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Mobile technology ‘bridges gap’ in standard of care
With some diagnostic equipment costing as much as a luxury vehicle, it may be a struggle for clinicians to purchase the latest technology for their practices. Mobile diagnostic companies such as Mobile Glaucoma Solutions, the Technology Source and Mobile Diagnostics provide the newest instrumentation and trained technicians with no cost outlay for practitioners.
Business of mobile testing
Mobile diagnostic companies travel within specific areas and bring cutting-edge technology to practices by appointment. Equipment varies, but the standard offering is a GDx VCC (Carl Zeiss Meditec, Dublin, Calif.). Some companies also may include the Ocular Blood Flow Analyzer (Paradigm Medical, Salt Lake City), a pachymeter and a number of other Carl Zeiss Meditec products: Humphrey Matrix perimeter, Visante OCT, Stratus OCT and a Cirrus HD-OCT.
Mobile equipment companies also may provide trained technicians, offer scheduling suggestions, organize patient flow for testing and have a trained professional available to serve as an advisor to practitioners who are unfamiliar with interpreting the data gathered from the tests. Some companies even offer advice on proper billing and coding for services rendered.
Billing for services differs depending on hours needed and services required. Some companies will simply drop off the equipment and charge a rental fee, while others will supply a technician who will operate the equipment for a set cost. Some services will charge a fee for each test performed, and others bill Medicare for the technical component of the testing and allow the doctor to bill for the professional fees he or she will collect.
Technology becoming standard
According to John A. McCall Jr., OD, a member of the Primary Care Optometry News Editorial Board and founder of Mobile Glaucoma Solutions (MGS), a nationwide service, the greatest advantage of using a mobile company is the opportunity to have access to the latest equipment available and provide the best possible care.
“I feel that we’re one lawsuit away from these new imaging devices becoming standard of care,” Dr. McCall told PCON. “These instruments enable you to diagnose glaucoma much sooner and with more accuracy than not having them. If a glaucoma suspect comes into your office, you should be able to make a diagnosis with 100% accuracy. Without these instruments, it could be difficult.”
Offers continuity, convenience
David C. Brewer, OD, uses MGS as a convenience for elderly patients. “I’m in a suburb of a larger metropolitan area, and it’s hard for our older patients to travel in the larger city to a specialist for these tests. Being able to offer it right here in this small town is great,” he said.
T. Geoffrey Iszard, OD, agrees. “It’s nice to not have to refer out a patient who’s comfortable [in your practice], and it’s obviously nice to keep some of that revenue stream in your office,” he said.
Affordable for small practice
With some of this diagnostic equipment listing at close to $100,000, some say “sticker shock” prevents practitioners from investing in technology if they do not have the patient base to substantiate the purchase.
The Technology Source, which operates in 20 states throughout the Midwest and Southeast, was founded by Duane R. Morrison. Mr. Morrison began his service to help close the gap between the larger practices and the average practitioner who was struggling to justify the cost of expensive technology that changes almost yearly.
“This technology really is the future, but unfortunately the cost, rapid obsolescence and the potential of falling reimbursements deter a lot of doctors from purchasing it,” Mr. Morrison said. “Mobile diagnostic companies are available to fill that gap and allow doctors to remain at the cutting edge in retina, macula and glaucoma.”
Bonny Eads, OD, is one of Mr. Morrison’s clients who falls into this category. “The equipment is relatively expensive and we were fearful we couldn’t justify the expense of purchasing it and keeping it upgraded with the latest changes in the program,” Dr. Eads told PCON.
Better quality of care
Albert A. Morier, OD, founder of Mobile Diagnostics, which serves an area of New York State, is concerned that patients who need to be tested are not given access to this technology because of providers’ unwillingness to adapt. “It’s been well reported, primarily from Harry Quigley, MD, that a patient must lose 50% of the nerve fiber layer before glaucoma would show up on the visual field test,” he said.
“What disturbs me the most, though, is that I see a tremendous division between some of my colleagues who depend on this information and really value and appreciate it, and others who are not using this technology either in a mobile service or purchasing their own,” Dr. Morier continued. “There’s no reason for patients not to have access to technology such as the GDx or HRT [Heidelberg Engineering, Vista, Calif.], and I’m concerned that some of my colleagues are slow in getting on to this,” Dr. Morier told PCON.
Making decision to purchase
Charles Rheeman, MD, a Mobile Diagnostics customer, is now considering purchasing his own equipment. He cited patient inconvenience as one factor. “I [could run the test] on the same visit instead of making them come back another day,” he said.
Better patient care is another factor. “[GDx] technology is almost a standard of care not just for glaucoma, but for optic nerve problems as well,” he said.
For more information:
- John A. McCall Jr., OD, is a Primary Care Optometry News Editorial Board member, a private practitioner and senior vice president of vendor relations for Vision Source.
- Mobile Glaucoma Solutions can be reached at (713) 303-5572; Web site: www.mobileglaucomasolutions.com.
- David C. Brewer, OD, can be reached at 1207 S. Cornwell Drive, Yukon, OK 73099; (405) 354-3384; e-mail: drdcbrewer@jbeye.com.
- T. Geoffrey Iszard, OD, can be reached at 2323 Clearlake City Blvd., Suite 150, Houston, TX 77062; (281) 480-1002; e-mail: tgiszard@pdq.net.
- Duane R. Morrison, of the Technology Source, can be reached at 508 Andros Lane, Indian Harbour Beach, FL 32937; (321) 777-5353; e-mail: drmorrison@earthlink.net.
- Bonny Eads, OD, can be reached at Drs. Dery, Eads, Barton & Witten, 60-10th St. North, Naples, FL 34102; (239) 261-7071, fax: (239) 263-0807; e-mail: drdery@embarqmail.com.
- Albert Morier, OD, of Mobile Diagnostics, can be reached at Di Napoli Opticians, 1220 New Scotland Road, Suite 101, Slingerlands, NY 12159; (518) 439-0935; e-mail: amorier1@nycap.rr.com.
- Charles Rheeman, MD, can be reached at 63 Shaker Road, Suite 101, Albany, NY 12204; (518) 434-1042, fax: (518) 434-4327; e-mail: crheeman@nycap.rr.com.