Why It’s Important to Stay at the Forefront of Eye Care Technology

There’s no denying that optometric practice has changed since the onset of the COVID-19 pandemic. In fact, it was changing even before the pandemic. The quantities of data we deal with have multiplied, our storage and processing have been increasingly moving to the cloud, and patients expect to be able to be seen or managed remotely through telemedicine for interactions that would previously have brought them to our offices. Many practitioners took notice, got in front of this trend, and have invested in new technologies to ensure that their practices were able to adapt to the changing times.

The pandemic rewarded those who invested, allowing them to survive and even grow. However, this scenario has also heightened patient expectations.

Many patients who come to our offices for the first time (aside from our established patient base) do so because they have heard or read about the technology we use. This can be a good thing, but beware. Investment in technology is not an end in itself. Technology must improve care, and hopefully pay for itself, in order to be a worthwhile acquisition. A technology that looks cool but does not drive outcomes can be a drag on income or profitability, rather than a practice booster.

TECHNOLOGY BENEFITS

A new technology can benefit a practice in several ways. One is by improving patients’ interest in their own care. Consider our clinical trial patients who come to us from all over the region. When I demonstrate some of our advanced imaging technologies—an OCT angiogram (OCTA) or an ultra-widefield image, for example—they’re blown away because they’ve never seen the manifestation of their condition in their eyes before. Being able to visualize the impact of their health on their eyes at each follow-up visit helps them remain invested in their eye health and in the trial results, and willing to make the long trips needed to stay compliant with trial schedules.

Another benefit of some advanced diagnostic technologies is their ability to acquire data remotely and to store and process that data in a cloud environment rather than on the device itself. These capabilities have stepped up telehealth services by leaps and bounds. The ongoing COVID-19 pandemic has demonstrated this. Diagnostic technologies that allow us to screen patients without risky exposure, upload the results to the cloud, review them remotely, and discuss the findings without the requirement of traditional office appointments, have all helped to increase patient confidence in our services—and potentially limited unnecessary exposure.

It is also vital that the information we acquire can be shared and integrated with findings across different modalities, by different software platforms. The days of siloed technologies and proprietary platforms are, we hope, behind us, and many companies have made significant moves in this direction.

It is helpful, for example, to see how a visual field and an OCT tie into one another. Similarly, overlaying a retinal photo with OCTA can give us insights about the relationship between pathology and blood flow.

SURVEYING YOUR TECHNOLOGY

How do you know when it’s time to update your technology or bring in new technology? Ask yourself two questions.

What does your current patient population look like?

If you see, let’s say, roughly 3,000 patients a year, and you know that 30% of them are over age 60 (roughly 1,000 patients over age 60), that’s useful information. You could then further tally the percentage of patients with diabetes, macular degeneration, and dry eye for a good, round estimate of what conditions you’re treating and how frequently.

Now, say you have an OCT unit that’s 10 years old, that does not have angiography capabilities. You know that OCTA can give us a real leg up in managing patients with diabetic retinopathy or age-related macular degeneration (AMD), particularly in terms of understanding when a patient might be converting from dry to wet AMD. With patients’ best interest at heart, technology available today compels us to invest.

These kinds of data, even if they are back-of-the-napkin calculations, can help you figure out whether your patient base justifies updating the technology in question.

What specialty do you wish to develop?

Given the patient base analysis that you just performed, think about a specialty you might want to develop that you already have a decent baseline for. This allows you to consider making an investment or technology upgrade. If it’s an upgrade, consider whether the device will allow data to be exported for deeper analysis or will trap that data on that machine.

KEEP THE MIND ON FINANCES

Demographics aside, decisions made about technology upgrades should always consider the return on investment.

Let’s say you’re building your practice and you’re about to hit a sweet spot where you will have really consistent revenue. This is when you have to start thinking about tax implications such as depreciation and amortization, because that depreciation acts as an indicator of the real value of the technology asset.

Suppose you’ve made a purchase that allows you to write off $30,000 in depreciation. You were either going to pay a portion of that money in tax to the government, or you could use it to purchase a device that gives you a deduction and potentially boosts revenue. That’s where having that conversation with your financial advisor is so important. That device and its depreciation essentially can become an asset management account against tax liability. The best clinicians who are also businesspeople do a really effective job of understanding how much their estimated tax liability is, and when to turn that into a compelling reason to buy something that will benefit the income of the practice. Keeping in mind the 1,000 patient estimate above, a technology that nets ~$30 per patient would essentially produce $30,000 in profits in year 2.

You really want to do your tax and purchasing planning in July and August. If you’ve maintained your financials, by July or August you should know what September through December will generally look like, give or take. You might consider aligning your purchases with the fiscal behavior of the manufacturers. If you know when different companies will have specials or will be pushing sales based on their fiscal calendars, you can plan ahead for purchasing and strike some great deals.

When it comes to staying on the cutting edge and embracing new technology, affordability is crucial. You don’t want to break the bank and put yourself into a $1,500 or $2,000 monthly lease if you won’t have the money to spend. But if you can generate enough revenue in the first year to perhaps break even, and you have the potential to do the same next year and hopefully grow the practice through the new functionality provided by this new instrument, then it’s a zero-sum no-brainer.

QUALITY OVER QUANTITY

It’s vital to our practices that we stay at the forefront of technology. It’s what our patients want and what trends indicate. However, it’s imperative that we exercise caution about the kinds of technological investments that we make.

Case in point: Digital refractors are pretty cool. They come with lots of bells and whistles and can make us faster in clinic—if our goal is to fly through as many vision examinations as possible each day. On the other hand, digital refractors do nothing to drive additional revenues, unless you’re strictly talking about seeing more patients. But higher volume doesn’t necessarily translate into more dollars per hour because it tends to erode the patient experience. So we have to think long and hard about whether a particular technology is a good investment.

During the pandemic, our practice had the same financial performance in 2020 that it did in 2019, even though we saw fewer patients. So yes, invest in technology, but consider the pros and cons for your own particular situation before you invest.