Optometric Management Supplements

Dry Eye 2017

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14 JANUARY 2017 Better Care Drives Revenue Growth For dry eye, we've created a practice within a practice B ecause dry eye can be a consequence of ocu- lar surgery and best eliminated prior to sur- gery to foster the best outcomes, we decided to make treating it a priority in our practice. To do so effectively, we incorporated new diagnostics and treatments and made available to our patients vari- ous over-the-counter products to help them care for their eyes. Essentially, we created a practice within our practice. We did this first and foremost to provide bet- ter care for our patients, but there are many other good reasons, too. Developing a strong dry eye component in a practice bolsters the patient perception of the practice as a leader in the field, reduces the contact lens dropout rate, and generates referrals. In addition, treating this chronic, progressive disease is a significant contributor to the bottom line. POINT-OF-CARE TESTING IS A RECENT DEVELOPMENT Point-of-care testing for dry eye has been a posi- tive development. Two tests we use in our practice are the TearLab Osmolarity System (TearLab) and InflammaDry (RPS). Technicians can perform either of these tests efficiently as part of the patient workup, and both companies help with all aspects of adopting the technology, including practice logistics and marketing. For Medicare patients, these tests are 100% reimbursed as long as the practice obtains a Clinical Laboratory Improvement Amendments (CLIA) waiver, which isn't difficult to obtain in most states. Optometrists should embrace point-of-care testing as a means to achieve more accurate diagnoses and treatment plans. Not doing so could lead to eventual exclusion from insur- ance panels. In addition to point-of-care tests, meibography and anterior segment imaging, including new features on some topographers and tomographers, can be used to help detect and document the signs and causes of dry eye. e LipiView II interferometer (TearScience), for example, takes meibography to a new level with its abil- ity to measure lipid layer thickness, evaluate blink rate, and allow visualization of the structure of the meibo- mian glands. e clarity provided by the LipiView II was recently enhanced with the addition of Dynamic Meibomian Imaging. Used in conjunction with the LipiView, the Korb Meibomian Gland Evaluator (TearScience) enables standardized, repeatable evalua- tion of meibomian gland function at the slit lamp. All of the tests related to dry eye and meibomian gland dysfunction (MGD) are revenue generators for a practice, some more so than others. However, overall, they fuel the dry eye segment of the practice by allowing us to identify more dry eye, schedule more patient visits, and provide more treatments. RE-APPOINTING PATIENTS FOR TREATMENT Scheduling dry eye treatments separate from routine exams and dry eye testing, i.e., re-appointing patients for subsequent visits, is key to ensuring not only that you have adequate time to spend with the patient, but also that you will receive appropriate payment for services. Re-appointments are a staple in most medical care mod- els, in which patients are rarely if ever diagnosed and treated in the same day. e subsequent appointments By Douglas K. Devries, OD

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