the High-Tech Practice
Technology can dazzle patients and provide you with the latest tools for patient care and practice management.

Electronic technology affects virtually every American. AOL, MSN and eBay have become household names. Booking airline tickets and making hotel reservations over the Internet are standard procedure for today's traveler. From automated teller machines and electronic investing to cell phones that feature cameras, we're a society driven by electronic technology. Your eyecare office should be no exception!

Enter your new practice

I'd like you to take this premise of an electronically technological society as you walk through the front door of your eyecare practice. What do you see? Hopefully, a busy reception area with patients mesmerized by a plasma screen or large LCD monitor that displays a catchy continuous loop of information about your office. The "high-tech" atmosphere immediately captures your patients. Slide show presentations run for maximum impact.

Alternatively, continuous loop tapes explain the newest eye examination equipment your office has to offer. At the front desk, computer terminals are visible, with staff inputting information. Patients immediately feel that this office is on the leading edge of technology. Your patients' perceptions and trust in your ability to deliver the finest modern-day eye care hinge on their observations and clinical experiences as well as how they are educated -- from your front to back door!


Start up front

For the front office, technology now allows the staff to enter patient information into practice management software, which updates records and thus "feeds" the examination process. With merged data capability, information placed in the practice management systems now automatically transfers into your electronic medical records (EMR) system. Health Insurance Portability and Accountability Act (HIPAA) and insurance requirements are easily satisfied and recognized. Prior authorization from insurance companies, previously obtained on line, displays exam and material eligibilities.

As the exam process begins in the pretest area, a networked computer workstation displays the patient's EMR, complete with data entered from your front office. It's imperative to explain to patients the advantages of your EMR system, including increased documentation and eye disease-tracking capabilities. For example, explain that there's an interfacing system between the testing equipment and their EMRs that documents their information. Educating them as to the benefits of your computerized equipment makes them more likely to remain faithful to your office. As you conduct the exam, help them understand what each piece of equipment is and how you use it to assess their overall eye health.

Use the exam too

You can further emphasize the impact of technology in the management of ocular health during the examination. For example, as you review his computerized EMR on a screen in front of the patient, you can observe pre-testing results including autorefractor, pachymetry, topography and blood pressure. As you begin the refractive process, you can enter the results into the EMR with minimum effort.

You can also review retinal findings, obtained in a separate pretesting area, on the screen in view of the patient. If necessary, you can "attach" laser scanning devices documenting retinal disease to the EMR or send them electronically to a specialist via the Internet. This allows optimum opportunity for patient education, as it's likely the first time a patient has seen the back of his eye. And the technology involved makes a maximum impact.

If you must dilate the patient, there's software that displays animated explanations of eye conditions, treatment options, spectacle considerations and surgical outcomes. From explanations of progressive bifocals to monovision to LASIK procedures, this option greatly reduces the amount of chair time required by doctor or staff. The patient can even review contact lens explanations and training alone.

EMRs help you impress

As you complete the remainder of the patient's examination, EMR capabilities make it easier than ever to document findings. Within minutes, you can document a wealth of information describing eye health findings, impressions and treatment. You can display contact lens and spectacle information from previous years to the present, documented in logical fashion to observe progression over time.

You can describe abnormal ocular heath findings in depth, while additional displays of ocular structures, which include drawing capabilities, allow you to sketch specific eye abnormalities. This feature allows the patient a complete anatomical depiction of his overall eye health status and a fundamental understanding of where disease exists.

The speedy documentation that the technology affords permits quality doctor-patient time -- another major plus in the patient's eyes. At this point in the exam, you should also emphasize the importance of electronically filing his ocular findings -- that advancement of disease or changes in any condition may be recognized much earlier as a result of this technology.

Before the record is completed or finalized, software exists to check your procedure code selection. This ensures that you've provided proper documentation to support the code, greatly reducing coding-related errors that may lead to an audit.

It doesn't end with the exam

Your opportunity to educate and impress the patient continues at the conclusion of examination. Sophisticated EMR management systems allow you to prepare and print an educational report describing eye conditions, spectacle recommendations, special testing needs and recall information from the examination room. Alternately, it's possible to route the report to the front desk area where staff may print it out and review it with the patient.

The systems highlight recall information in particular for explanation. If a referral is necessary, then the capability to send an "automatic" letter, generated from previously entered examination findings, allows you to print one in seconds. Additionally, your staff can send a full report of ocular health findings to the patient's specialist or primary care physician.

This builds inter-professional relations with a minimum of effort. When your patient leaves your office with a full report describing his ocular health status, it's a reminder that your office is on the cutting edge of eye care.

Moving onto the dispensary

If your patient is to select eyewear at this time, a computer terminal in the optical department with specific slide shows or animations can explain the benefits of anti-reflective coatings, ultraviolet protection and progressive lenses, thus saving your staff time.

It's helpful for staff to instruct the patient that "the doctor recommended you watch this educational display, which is specific to what he/she is prescribing for your lenses." This marketing tool can significantly increase your bottom line in the optical, particularly with add-on sales.

Your optician can electronically deliver spectacle prescriptions, lens choices and frame information directly to the laboratory. Not only does this expedite return delivery of eye wear, but it eliminates errors because of poor handwriting, transpositions, or incomplete information. Through an interface, the spectacle correction is directly transferred to the laboratory order.

This returns the responsibility for the final prescription back to the doctor. As the order is completed, the software removes the frame from the inventory component of your practice management system and may place it on a reorder list for your optician. You can generate reports at any time to monitor various factors such as style of frame sold, material, manufacturer and cost.

Retention made easy

Finally, the patient record may be updated and placed in your automated recall system: Software supports both telephone and paper-driven recalls. Patient retention is crucial and with automated recall, there's a far less likelihood of patients slipping through the cracks.

Automated voice messaging systems are available through yet another management interface, which calls your patients to confirm, change or make appointments directly into your scheduling system. This can be done off hours to increase the likelihood of reaching patients at home while eliminating staff time. This software has eliminated no shows dramatically.

Once an appointment is scheduled, it automatically confirms insurance information and notes eligibility and deductibles. The information is attached to the patient record for use during the examination process. If the patient misses an appointment, it's documented in his record.

Technology is our friend

Computerization in the optometric office is vital to the success of the practitioner. After all, not only is technology on the rise, but so are patients' expectations. To stay competitive, not only must the eyecare professional continually deepen his clinical understanding, but also create a desire for the patient to return to his office. Advanced computerized technology has created such an avenue.


Practice Management Software Vendors

Here is an abbreviated list of vendors that offer practice management software.*

Compulink Business Systems
Advantage Software
Phone: (800) 456-4522

Crowell Systems
Phone: (800) 366-4564

Healthline Systems Inc.
Phone: (800) 788-3365

First Insight Corp.
Phone: (800) 920-1940

OfficeMate Software Solutions
ReportWRITER/ExamWRITER Medical Records
Phone: (800) 269-3666

RLISYS Practice
Management Systems
Rlisys Systems
Phone: (877) 754-7971

*Note: Not all vendors offer integrated practice management-EMR solutions.


Dr. Lippiatt is president and founder of The Salem Eyecare Center Inc., where she has been in private practice for the last 15 years. Contact her at


Optometric Management, Issue: November 2003