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Say Anything | July 2018

Say Anything

What do you consider to be the most important tools and technologies you have available at your practice to boost efficiency inside the OR? Outside the OR?

If money was no object, what additional tools or technologies would you look to purchase that could help you to boost practice efficiency?

Kenneth Beckman, MD, FACS<br>• Comprehensive EyeCare of Central Ohio, Westerville, Ohio

Kenneth Beckman, MD, FACS
• Comprehensive EyeCare of Central Ohio, Westerville, Ohio

"There may not be a specific item that improves efficiency—it’s more about the setup of the practice and the use of two ORs. This is just as important outside the OR because office flow plays a pivotal role in keeping things running smoothly. To improve efficiency further, I would like to add an extra visual field analyzer and OCT device to help decrease wait times in the practice.”

John P. Berdahl, MD<br>• Vance Thompson Vision, Sioux Falls, South Dakota

John P. Berdahl, MD
• Vance Thompson Vision, Sioux Falls, South Dakota

"The most important element to boost efficiency in my practice is a well-trained team—both inside and outside the OR. Any way that we can provide opportunities for our staff to grow can only benefit our practice in the future.”

Daniel H. Chang, MD<br>• Empire Eye and Laser Center, Bakersfield, California

Daniel H. Chang, MD
• Empire Eye and Laser Center, Bakersfield, California

"Having staff that understands the importance of efficiency and has the ability to troubleshoot problems while remaining compliant is a huge benefit to our practice. If I could, I would expand our surgery center to have more space.”

Arthur B. Cummings, MB ChB, FCS(SA), MMed(Ophth), FRCS(Edin)<br>• Wellington Eye Clinic and Beacon Hospital, Dublin, Ireland

Arthur B. Cummings, MB ChB, FCS(SA), MMed(Ophth), FRCS(Edin)
• Wellington Eye Clinic and Beacon Hospital, Dublin, Ireland

"The biggest key to efficiency in the OR is to enter with a plan, with all of the work for selecting an IOL already performed. Planning is just as important outside the OR. To improve efficiency even further, I would invest in intraoperative axis marking and a more powerful electronic health record system than we currently use.”

Sheraz M. Daya, MD, FACP, FACS, FRCS(Ed), FRCOphth<br>• Centre for Sight, East Grinstead, United Kingdom

Sheraz M. Daya, MD, FACP, FACS, FRCS(Ed), FRCOphth
• Centre for Sight, East Grinstead, United Kingdom

"Outside the OR, the OPD-Scan III (Nidek) and its Daya Overview software provides considerable preoperative information. This tool, when combined with an examination lane next to the OR, really helps efficiency with regard to preoperative marking for limbal relaxing incisions or toric lens positioning. In the future, I would like to have OCT-based diagnostic devices that can provide anterior and posterior topography.”

H. Burkhard Dick, MD, PhD<br>• University Eye Hospital, Bochum, Germany

H. Burkhard Dick, MD, PhD
• University Eye Hospital, Bochum, Germany

"Having an OR manager who can take care of patient flow, manage surgeons and nurses, and coordinate surgical procedures is an important tool for improving efficiency.”

Sumit “Sam” Garg, MD<br>• Gavin Herbert Eye Institute, UC Irvine, California

Sumit “Sam” Garg, MD
• Gavin Herbert Eye Institute, UC Irvine, California

"The IOLMaster 700 (Carl Zeiss Meditec) is one of the most important tools to boost efficiency outside the OR. If money was no object, I would invest in a better electronic health record system to further improve our efficiency.”

John A. Hovanesian, MD<br>• Harvard Eye Associates, Laguna Hills, California

John A. Hovanesian, MD
• Harvard Eye Associates, Laguna Hills, California

"The ORA system (Alcon) saves us time by making surgery more accurate and avoiding enhancements. Outside the OR, the software program MDbackline helps educate patients about refractive options and has increased our practice’s premium conversion rate by more than 50%.”

Mitchell A. Jackson, MD<br>• Jacksoneye, Lake Villa, Illinois

Mitchell A. Jackson, MD
• Jacksoneye, Lake Villa, Illinois

"The most important tools to improve efficiency in my practice are Motorola single-earpiece radio devices that we use to communicate with each other. This offers huge time savings for us. If money was no object, I would redesign and build a new office building and go completely paperless. We would perform all work by computer, tablets, smartphones, etc.”

