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The Fluid Practice - EPIC Success

A practice that started with one EPIC system upgrades to 14 systems — all providing accurate, reliable refractions in less time.

By Tom Restivo and Donna Diehl

A single purchase more than a decade ago has shaped the way our practice functions today. In January 2000, we purchased an EPIC system and began using it to obtain consistent, reproducible laser vision correction refractions — before and after surgery. This remarkable system has proven valuable — even beyond refractive surgery.

As we grew, we began to broaden the use of the EPIC throughout the clinic, and today, our goal is to use it for almost every patient. As a result, we now have six EPIC systems in our main office, and we'll soon add two more for a total of eight. Six of our 14 satellite offices have an EPIC as well, with plans to equip most of the remaining satellite offices in the near future.

Our 11 ophthalmologists and four optometrists aren't simply into buying “toys” — they only purchase those technologies that improve outcomes and revenues. Once they saw what the EPIC system could do for the practice, buying more EPICs was an easy “big picture” decision.

The EPICs offer consistent refractive results, move patients through the practice in less time with greater satisfaction, and even reduce the square footage required in our offices. Our continued investment in more EPIC systems has been a fast green light from our accountants, too. The time savings we achieve using the EPICs easily translate into greater revenue for the practice.

Smoother Patient Flow

The EPIC streamlines patient flow and cuts workup time significantly, and this achieved by simply implementing the EPIC, not by undertaking a major overhaul of practice procedures.

In our practice, the six EPIC systems are running all the time. When a technician is available, he calls the patient back to an EPIC room and performs the necessary testing, and then moves the patient along to an exam room. This saves several steps from the manual process, which also requires technicians to leave the workup room to measure the patient's eyeglasses, return to complete a history, check visual acuity, perform refraction and enter all of these numbers into the electronic medical record (EMR). The saved minutes quickly add up.

Performing a complete workup manually can take 20 minutes or longer. With the EPIC, everything is done in one room — there's no need to move patients from machine to machine. Visual acuity testing and refraction happen at once, and results go straight into the EMR system. In our practice, this only takes 7 to 15 minutes, depending on how much of the patient history has previously been entered into the EMR system. Our technicians who are trained on the EPIC dislike getting assigned to use the manual lane, so we're eagerly awaiting the arrival of two new EPIC sytems.

See More Patients

If technicians can move patients through the practice more quickly, then physicians can see more patients per day. At first glance, “faster” brings to mind a reduction in quality time with patients, but in the case of the EPIC, counter-productive time is cut, allowing better clinical results and patient satisfaction.

By shaving an average of 10 minutes from the 20-minute manual workup, we have enabled the volume capacity of the practice to increase. It's difficult to quantify the change in our patient volume because we've simultaneously expanded the facility and added doctors, but we comfortably reach our goal numbers every day with no added time or staff.

Marketing Tool

In the case of the EPIC, what's good for the practice is good for the patient, and what's good for the patient is good for the practice. The most obvious example to us is that many patients see the “wow factor” in the EPIC, and they actually mention it to family and friends.

The EPIC systems have increased patient satisfaction as well. When workups are faster and patients have one-stop testing in the office, we're expediting their visit in the clinic. Patients finish and get on with their day sooner, and they appreciate that. Because we still have some manual lanes, patients who want to save time on return visits often ask us for EPIC testing. The fact that the EPIC's results are so consistent and accurate also means less time tweaking prescriptions and fewer mistakes.

The EPIC is of great benefit to our elderly patients, offering them increased comfort and convenience while saving us time. With the EPIC, patients don't have to be moved several times between machines, which can be uncomfortable for them and time-consuming for us. Patients in wheelchairs don't have to go from the wheelchair to the exam chair and back again, which is an enormous benefit. It's excellent customer service to make sure all of our patients are comfortable in testing. It's also excellent business to save 2 to 4 minutes per elderly patient by not moving them up and down the hallway and in and out of wheelchairs. Multiply those minutes by 30 patients per doctor per half-day, and you're looking at a gain of about 90 minutes.

Finally, the EPIC helps us reach our clinical and marketing goal of consistency throughout all of our satellite offices. We can't quantify this in minutes or dollars, but we're trying to build a brand, and that means patients need to have the same experience in our main office and all of the other locations. The EPIC is one step toward gaining that consistency — patients have the same experience, and doctors get the same, consistent, reliable results.

Smaller Footprint

Although building costs are lower than they were 4 or 5 years ago, space is still very expensive. As we build new offices and evaluate the need for space in our existing locations, the EPIC allows us to plan a space with a smaller footprint than traditional exam lames. In fact, EPICs have such a small footprint that it's quite easy to designate their rooms, get them installed and open the doors. In our newly constructed clinic in Springfield, Ill., the two EPIC rooms required less square footage than we would have used for workup rooms, and that represents a savings that helped offset the cost of the systems.

Confidence in the System

Our practice had one EPIC system in 2000, and soon we'll have 14 of them. That's an indication of how much our doctors believe in the EPIC system. It's a very serious investment in a short period, and one that has changed the practice dramatically. The EPIC has reduced workup time and helped us manage revenues while still achieving the purpose for which we bought it in the first place: consistent, accurate and reliable refractions.