It’s no secret to any practicing ophthalmologist that the surgical process can be cumbersome for clinicians and anxiety-inducing for patients. Despite cataract surgery being one of the safest surgical procedures,¹ patient confusion and doubt remain. Moreover, we know that inefficiencies and administrative red tape can abound in many medical practices.

While cataract surgery itself is an efficient procedure completed in as little as 10 minutes, the journey begins well before a patient enters the operating room and continues long after they leave.¹ In fact, in my work researching the comprehensive cataract journey, I’ve determined there are up to 43 unique steps a typical patient undergoes in the pre-, peri- and postoperative process.

Also, consider that the average cataract patient is 70 years old.² He or she is losing sight due to a fixable condition, but it’s nonetheless a fearful realization.

One can easily see why many patients find this lengthy process confusing. With so much that is expected of patients leading up to, on the day of and after the surgery, it becomes clearer to understand why 80% of cataract patients would want premium IOL technology if they understood the value proposition, but only 15% receive it.³

As with any field of medicine, clear communication and streamlined patient engagement is paramount to achieving superior outcomes. In ophthalmology, this is especially critical given the multifaceted challenges of our industry: the growing global incidence of cataracts and other eye conditions due to an aging population;⁴ a global surgeon shortage;⁵ and heightened patient expectations.

The cataract surgical process, however, can be made easier and more effective with digital and cloud-based technology. Digital workflows, automated communication and administration as well as pre-op education resources not only improve this process but can also be used to make the cataract surgical process more human. It can bring clarity and peace of mind to patients, enhance staff satisfaction and drive patients toward better, long-lasting refractive outcomes with premium IOL technology. Here’s how the process works.

PATIENT ANXIETY IS REAL

My patients often remind me how scary the prospect is of losing vision. Already dealing with clouding vision, they’re then faced with a series of critical actions and decisions throughout the surgical process, with varying degrees of information and support at each stage.

Some steps are emotional, such as coming to terms with one’s blurring vision and accepting the need for cataract intervention. Some are administrative, such as filling out insurance paperwork, submitting medical history and considering financing options. Some are physical — receiving uncomfortable drops to have an eye exam or even fasting the night before surgery. And above all, some are mission-critical, such as choosing the right IOL to deliver superior refractive outcomes well into the future.

AUTOMATION TO THE RESCUE

One of the conversations that is commonly sidelined when discussing the cataract journey is the role automated communication can play at various points throughout the process. At its core, pre-surgical assessment and education is akin to risk management. By proactively engaging in just-in-time conversations with patients — and providing them the educational materials (and time) to make an informed decision — physicians can ensure greater patient satisfaction and comfort from beginning to end.

Engaging with a cataract patient should start before the patient arrives in the office, but it also shouldn’t be a bombardment of information and decisions to make. It should seek to streamline and clarify the process, putting agency into the hands of the patient. One way to do so is with automated pre- and post-op communication, which can lessen the fear of the unknown, help patients better understand their refractive options and enhance confidence of care.

For example, targeted, automated outreach can be used to collect a patient’s medical history and initiate the relationship as soon as the first appointment is made and well before a patient steps into an exam room. Through email and short messaging service (SMS) delivery, administrations and clinicians can also leverage multimedia educational tools — from images to audio to video — to allow patients to naturally discover the information they need. In fact, it’s shown that self-directed online learning resolves 90% of patient inquiries.⁶ Tools like MDbackline come preloaded with patient-tested educational materials, and physicians can customize content, adding video, images or anything hosted on the Web to enhance the patient’s interaction.⁶

Better informed patients are not only more empowered and independent, but they also have less fear, better compliance, fewer complications and are more likely to choose refractive upgrade options when they are offered.⁷ In ophthalmology, this could mean getting them pre-educated not only on their surgery but also on premium implant options that they may be a candidate for that they hadn’t previously considered.

MORE SATISFIED PATIENTS AND PHYSICIANS

Another key benefit of pre-visit communication is that it helps make the best use of often limited doctor-patient interface time. In a physician’s busy week, they might have approximately 10 minutes to complete a variety of necessary tasks with a patient: establishing trust, interviewing the patient to understand the problem, collecting medical history, examining the patient, developing a treatment plan, answering questions and more.

