Article

INTRODUCING AUTOMATED REFRACTION

THE “RIGHT” WORDS CAN MAKE PATIENTS BOTH VALUE AND GET EXCITED ABOUT ANNUAL EYE EXAMS

When I look at the patient confusion regarding optometry, I find much of it is due to our (the doctor’s) lack of effective communication about our technology and “why” it is so important to see us annually. The good news: Using automated refraction and the “right” words can make patients both understand the importance of and become excited about an annual eye exam. (See “Automated Refraction Benefits,” right.)

At my practice, we start the conversation about automated refraction on our website. Specifically, we have information from the company on our website in both digital format for those who prefer a video, as well as written information.

When patients enter the office, they hear from our technicians and from doctors exactly what makes the technology special in words that matter to them. Here’s a look at what the technicians and the doctors say about automated refraction at the patient touchpoints:

Automated Refraction Benefits

AS YOU CONSIDER THE COST OF AUTOMATED REFRACTION, I WOULD ENCOURAGE YOU TO WEIGH THE COST WITH ITS “WOW” FACTOR, AS WELL AS ITS EFFICIENCIES. (FOR A TECHNOLOGY THAT YOU CANNOT BILL A SPECIFIC CODE FOR, YOU WILL REAP UNTOLD BENEFITS.)

State-of-the-art Features

Here is a list of some of the benefits of automated refraction:

  • All the tests available on a manual refractor are available.
  • Increased accuracy: 1/8 D Sphere and 1° Axis.
  • Increased efficiency (of patient flow and refraction itself): Refraction time is typically less than a minute, allowing greater time to communicate prescription needs with patients.
  • Can assess acuity to 20/10 (or smaller) with LCD charts.
  • Can refract in light or dark conditions with LCD charts as opposed to the projector with the light bulb set up projecting on a screen.
  • Coordinates chart selection with test performed automatically with LCD charts.
  • Allows patients to quickly compare their old prescriptions to their new prescriptions, so they can be assured of the value of buying new glasses regardless of the degree of change.
  • Provides for rapid, error-free transfer of data into EHR records, which saves an average 50 mouse clicks.
  • Provides for digital integration of data from multiple instruments/autorefractors/topographers.
  • Can be programmed, so each refraction is done the same way.
  • Programs can be customized for practitioners to allow for their specific preference of test type and order or patient type, such as children and adults.
  • Accurate and demonstrable to the patient instantaneously. Remakes are much less likely when a patient is confident in the results they have seen.

Creating Space

My original challenge in practice was high patient volume with very little space. I was seeing 24 patients a day in less than 900 square feet of space, which included an optical. I evaluated the situation and determined that the fastest way to become more efficient with my time and make better use of my space, while preserving patient care, would be to bring in automated refraction. It worked.

Alleviating Pain

I was also living with constant pain in my right arm from using manual refraction, so I knew that I needed a way to decrease the repetitive movements created by traditional refractions. (This is one of five ways doctors can relieve physical strains: https://bit.ly/2A1KPl4 .)

Patient Excitement

I was shocked to discover how many patients admitted to being nervous, even fearful, of the traditional refraction. One of the most common statements I would hear from patients was, “I know my glasses have never been right because I never gave my doctor the right answers on this test.”

When I brought in my new wavefront autorefractor/topographer and combined it with the digital phoropter, I was amazed at not only the increased efficiencies and ergonomics, but also the patients’ responses to the technology. They commented on a daily basis, and still do, on how impressive the technology is and their happiness that eye exams have improved so much.

I know that I am not alone in my experience with this technology. I have had the honor of visiting many practices over the past 10 years and not only single doctor-owned practices, but also commercial-owned practices, group practices, teaching institutions, as well as Veterans Affairs Medical Centers. In every practice setting, I have seen a distinct difference in the doctor’s quality of life and the patient’s perception of the practice (Net Promoter Score) when they experience an automated refraction. The key word in that sentence is “experience.”

PRE-TESTING

This is where the technicians start the conversation:

“This wavefront technology allows me to gather information regarding your prescription to help the doctor determine the best correction for your glasses and contact lenses. She recommends you have this measured every year to provide you with the best vision.”

EXAM ROOM

When patients see the doctor, the conversation continues regarding the technology, the patient benefits of automated refractions and the need for repeating the test in the future:

“I am going to use these glasses to finalize your new prescription. You may have noticed all the amazing technology we utilize in our office. We invest in the best technology to be certain we get the best results every year. This is one of my favorites because it enables me to determine your prescription with no stress on you to make the right choice. The technology has done most of the work; we just fine tune it. The best part is that when we are done, I’ll show you the improvement in your vision, so you can see for yourself exactly how amazing your new glasses will be.”

After, I use a paging system to notify my optician to come to the exam room, if she is not already there. I then ask the patient for permission to review the results with my optician and then turn the patient over to the optician for contact lens and eyewear selection.

Here is an example of what I say during this process:

“Mrs. Jones, this is Sally. I am going to let Sally know what we have talked about, so she can help you with the contact lenses we discussed. And while the lenses are settling, she will help you with your glasses selection.”

I then turn to “Sally” and say:

“Sally, Mrs. Jones has completed her eye health evaluation. We found that she needs contact lenses for near and far, and I would like for her to put on x brand lenses. I told her how amazing they are. While the lenses settle, I would love for you to help her select her frames for her primary, computer and outdoor vision. Mrs. Jones was super excited to see what a difference the new glasses prescription make in her vision.”

GETTING A “RETURN”

Automated refraction can make refracting fun for the doctor, technician and patient. Many offices teach their support teams how to use the technology and have had great results. Some offices do as I do, which is to have my team take the measurements, and then I fine tune and “bless” the results. Either way, the patient’s perception is that a practice that adopts this technology and tells them why it is amazing is definitely a practice of distinction that they want to return to annually. OM