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Michigan company offers practitioners door-to-door topography service
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ROCHESTER HILLS, Mich. — Eye care practitioners in Michigan and Ohio and parts of Indiana, Illinois and Canada who do not own a corneal topographer now have an option when their patients need mapping: Mobile Corneal Topography.
Shawn Lally, said he founded Mobile Corneal Topography last July to "offer both primary care doctors and surgeons topography so they don't have to make a large cash outlay."
Lally owns a Humphrey Atlas topographer and transports it to eye care practitioners in the area, providing corneal mapping at per-use pricing. He also brings a printer so he can leave maps at the doctors' offices. Lally received topography training from Humphrey and said he has performed hundreds of tests.
The topographer takes up little space in the doctor's office. "Most offices have a retractable table I can use," Lally said.
Some seldom use topography
Lally saw the need for such a service while he was managing an ophthalmology practice. The practice bought a topographer, he said, but found that it was not paying for itself because "the doctors did not need to run topography often," he said. "I thought other doctors might be in the same boat."
Lally knew fundus photography and angiograms were done on a service-type basis, "So I thought: why not corneal topography?" he said.
Lally believes interest in the concept will increase as more doctors become involved in comanaging photorefractive keratectomy (PRK) patients. "Many of the doctors set up for comanagement will have all of the equipment necessary for comanaging except a corneal topographer," he said, pointing out that laser centers want topography done as part of the preoperative examination.
In addition, the ability to send topography maps over the Internet makes them even more useful to practitioners. "A surgeon can review and manipulate the data before seeing the patient," Lally said.
Lally is seeing that not only keratoconus patients are being fit for contact lenses by using a corneal topographer. Contact lens manufacturers can produce first fit contacts using topography on irregular corneas, he said.
Lally is working with 18 doctors, including 10 optometrists. He transports the topographer — enclosed in a secure, foam-padded case — in a van on scheduled days. "Refractive surgery, contact lens and keratoconus patients are asked to return to the doctor's office on one of the days I'm scheduled to be there. Also, I am being incorporated into the initial refractive surgery exam."
He usually sees between three and six patients each day. "I want to be available to doctors within 1 week of their call," Lally said. "If I get to the point where I can't do that, I'll expand."
Money invested in other areas of practice
Danna Haba, OD, a private practitioner from Utica, Mich., who uses Mobile Corneal Topography's services, said access to topography helps her compete in the market, as she can offer "the best quality of care without having to make the outlay for the equipment. You can put money in other areas and still have the technology available to your patients," she said.
Haba previously worked with a group of ophthalmologists who had a topographer. When she stopped working with them, she said, "I realized I couldn't manage without a topographer, but I didn't have the money to purchase my own."
She uses topography for surgical comanagement, keratoconus patients and difficult contact lens fits. Haba said she has no problem asking patients to return on a day when Lally will be at her office, because many of those patients are contact lens wearers scheduled for refractive surgery and must spend some time out of their lenses, anyway, before being mapped.
In negotiations to expand
Lally is offering proposals to laser centers, contact lens manufacturers and PRK surgeons in comanagement systems and optometric vision groups in hopes of expanding his company. In contracts with laser centers, he said, Mobile Corneal Topography will be billed as part of the service from the center. For comanaging optometrists, Lally sees his company as a way to help them retain their patients before referring them to a surgeon and provide a better standard of care postoperatively.
Lally bills the doctor's office or the patient directly. If he bills the doctor, he said, "It's up to individual doctors to figure out if they want to charge over my cost for the procedure." Most insurance companies reimburse for keratoconus, but not refractive surgery.
Haba said she bills the mapping as part of the preoperative surgical care or part of the contact lens fitting fee. "Patients perceive that I have the best hands-on technology," she said, "and they don't see it as a problem that I don't have a topographer in my office."
For Your Information:
- Shawn Lally can be contacted at 2899 South Rochester Road, Suite 316, Rochester Hills, MI 48307; (810) 853-9818; fax: (810) 588-9983.