Preparation key to success with elective IOLs

“Everyone should
understand this
isn’t something the
practice is under taking lightly. Full
buy-in and partici pation from every one is needed. The
sooner you can get
that established,
the sooner you can
get started and the
more successful
you’ll be
”
Stephen S. Lane, M.D.

Surgeon explains his strategy for creating the ideal patient journey through the practice

Setting proper expectations leads to happier patients



Educating your patients with high-quality patient education materials pays off

The latest advances in IOL technology have turned the concept of refractive cataract surgery into reality. With today’s astigmatism- and presbyopia-correcting implants, surgeons can offer patients potentially life-changing visual results. First, however, the practice must lay the necessary groundwork.
For Stephen S. Lane, M.D., Associated Eye Care, Stillwater, Minn., ensuring success with what he calls “lifestyle IOLs” meant preparing the practice in three key areas: mindset, commitment, and education. “First and foremost there needs to be a champion in the practice for adopting these lens es,” he said. “There has to be physi cian buy-in that this is an area in which we want to be involved. If you don’t have a physician champi on, you won’t be successful.”
In addition, the physician must approach lifestyle IOLs with the appropriate mindset, which is that of a refractive surgeon. “A cataract surgeon aims to give patients better vision than what they had with cataracts,” Dr. Lane said. “But a refractive cataract surgeon must want to give patients better vision than they’ve ever had. That’s the difference in mindset.”

Commitment and education

The surgeon should also be respon sible for making sure the entire staff
shares his or her commitment to succeeding with lifestyle IOLs, according to Dr. Lane. “Every step of the way, everyone should under stand that this isn’t something the practice is undertaking lightly,” he said. “Full buy-in and participation from everyone is needed. The soon er you can get that established, the sooner you can get started and the more successful you’ll be.”
Putting the commitment into motion begins with staff education.“Again, this is where the physician comes in,” Dr. Lane said. “Not only technicians but everyone on staff needs to know what lifestyle lenses can and can’t do for patients. They need to know the relevant termi nology, how patients will be edu cated and moved through the prac tice, what testing will be required, everything from A to Z.”
Via a series of presentations, Dr. Lane and other surgeons at Associated Eye Care provided each department, including front desk, phone triage, technicians, and billing, with the information they needed. They first trained people in key positions, who were then able to pass the knowledge to their col leagues. “It’s also helpful to desig nate a counselor to work directly with patients on non-medical issues such as scheduling, costs, and payment plans,” Dr. Lane explained. “Having someone to handle the ‘paperwork’ aspects of lifestyle IOLs greatly minimizes chair time for the surgeons. In our practice we had already been pro viding corneal refractive surgery, so members of our staff were accus tomed to working in this role.”

Walk in the patients’ shoes

“After the staff education process is complete, it’s important to look at the office itself,” Dr. Lane said.“How is it set up in terms of flow and in terms of the environment? Patients who are likely to choose a lifestyle lens have high expecta tions. They want a first-class experience from start to finish. The atmosphere should exude the fact that the practice is immersed in these new lens technologies and that it knows what it’s doing. Finally, a tone should be set where patients hope they are good candidates for one of the lifestyle lenses.”
An educated staff is vital for setting the right tone, as is the office furniture, artwork, and patient education materials. “It should be very much akin to a purely refractive practice,” Dr. Lane said.
Prior to making lifestyle IOLs available to its patients, Associated Eye Care installed large flat-screen monitors in the waiting room. The screens continuously show educa tional videos about lifestyle lenses. In addition, all patients scheduled for a cataract evaluation receive a professionally produced DVD and printed materials about IOL options in the mail prior to their first appointment. The practice uses sev eral sources of high-quality patient education materials and marketing tools, including Patient Education Concepts (Houston, Texas) and Eyemaginations (Towson, Md.).
“Between the educational mate rials and one-to-one discussion with a technician, by the time our patients see the surgeon they have a good background on their IOL options,” Dr. Lane said. That solid background goes a long way toward creating the comfortable, stream lined experience the practice wants to provide. Patient time with the surgeon is streamlined as well.
“When patients meet with me, I have the results of their initial workup in hand,” Dr. Lane said.“Therefore, I know their K readings what IOL power they would need if they were to get a standard IOL, and whether they would benefit from LRIs or a toric lens. From there I make it simple for them to decide what lens is best for them by pre senting what essentially comes down to three choices: a standard IOL if they don’t mind wearing reading glasses post-op, a toric IOL if they have astigmatism and would like to be relatively free of glasses at distance, or a presbyopia-correcting IOL if they have a desire to be free of glasses most or all of the time.”
Dr. Lane provides a ballpark estimate of out-of-pocket costs involved and fields whatever med ical questions patients may have at this point in the visit. However, he allows the appropriate staff mem bers to answer any other questions they may have. “It all works very smoothly, with not a lot of chair time for me. Also, we don’t want patients to have to spend several hours in the office, so those who choose a lifestyle IOL come back for a separate visit to have the addition al testing they need. Then they can be scheduled for surgery.”
In 2009, 33% of Dr. Lane’s cataract surgery patients chose a lifestyle IOL, as did 18% in the prac tice overall.

More pearls for success

Dr. Lane offered three final recom mendations for successfully incor porating lifestyle IOLs into a prac tice. First, discuss the lenses with all cataract patients, even those who aren’t candidates. “Explain why they are not candidates so they don’t end up angry because they were never informed these new options exist.”
Second, extend the practice’s educational efforts to referring optometrists both inside and out side of the practice, but keep patients in your care until you’re sure their expectations have been met. “Most of the optometrists we work with like to see their patients after surgery, but we both want to avoid sending an unhappy patient back,” Dr. Lane said.
Third, Dr. Lane recommends striving to enhance the experience with the practice for all patients, not only those who choose lifestyle IOLs. “The experience should be the same for both groups,” he said.“Don’t get caught up in a ‘two classes of citizens’ type of scenario.”

Contact information

Lane: 651-439-8500; sslane@associatedeyecare.com