Have you ever been disappointed by your favorite restaurant? You make a reservation and show up expecting to order your “go-to” only to find out that the kitchen ran out of an item and now you must settle for an alternative. As a consumer, this is disappointing and is a telltale sign of inventory issues within the establishment.

Many ophthalmic practices have embraced a “one-stop shop” mentality when it comes to handling their dry eye patients and are making products available to them. There are typically two specific categories when it comes to inventory of dry eye “goods.” One type of inventoried item is the consumables that are recommended in the patient home treatment regimen; the other is the “disposables” that are required to deliver the in-office care to the patient. Patients are appreciative of office product availability, and that you and your team have taken the time to identify quality products and give them your stamp of approval. However, fitting these supplies into our normal supply management can be challenging because of the costs associated with managing an inventory.

Here are some important considerations to keep in mind when conducting inventory management within your practice.

INVENTORY TIPS

Champion for inventory control

Choose a “champion” from your team to be the inventory controller. Depending on the size of your practice, this person will need at least between a half and a full day each week to handle ordering, reviewing inventory and distributing items to exam rooms or locations. This time management will depend on the number of dry eye patients you see, the number of locations and how good you and your team are about educating the patient regarding the products/treatments

Weekly, the champion will gather the inventories from each department/location. He/she will review the quantities on hand and pull supplies for the necessary departments. It is important to inventory by location if you have multiples and to make sure that the inventory includes items stocked in exam rooms, etc. All too often, you can find expired items that were stashed in areas that no one even knew existed. We create a master supply closet and pull from that master inventory to send to the locations/departments that have reached a critical low. Your critical lows should be established based on volume. Also, we use shopping bags to distribute, and the person responsible on each team puts the supplies away.

Responsibility by committee does not always work in this process, so I highly recommend that you have specific people own these tasks.

Tips on dispensing dry eye products

• Your staff and providers should be confident in the products and use the actual brand names on the medication lists provided.
• Include instructions for dry eye care the same way you would for a patient’s glaucoma medication, steroid, etc.
• Have a branded bag for your practice to put products in. After all, a retail store would bag the product for the patient.

 

 

Use a central location

Have a closet that stores the base inventory. Try to always have at least a week’s supply of back stock stored in this central location. This will prevent running out completely of any given supply.

If possible, have someone in each department put the supplies away weekly. This ensures consistency and helps to not end up with items stashed in nooks and crannies around the office.

Develop an inventory list

Have assigned individuals inventory the supplies listed weekly. This should include expiration dates on the listing. If you are in one location, one person can easily handle all of the tasks involved. If you have multiple providers and multiple locations, assign per location the person responsible to communicate the inventory numbers to your inventory champion or manager.

Be careful that they do not just list items they feel they need — have them count/inventory every item. The dry eye inventory champion will start to notice patterns of usage quickly, and this will help to establish minimums. This system will also allow you to monitor items that are not moving at all.

The central inventory location is also inventoried weekly, and the champion places orders based on volume needed — to prevent confusion, no one else should order the supplies

Look at your volume

Calculating need is based on volume. If you are hitting a known slow period for the practice, you can back off quantity. If you are coming up to a busy season or are running a special, then you can increase your volume on hand. Many dry eye vendors have the availability to set up autoshipments. Make sure that you are still doing due diligence with your inventory process because it is easy to suddenly be overstocked in areas that might slow down because of a provider being out, holiday season, pandemics, etc.

When purchasing, many vendors offer volume discounts. Purchasing in volume always gets you your best pricing. But if the vendor expects you to pay in full within 30 days for something that you must sell, you need to be careful. This can quickly get you into a cash flow problem. I encourage you to negotiate at least 60-day terms with your vendors. If a product is over $300.00 and purchasing in volume gives you your best pricing, negotiate 90-day terms. This allows you to sell the product profitably and have revenue in hand to purchase more.

Also, watch for expiration dates. You do not want to have to toss product that expires before it can be sold or used. Watch those special volume purchases — sometimes they yield items with a short shelf life, which is why they are on sale.

INVENTORY ITEMS

At-home dry eye products

At Dry Eye University, we discuss maintaining a standard of care. Your standard of care is best when the patient embraces the home care/maintenance that is required to achieve homeostasis.

Home supplies most often carried in inventory that are considered standard of care include:

• Masks (Bruder, EyeEco, Quidel)
• Lubricants (Eyevance, Oasis, Quidel, Regenereyes, Scope)
• Neutraceuticals (PRN, ScienceBased Health)
• Lid scrubs/cleansers (Avenova, Bruder, EyeEco, Oasis, Ocusoft, Scope)
• Nighttime masks (EyeEco)

Be prepared to occasionally deal with vendor backorder issues. These can arise with any of your vendors, as some manage their inventory on their end better than others. After hitting the wall on this a couple of times, I created some “cross overs.” We carried two types of each category and were prepared to explain to the patient if we needed to make a substitution.

We stock each front desk with dry eye products to pull and dispense as the patient checks out. The patient also receives a medication list with products highlighted by the scribe, who explains that we have the product available.

In-office dry eye supplies

A large percentage of dry eye patients suffer from meibomian gland dysfunction as well as blepharitis. This requires some disposable items to be readily available for certain services. These items include:

• BlephEx tips
• Meibomian gland Maskin probes
• LipiFlow applicators (Johnson & Johnson Vision)
• iLux tips (Alcon)
• TearCare tips (Sight Sciences)

Moderate to severe ocular surface issues sometimes require amniotic membrane to help get the surface under control. ProKera has been the recommended product by Dry Eye University and remains the gold standard. This product has a higher ticket price to stock and thus also comes along with a higher reimbursement (insurance coverage is available). I encourage a higher level of control with your inventory on items such as this. You want to log the serial numbers and track the product. Losing even one can negate profitability. This product also requires a locked refrigerator.

Diagnostics also play a role in the diagnosis and monitoring of dry eye disease. These are also necessary to inventory and monitor. Should a diagnostic fail, the manufacturer will replace it if you return the product. Many times, staff unknowingly discard the failed test, which can be costly to profitability. Diagnostics stocked in comprehensive dry eye practices include InflammaDry (Quidel) and TearLab Osmolarity test cards.

CONCLUSION

Inventory management is a crucial part of your practice. Profitability is important, and administrators must focus on the costs associated with inventoried items and the charges for the services or products. Revenue associated with providing products and services that require goods is lucrative, and they serve your patients well. Don’t shy away from out-of-pocket services — just monitor and count the returns. OM

About the Author

Patti Barkey, COE, is the administrator for Bowden Eye & Associates, Eye Surgery Center of North Florida. She is also director/partner, Dry Eye University and Dry Eye Access. A member of the ASOA Board of Directors, Ms. Barkey has more than 40 years of experience in ophthalmology.