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BLOG: Climbing the technology ladder
It was an interesting week in New York City for the many attendees of Vision Expo East. We dodged big snowflakes, stepped over mounds of slush and saw that it takes more than snow to stop the city that never sleeps. My Fitbit recorded my number of steps, and on one of the days I clocked over 8 miles of walking. My ears are still ringing from the “Eye Docs of Rock,” and it wasn’t until the Amtrak ride back to Philly that I had a chance to reflect on all of the things that I had learned and what they all mean.
I must say that before this meeting I did not see the importance of advanced glycosylated end products for optometry, but now I certainly see it. There are a number of other things that I did not see clearly but are now coming into better focus.
I want to talk about the future of private practice optometry as well as the advances in the profession overall. I spent most of the New York meeting in the medical technology section of the exhibit hall and did not even make it over to the frames. I like frames, but I just don’t see them as part of the future of private practice optometry.
Initially, I don’t think that I quite grasped the fundamental importance of the basic move of an optometry practice to electronic health records (EHRs). In our office, as we struggled through the steep learning curve, the slowdown in patient traffic and many of the other issues that I mentioned in “The practicality of meaningful use,” I did not see their ultimate value. I only thought of it as a better organization of each patient’s information and some extra space in that area that used to house all those paper charts.
With that transition behind me, I now stand on a new plateau and can see a number of ways that our practice can provide better medical care, communicate with other providers and truly participate in coordinated, collaborative health care.
As I looked around at the different vendors and their respective products, I suddenly realized that most of the new hot instruments, concepts and programs required a practice to have a fully operational EHR system to even consider their use. I noted that many of my optometry colleagues in private practice and without EHRs were just strolling by most of the new vendors and shaking their heads as if they had just landed on Mars.
I remember when our family got our first personal computer. We were not sure exactly what we wanted it for, but it seemed like it could help us organize our checkbook. There were also some cool games, and it might even be able to replace our typewriter if we paid extra for a printer. I did not know at that time that I was on the first rung of the technology ladder.
As we worked with that first computer, we learned of more and more that could be done and continued to step up onto each new rung of the ladder with more confidence. Not long ago, I was rooting around in the basement and counted over 50 machines in our computer graveyard. In the main living quarters of our home today, there is some kind of computer on every flat surface.
When I think back now on how that all evolved, I should have seen that this process is still happening today. For an optometrist, converting to an EHR is the first step on the eye care technology ladder. If you don’t get on that first rung, you cannot even consider the second and third rungs. Your EHR is connected to your computer system. Your computer system is connected to the Internet. The Internet is connected to everything. If you count the number of “apps” on your smart phone, it is easy to understand how many apps will connect to you and your practice to mainstream medical care and make you a relevant primary care player of health care reform.
So the main lesson for this year is that every optometrist must have an EHR and, in particular, private practice optometrists must make this step to survive. Forget about stimulus money and Medicare penalties; those are footnotes of a much bigger picture. If you have not started, make this your top priority for 2015. If you have one and are struggling making it work, hang in there. Like the first computer, it is worth learning to master.
As my younger son once told me: “If you don't get a smart phone, you can’t use any of the cool apps.” I’ll pass on his advice in optometry-speak: “If you don’t have an EHR, you cannot provide modern medical care.”