Jason Jones, MD<br>• Jones Eye Clinic, Sioux City, Iowa

Jason Jones, MD
• Jones Eye Clinic, Sioux City, Iowa

"Some of the biggest tools for improving efficiency in our practice include video screens located both inside and outside the OR, surgical chairs that transform into beds and include onboard patient monitors, and the OPMI Lumera 700 microscope (Carl Zeiss Meditec). If money was no object, I would boost efficiency further by adding an anterior segment endoscope and anterior segment OCT.”

Michael Patterson, DO<br>• Eye Centers of Tennessee, Crossville, Tennessee

Michael Patterson, DO
• Eye Centers of Tennessee, Crossville, Tennessee

"Having a staff dedicated to excellence and efficiency is the single biggest factor to having a great OR team. Without them, we couldn’t do what we do. The staff sets the tone for a good day or a bad day. My staff members are always willing to do things that many others wouldn’t. They set the pace, the mood, and the tone for the daily grind both inside and outside of the OR.”

Audrey R. Talley Rostov, MD<br>• Northwest Eye Surgeons, Seattle

Audrey R. Talley Rostov, MD
• Northwest Eye Surgeons, Seattle

"The most important ways we boost efficiency in my practice are by having multiple trays of instrumentation, using two back-to-back ORs, and using reclining chair beds in the OR that eliminate the need to transfer patients back and forth. If money was no object, I would have two femtosecond lasers for cataract surgery—one for each OR.”

Stephen G. Slade, MD, FACS<br>• Slade and Baker Vision, Houston

Stephen G. Slade, MD, FACS
• Slade and Baker Vision, Houston

"The most important tool inside the OR to improve efficiency is an excellent microscope. Thinking outside the OR, the floorplan of the clinic plays a big role in how the practice functions. If money was no object, I would expand our floorplan even further.”

Christopher E. Starr, MD<br>• Weill Cornell Medicine, New York Presbyterian Hospital, New York

Christopher E. Starr, MD
• Weill Cornell Medicine, New York Presbyterian Hospital, New York

"We now have the LenSx Laser System (Alcon), the Verion Image Guided System (Alcon), the ORA system, and Callisto eye in our OR. I’m not sure that it boosts efficiency in the OR, but it certainly boosts outcomes, and that is what is most important to me. Another boost to refractive outcomes is our use of point-of-care diagnostic tests for diagnosing dry eye and ocular surface diseases. The Oculus Keratograph 5M is the number 1 thing I would like to add—bundling so many objective and noninvasive ocular surface tests into one machine would certainly boost our efficiency.”

Karl G. Stonecipher, MD<br>• TLC Vision, Greensboro, North Carolina

Karl G. Stonecipher, MD
• TLC Vision, Greensboro, North Carolina

"Anything that can improve my outcomes inside or outside the OR, such as the ORA system, is important to me; however, there is nothing more important than a well-trained staff. If money was no object, I would duplicate the technology in my practice to allow other rooms to open. Practice efficiency means improved outcomes, which means happier patients.”

William B. Trattler, MD<br>• Center for Excellence in Eye Care, Miami

William B. Trattler, MD
• Center for Excellence in Eye Care, Miami

"The Intelliaxis feature of the Lensar Laser System (Lensar) has been a game changer for improving efficiency in our practice. Data are sent directly from my topographer to the system, which performs iris registration to ensure that the axis marks will be correct. To boost efficiency even more, I would like an automated outcomes data program so that I can easily determine the percentage of eyes that achieve a specific visual acuity following surgery.”

Robert J. Weinstock, MD<br>• Eye Institute of West Florida, Largo, Florida

Robert J. Weinstock, MD
• Eye Institute of West Florida, Largo, Florida

"To improve efficiency in my practice, I use a fellow to perform femtosecond laser treatments and postoperative follow-ups, see emergency patients, help with surgical planning, and help see patients in the clinic. This has been a game changer for increasing my productivity. If money was no object, I’d hire more technicians and scribes.”

William F. Wiley, MD<br>• Cleveland Eye Clinic, Ohio<br>• Clear Choice LASIK, Ohio

William F. Wiley, MD
• Cleveland Eye Clinic, Ohio
• Clear Choice LASIK, Ohio

"Inside the OR, MKO melt (midazolam, ketamine HCl, ondansetron, lemon, Imprimis Pharmaceuticals) helps make our nursing team more efficient by not having to place an IV in patients. Outside the OR, Surgiorithm software helps educate our cataract patients about their options and relays key information about patient expectations to the surgeon. If money was no object, I would add an additional OR space. We could make much more efficient use of surgeons’ time and reduce the pressure on our nursing staff to turn over the rooms.”

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