Healio
Healio
Issue: November/December 2011
November 01, 2011
1 min read
Save

Premium care through superior technology

Issue: November/December 2011
You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com.

Creating the premium practice means staying “ahead of the pack” in a number of areas, not the least of which being the technology aspect of ophthalmology. At The Eye Institute of Salus University, James S. Lewis, MD, has done just that, creating a high-tech yet inviting environment for his patients.

“I’ve been interested in imaging, particularly video imaging, even before I started my practice,” Dr. Lewis told Premier Surgeon. “It’s the perfect match because ophthalmology lends itself to the creative use of optics, ultrasound, laser interferometry and laser techniques.”

Dr. Lewis’ love of technology can be seen in every aspect of the well-appointed office. Within the waiting areas, patients watch educational videos on large-screen, high-definition LCD and plasma monitors, and each surgical procedure is recorded to DVD using top-of-the-line cameras so patients can view their surgery at home. Images by Peter Olson Photography.

James S. Lewis, MD, shown in surgery.
“I became interested in refractive surgery in 1997 and have had a strong cataract and multifocal implant practice since the Array implants from Allergan was introduced,” Dr. Lewis said. As a primarily surgical practice, Dr. Lewis does not typically perform any routine patient care, with the exception of post-transplant cases.
“I became interested in refractive surgery in 1997 and have had a strong cataract and multifocal implant practice since the Array implants from Allergan was introduced,” Dr. Lewis said. As a primarily surgical practice, Dr. Lewis does not typically perform any routine patient care, with the exception of post-transplant cases.

In 2005 Dr. Lewis was asked to move his practice onto the campus of the Pennsylvania College of Optometry (now Salus University) to teach optometry students and residents the management of more advanced cataract surgery, corneal transplantation and refractive surgery.
In addition to LASIK, epi-LASIK and PRK, Dr. Lewis uses his excimer lasers to treat pathology. Here, a patient with severe anterior corneal dystrophy is having photo-therapeutic keratectomy. The Amoils Brush (Innovamed) and Mastel Laser Clean Room (Mastel Precision) are staples of his operating suite.
In addition to LASIK, epi-LASIK and PRK, Dr. Lewis uses his excimer lasers to treat pathology. Here, a patient with severe anterior corneal dystrophy is having photo-therapeutic keratectomy. The Amoils Brush (Innovamed) and Mastel Laser Clean Room (Mastel Precision) are staples of his operating suite.

Capturing surgical procedures on high-resolution video plays an important role in physician education, according to Dr. Lewis. “I’ve always recognized how powerful and effective this technology can be for the dissemination of medical information, especially surgical technique,” he said.
In keeping with the high-tech feel of the practice, the surgical suite has three HD displays for each laser — one for the patient’s medical record and surgical data, another for entry and validation of the excimer laser’s refractive plan, and a third for real-time video imaging. Additionally, a large-screen display (seen here in the background) and a three-chip, high-definition camera (Ikegami and TTI Medical) aid in the recording of every procedure. “It gives [patients] insight into what’s involved and essentially helps them understand what is done to achieve their desired visual results. Patients are often genuinely interested, and if they’re not, their kids, their spouse or their grandkids are curious,” Dr. Lewis said. “With patient approval we webcast the surgeon’s video, along with video from a pan-tilt-zoom camera showing a live view of the operating suite. This is fun for the patients and their friends and family, but also valuable for physicians and industry,” Dr. Lewis said.
Dr. Lewis has been writing medical simulation computer software since the age of 12 and, in fact, wrote software for a number of major publishing companies during his residency. “Even as a resident, I tried to automate some of the repetitive work, such as the forms we fill out and the calculations of implants,” Dr. Lewis said. “I finally decided I needed to take some time and write a database for my clinical work, which became a medical records system designed for my practice.” Having less tedious work allows Dr. Lewis and his staff more time to focus on interacting with the patients and to run a more efficient practice.

LASIK coordinator, Michelle Nolan, preps a patient for his exam with Dr. Lewis prior to selective laser trabeculoplasty.
Dr. Lewis’s favorite exam room has a prototype single-chip HD camera (on his left) and a full-frame Canon DSLR (not shown) for clinical documentation and education.
Dr. Lewis examines a patient with meibomian gland dysfunction prior to treatment.

Dr. Lewis performs an intense pulsed light (IPL) procedure using a DermaMed laser for the treatment of this patient’s dry eye symptoms. “It’s a fantastic device for dry eye, blepharitis and the rosacea often associated with these conditions. I salute Dr. [Rolando] Toyos for recognizing the utility of this device in the care of the dry eye patient,” Dr. Lewis said. “We’ve been dabbling in IPL immediately before LASIK and it seems to be helping, so we may make that our standard.”
A portion of an i7 quad processor 27-inch iMac shows patient data. A similar machine is housed in every exam room. “I wanted the [health records system] to be like the control panel of an airplane, so when you look at the [patient’s] chart, you see everything,” Dr. Lewis said.
In an effort to make his practice more streamlined, Dr. Lewis created his own customized EHR program, affectionately known as Gloria, “from the middle out, as opposed to the top down,” with three tenets in mind. “First, it had to reduce employees. Second, it had to be physically faster than a piece of paper. And third, it had to make my ability to review the patient’s chart efficient,” Dr. Lewis said.

In an effort to make his practice more streamlined, Dr. Lewis created his own customized EHR program, affectionately known as Gloria, “from the middle out, as opposed to the top down,” with three tenets in mind. “First, it had to reduce employees. Second, it had to be physically faster than a piece of paper. And third, it had to make my ability to review the patient’s chart efficient,” Dr. Lewis said.
The practice houses several YAG lasers in a separate suite, where patients and their family members can view the equipment in advance, as well as a high-definition monitor on which the procedure itself can be seen. “When people see [the equipment], nothing is scary to them, and everything makes sense,” Dr. Lewis said.
Dr. Lewis discusses results from various diagnostic tests, each displayed on a separate screen in the exam room, with a patient scheduled to undergo peripheral iridotomy.

Having a tech-savvy practice with fewer staff members doesn’t equate to a less-personal experience. The staff work hard to ensure patients’ time at the office is both pleasant and informative.
“I’m very fortunate to have a great team. I have a great group of referring optometrists and ophthalmologists, as well as the support of The Eye Institute at Salus University and their optometric residency program,” said Dr. Lewis, who attributes much of his sanity and the practice’s success to the work of Chief of Refractive Services Marcus Devlin, OD (left), optometrist Brett Neal, OD (far left), and Director of Refractive Services – Phoenixville Barry Fabriziani, OD (not pictured). “I call them optomologists. They are a unique group of eye care professionals who are responsible for my ability to provide this level of patient care and surgical service.”
Dr. Neal examines a patient who underwent cataract surgery several months previously to measure her visual progress.

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com.