Dr. Horie’s office. She says a few key recent purchases have made a huge difference to patient care and profitability.
By Tia Horie, OD
Nov. 17, 2021
Technology and scientific innovation can take your practice to a whole new level, both in the patient care you are able to provide and in the level of profitability you are able to attain. Here are two key technology investments and a scientific innovation my practice has invested in, which will help our patients while enabling us to grow our profitability.
Topcon CV-5000s with Digital Chart & RDx Capability
With the rise of the COVID variants, it appears that social distancing and masking are here to stay. I decided to invest in the Topcon CV-5000s with digital chart and RDx capability. This is a tool that allows me to stay as far away from patients as possible during exams while giving them the benefit of the latest technology.
This new device, which I started using in late September 2021, enables me to remain at a desk while I refract. I do not have to be right in the face of the patient. It also has the capability of facilitating remote refractions. It is possible for me to do a refraction remotely, with the patient in-office while I could be in a separate room (at a computer) or at home. This allows for fewer people in the office, and if I had to quarantine because of COVID, I could still see patients remotely.
Cost: I paid for the system, which comes with a warranty, and installation included, for $11,420. I purchased the Topcon with an equipment practice loan through Wells Fargo. My monthly payments begin December 2021 for $220 a month for 60 months. I went through a broker to find the right practice loan. Brokers can help speed up the search for good rates, and searching this way doesn’t limit you to getting only one quote at a time.
ROI: With this new technology I expect to improve accuracy. This should decrease our redo rate. I have noticed that redo rates have increased with the fogging of previous phoropters. With Topcon, a patient can remove their mask while refracting, decreasing fogging. The refraction itself is about 15 percent faster than before. With the time saved, I could add one more patient into my schedule per day.
The Topcon CV-5000s in Dr. Horie’s office. She says the technology has boosted efficiency and safety for her patients and practice.
I also am able to retain current patients and attract new patients with the upgraded technology. While some of these factors are not directly measurable, I would expect it to take about 3.8 months to break even on the investment if I just factor in adding in one extra patient per day, with an average of about $150 of revenue gained per patient, totaling an additional $36,000 annually. I expect to start profiting from the investment by early this winter.
This technology creates a safer environment for my patients, especially during the COVID pandemic. I can offer patients more efficient and accurate exams and a new technology that shows that we as a practice are willing to invest in our patients’ well-being.
Uprise EHR by VisionWeb
I was using a general medical EHR system, and I needed something more specific to optometry. Starting in January 2022, all prescribed medications have to be sent electronically. I wanted to have an EHR system in place that allowed for eRx. This fall we started using EHR by VisionWeb.
Cost: The training sessions take about 10 hours away from patient care. I need to set aside extra time for staff and doctors to train. This cuts into the amount of exams I can see during that time. I estimate 20 patients or $3,000 will be lost during training. The monthly cost for the EHR is $299.
ROI: Profit will come from being able to maintain the office visits and our medication prescription capability and from a decrease in costs for physical goods.We see about 10 patients on average per month for office visits that require medication prescriptions. With the incorporated eRx feature, we are able to continue seeing those patients and keep the approximately $550 per month of revenue those patients bring into the practice.
Additionally, there will be a savings in paper, toner, filing supplies and filing cabinets. That cost I estimate to be about $100 a month. With all of that considered, I expect to break even after 7-8 months. I expect to start profiting from this investment in 8-9 months. Once we break even, this system can help us maintain and eliminate costs equal to about $650 a month in revenue.
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In addition, there are logistical improvements enabled by a switch to a high-quality EHR. Paper charts often get lost. Electronic charts offer more organization and decrease the chance of losing records. Having an EHR allows for charting that makes sure that all insurance and exam minimum requirements are met. We can save on the cost of paper, and it is better for the environment.
Don’t be afraid to shop around for an EHR that fits your needs. I have tried a few, and there are pros and cons to different systems. I always back up my patient files via an external hard drive to make sure I have access to my patient data outside of the EHR cloud-based systems. I do this in case the EHR system crashes, has maintenance planned or I change EHR systems altogether.
Pure & Clean Hypochlorous Solution HOCL 0.01% Stabilized Solution
I wanted an alternative way to keep my office and patients clean from viruses and other contaminants. Pure & Clean, which I began using in September 2021, is a solution that kills viruses and bacteria quickly and effectively by introducing concentrated oxygen to the treated site through hypochlorous acid. It kills COVID in 15 seconds. Some of the alcohol- and chemical-based cleaners we use require us to wait 5-10 minutes after application. Unlike alcohol or stronger chemical cleaners, Pure & Clean has little-to-no smell.
It is used on eye lids to treat blepharitis and does not burn or sting if sprayed in the eye. It is perfect to use for children. With alcohol-based cleaners, if a child immediately touches their eye after application of the alcohol, they show signs of irritation, and ocular ulceration in the worst cases. With Pure & Clean, you could spray the cleaner directly in your eye and have no irritation or adverse side effects.
Cost: I purchased a starter-kit bundle of hand prep liquid spray, hand prep liquid gel and hydrogel lid prep for blepharitis patients. This kit was $511 after sales tax. I expect the kit to last four months. I expect to buy a new set every four months, bringing the cost to the practice to about $127 per month. I am a Vision Source member, and have a discount for Pure & Clean through that organization. If you are going to buy this product, ask about discounts you may be entitled to through your buying group or insurance group affiliations.
ROI: The kit comes with individual bottles of hand prep and lid spray for my blepharitis patients. I can sell them in our office for $10-15 per bottle. Each kit comes with 16 retail bottles and two gallons of in-office solution and about four larger bottles to use in-office. With each bottle priced between $10-15, and about 16 retail bottles in a kit, revenue generated would come to about $200 per bundle order.
I have discontinued use of our previous chemical and alcohol disinfection sprays, which cost us about $100 a month. I project breaking even after the first four months of using Pure & Clean. I expect to start profiting from this investment after six months, generating an additional $600-$1,000 annually.
Tia Horie, OD, is the owner of Horie Optometry, a Vision Source Signature Eye Care practice, in Vacaville, Calif. To contact her: horieoptometry@aol.com