The result of this bottleneck? Doctors are left with little to no time to foster an authentic, trusted relationship with the patient. The result: no time to help patients understand and comply with treatment or consider premium alternatives. The doctor, who is the best educator, still leaves patients lacking information because patients forget much of what they are told, and not everyone is an auditory learner.

Communicating better means communicating over a longer period of time with multiple different interactions that benefit doctors, patients as well as staff. Platforms like MDbackline, Rendia and Ocular Engage can share information with patients before and after their office visits to give more detail on how to use eyedrops, reinforce explanations of common conditions like floaters and help alleviate worry after surgery by educating patients on the range of normal symptoms.

Interestingly and fortunately, better communication with patients has been linked to less physician burnout and increases in clinicians’ joy at work overall. Research by Emily Aaronson, MD, chief quality officer at Massachusetts General Hospital found that “At the practice level, physicians have higher proficiency and less burnout when providing increased communication with their patients.”⁸

We can see why: automation can lead to less repetitive work. Streamlined workflows can yield about a 30% reduction in post-appointment phone calls, according to administrative staff in multiple practices who have used MDbackline.⁶ Because the system can tell patients in advance what symptoms to expect after surgery, they are less likely to call and less likely to worry. This means more time returned to staff, allowing them to focus on other mission-critical objectives and the delivery of greater and more empathetic patient care, which is proven time and again to enhance outcomes in any field of medicine.

A CONFIDENT, WELL-EDUCATED PATIENT

In ophthalmology, increasing patient adoption of premium lens implants would be another benefit of serving patients with automated communication earlier on. With MDbackline, this change was measured rigorously at four practices of different sizes across the country. Adoption of premium cataract offerings increased between 23% and 175%, depending on the initial level of adoption.

Setting balanced, accurate expectations through well done, non “sales-y” educational material allows patients to understand their options and make an appropriate choice. Anecdotal reports from users of other solutions, including Ocular Innovations by Engage Technology Group, have shown that delivering high-quality, short-form educational content to ophthalmic patients leads to increased patient engagement, empowerment and confidence in the surgical process.

FUTURE-PROOF YOUR PRACTICE

Whether you have been practicing for 5 years or 50, a comprehensive digital strategy is simply table stakes for future-proofing your practice. A cohesive digital ecosystem pre-, peri-, and postoperatively — driven by human data —is proven to help more well-informed patients achieve success with premium IOLs.

Patients today want more and more personalized medicine, yet doctors have less and less time. The only way we can be better doctors is if we use technology to streamline our care and make the most of every patient interaction in the office. OM

REFERENCES

1. Behrens A. John Hopkins Medicine. Cataract surgery. https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/cataract-surgery . Accessed Oct. 18, 2022.
2. Page 6 MDbackline demo deck
3. Page 7 MDbackline demo deck
4. Hatch WV, Campbell Ede L, Bell CM, El-Defrawy SR, Campbell RJ. Projecting the growth of cataract surgery during the next 25 years. Arch Ophthalmol. 2012;130(11):1479-1481. https://jamanetwork.com/journals/jamaophthalmology/fullarticle/1390039
5. Terveen DC. Ophthalmology numbers cause for concern. American Academy of Ophthalmology. https://www.aao.org/young-ophthalmologists/yo-info/article/ophthalmology-numbers-cause-concern . Accessed Oct. 18, 2022.
6. MDbackline data on file
7. Krist AH, Tong ST, Aycock RA, Longo DR. Engaging Patients in Decision-Making and Behavior Change to Promote Prevention. Stud Health Technol Inform. 2017;240:284-302.
8. Berg S. Better communication with patients linked to less burnout. AMA. July 7, 2017. https://www.ama-assn.org/practice-management/physician-health/better-communication-patients-linked-less-burnout . Accessed Oct. 18, 2022.

John A. Hovanesian, MD, is an eye surgeon at Harvard Eye Associates, Laguna, Calif., and a clinical faculty member at the UCLA Jules Stein Eye Institute. Dr. Hovanesian founded MDbackline in 2012 to address the needs of patients, doctors and the health-care industry. He does strategy consulting and research for more than 20 health-care companies and has published textbooks and journal articles in his field.