Educate patients about premium IOLs without blowing up your schedule
Best practices should be implemented so that patients can learn about premium procedures while having a premium office experience.
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In our busy North Florida practice, more than one-third of our cataract patients choose femtosecond laser-assisted cataract surgery, a toric IOL and/or presbyopia correction.
Our “conversion rate” is well above the national average because we educate every patient about lens options, and we have been able to do that without increasing chair time or slowing down the schedule.
Patients who are electing a more expensive, premium refractive IOL expect to have a premium experience. And to me, that means minimizing wait times. Just like I value my time, I am a firm believer in respecting my patients’ time. It has also been shown that longer wait times have a negative impact on perceived quality of care, confidence in the care provider, patient satisfaction and willingness to recommend the practice (Figure 1).
Source Ravi Patel, MD
To improve efficiency, you need data. Using a robust electronic medical records and practice management system (athenahealth), we track check-in to check-out time, wait time, and time spent with each staff member or provider, and then use that data to improve staff training and adjust our schedule templates. Here are five best practices we have implemented.
Aim for multiple ‘touches’
Patients’ time in your office is limited, so an effective education strategy has to include digital and/or print components. In our practice, we send patients reading material and a link to our website before their appointment and have them watch an educational video while dilating. Staff members start talking about lens options during the workup, and we ask patients to complete a lifestyle questionnaire that gets them thinking about vision needs before they discuss options with the doctor. Multiple touchpoints provide patients the opportunity to absorb new information without feeling rushed or pressured.
Bring your staff up to speed
Patient education begins with staff education because patients will spend far more time talking to our staff than to us. I want staff members to fully understand the benefits of correcting astigmatism and who are good candidates for toric IOLs, for example, so they can answer patients’ questions. We script common answers to ensure that patients hear consistent messaging. To make sure the whole staff is up to date on the procedures we perform and the technologies we use, the physicians in the practice hold monthly after-hours in-services for staff, and we also dedicate time for industry vendors to train staff on new products.
Be smart about scheduling and flow
One of the best things about tracking wait and exam times is that it helps you plan an efficient schedule. It is important for each physician to know how many patients — and what mix of patients — he or she can realistically see during a typical day and then schedule accordingly. If you are only capable of seeing four patients per hour but you are routinely scheduling six, that is a recipe for patient dissatisfaction and physician burnout. Staff have varying levels of efficiency, too. We have set reasonable standards for the number of patients a technician should be able to handle in a day, but some staffers exceed expectations. We schedule more patients with the faster techs. My office is also set up to promote efficiency with a “racetrack” model (Figure 2), in which the patient progresses in one direction (from testing to dilating to physician exam to surgical counselor to checkout) without ever needing to go backward.
Choose technology wisely
I look for technologies that will meet patient expectations and not require a lot of extra hand-holding or counseling. Osmolarity testing is quick and easy and provides me with an actionable data point for ocular surface health. When it comes to IOLs, my preference for most patients who want spectacle independence is a Tecnis Symfony extended depth of focus lens (Johnson & Johnson Vision). I know they will get a wide range of good vision with minimal side effects and night vision complications. I can implant it in astigmats, and it pairs easily with a mid-add multifocal if the patient is not fully satisfied with near vision after the first-eye surgery.
Measure twice
I am an advocate for two preoperative visits for cataract patients. The first visit is a comprehensive eye exam with refraction and evaluation of the lids, cornea, lens, retina and optic nerve. We perform tear osmolarity testing on all patients at this first visit. Biometry and IOL selection happen at a second visit several weeks later. Importantly, this gives us time to identify and treat ocular surface problems in between, so that discovering the patient has dry eye does not set back the whole schedule. This also gives patients more time to be educated and think about their lens options.
By following these guidelines, practices can ensure high-quality patient education and a premium experience without long wait times.
- Reference:
- Bleustein C, et al. Am J Manag Care. 2014;20(5):393-400.
- For more information:
- Ravi Patel, MD, can be reached at Florida Eye Specialists, Jacksonville, Florida; email: rpatelmd@nflsurgeons.com.
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