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July 09, 2020
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BLOG: Evolving approaches to patient conversations: Optimizing time in the office

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Now that we have reopened our practices following the initial COVID-19 emergency and are seeing cataract patients again, all surgeons are forced to make adjustments.

One major area is taking extra steps to ensure patients’ comfort and safety. Patients now are more at ease when they can spend less time in the waiting area and in the exam lanes, moving from place to place.

In the exam room, patients appreciate seeing the staff diligently disinfecting surfaces and recleaning the instruments. If they need dilation or are watching an educational video, for example, they like that they can stay put. When patients stay in the exam room too long, however, that begins to disrupt the clinic flow. This is where pre-education becomes important to making consult time count.

Jared Younger, MD

Pre-education

I am now using our patient education software (TouchMD) to reach out to patients before their appointment. This application, or any other customizable software, allows me to include a “Welcome to the Practice” letter, a brief description of the surgery, as well as the surgery options. The email also explains what is required for cataract surgery and what tests and procedures are done at each visit. By sending this information ahead of visits, I have a head start on the process, reducing the time needed for the consult.

I still want my patients to watch an animated 4-minute video right before I enter the room and not a week before. Then, after the exam, I send them the video. I believe this video is the most powerful thing that they see because it explains what a cataract is and the laser surgery options and briefly describes the lens implant options. Most patients will need to be dilating anyway, so this is an effective and efficient use of time.

The key is to modify the schedule or clinic flow so that cataract consults do not make patients feel like the visit drags on, yet they are still receiving necessary education. I continue the same flow for testing as I did before COVID, but patient visits are spread out by an extra 15 minutes. This allows patients to stay in the room while dilating, and it is less stressful for the technicians.

Another adjustment is performing all of the testing on the first visit. When patients come in for the preoperative visit, they only need an additional test if there were any concerns with the first round. Ultimately, this lets me shorten the total time they spend in the office before surgery.

Astigmatism management

The FDA recently granted 510(k) clearance of new software for the Catalys precision laser system (Johnson & Johnson Vision) that I believe will simplify astigmatism management workow and make my surgical process more efficient. This will also add another layer of time savings for my cataract procedures.

The software upgrade is built around a collaboration with Cassini Technologies, increases the accuracy of surgical alignment and allows for automatic cyclorotation compensation that is reportedly threefold better than manual markings.

Conclusion

The company plans to make the package available later this year, and I look forward to incorporating it to further optimize the efficiency of my surgeries and accuracy of astigmatism management. Coupled with the more streamlined approach to patient education and preoperative testing that I have adopted, I believe my patients will be more satisfied than ever with laser cataract surgery.

Sources/Disclosures

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Disclosures: Younger reports he is a consultant to Johnson & Johnson Vision.