DRIVING SIGNIFICANT TIME SAVINGS WITH SMARTCATARACT

BY ZACHARY ZAVODNI, MD

As we near the end of 2022, ophthalmologists face a number of compounding challenges. Baby boomers are flooding our practices, and the subsequent number of patients in need of cataract surgery is growing rapidly despite a stagnant number of cataract surgeons. The increase in demand has been coupled with a drop in the relative number of surgeries as a result of the pandemic. Other problems such as global supply chain issues, record levels of inflation, high workforce turnover and high overhead costs have impacted practices across the country.

In this environment, the need for cataract practices to operate at maximum efficiency has never been greater. As medical director of The Eye Institute, I was able to work with Alcon to implement SMARTCataract, a comprehensive cloud-based platform that seamlessly connects our EHR to our preoperative diagnostic instruments to our intraoperative technologies. It has truly been a game-changer for our practice in terms generating quantifiable, significant time savings.

OUR TRANSITION TO SMARTCATARACT

In my practice, we have a wide collection of diagnostic devices from four different manufacturers. When Alcon came in to work with us to implement SMARTCataract, they provided a team of IT professionals and demonstrated that these various platforms and technologies could merge.

Once SMARTCataract was up and running, fears of a cumbersome learning curve for myself and my staff were quickly alleviated. It is easy to use, and the preoperative data is accessible to us from any computer or tablet, providing improved flexibility for cataract planning and avoiding traffic jams at workstations in the office.

To establish trust in the platform, for the first week we continued to plan our IOL calculations on paper while simultaneously using SMARTCataract. In this fashion, we quickly learned the system was able to synthesize data from all our diagnostics and generate the same answers we anticipated — but in a fraction of the time and without need for cumbersome review from my staff.

QUANTIFYING THE EFFICIENCIES

Once we transitioned to use of SMARTCataract by itself, we started to realize significant time savings.

To evaluate the time savings associated with the utilization of SMARTCataract my team and I performed a prospective time-and-motion study. We looked at the time taken and number of manual data entry transcription points for clinical activities and devices associated with pre-, intra- and postoperative cataract surgery implementation. Our data included the processes associated with use of intraoperative aberrometry.

Time differences between our standard cataract workflow and SMARTCataract were calculated in the diagnostic workup, preoperative planning (including IOL selection), intraoperative aberrometry preparation and postoperative data input processes. We looked at three cohorts of patients: conventional, astigmatic and post-refractive.

Notably, we found that:

• For conventional patients, SMARTCataract can save a total of 4.3 minutes vs traditional methods.¹ For post-refractive and astigmatic patients, SMARTCataract can save a total of 13.2 and 12.6 minutes, respectively.¹
• The greatest time savings were realized by eliminating the need for staff data entry into the aberrometer cloud-based system.¹
• SMARTCataract reduced the number of manual transcription points per patient by 25 in our conventional patients and significantly more in the post-refractive and astigmatic groups.¹

WHAT THE TIME SAVINGS MEAN FOR MY STAFF AND ME

The efficiencies provided since transitioning to SMARTCataract have been profoundly impactful for my practice. On the staff level, my team no longer consumes time with manual data entry. This time savings has allowed us to provide new growth opportunities to some of our staff. For example, one member of our team with an interest in marketing has been able to spend some time pursuing that. With more staff time available, we’ve also been able to grow our research department and I have been able to consistently see more patients.

The automated connectivity also helps instill confidence in my staff. The pressure of preparing surgical charts for a busy surgeon is a real stress on staff. With SMARTCataract, my team has noted a reduction in stress, as they no longer have to worry about transcription errors and they have enjoyed reallocating their time.

THE FUTURE

Seamless data transfer from the EHR, to diagnostic devices, to IOL planning and to intraoperative aberrometry undoubtedly adds efficiency and confidence at every step of the cataract workflow for surgeons and staff.

The time savings from systems like SMARTCataract translates to an increase in patient encounters and surgery volumes, thus aiding cataract surgeons as they navigate the challenges of an ever-increasing demand for their principal surgical product.

Cloud-based connectivity will soon be commonplace, and practices that don’t adopt these technologies will struggle to keep up. OM

REFERENCE

1. Zavodni Z, Li-Chen P, Saylor M, Cheng H. Enhancing Clinic and Operating Room Connectivity Via a Cloud-Based Application to Improve Practice Efficiency for Cataract Surgery. ASCRS, Washington D.C. April 22, 2022.

Zachary Zavodni, MD, is medical director of The Eye Institute in Utah.Disclosure: Dr. Zavodni is a paid consultant for Alcon.

PAPERLESS, STREAMLINED FLOW WITH VERACITY

BY KERRY D. SOLOMON, MD

VERACITY Surgical (Zeiss) is a web-based software that makes use of data from the EMR and diagnostic devices to help surgeons work faster and improve decision making. It is a powerful, effective tool that is easy to implement, creating a seamless digital workflow. Its features include a web-based platform, a secure cloud for patient data and EMR and diagnostic device integrations for one-stop planning.

NO MORE PAPER

In the past, we would print the patient’s information and relevant variables from the EMR then spread out the papers to create the plan. This process took quite a while and required significant paperwork for each patient as well as manual data entry and a host of websites. For example, if we needed to perform an LRI, we would go to a website and manually enter the patient’s information in order to derive the correct calculation. The same process would be followed for IOLs with yet another website for toric implants. If the patient had previous refractive surgery, then we also needed to use the ASCRS website.

Now, all of the needed information from the diagnostic sources incorporated into the EMR is seamlessly sent to VERACITY with one mouse click. From a flow standpoint, it’s simplified and streamlined everything.

We do the planning in front of the patient in real time. This is helpful because the patient knows exactly what is involved with their surgery before they leave the office and their candidacy for certain types of IOLs. This also helps them know exactly how much it is going to cost. The system contains all of the nomograms and recommends the best solution to get the patient the goal refraction. It can even calculate for the Barrett Integrated K formula, which requires multiple K readings. Before we had to use another third-party website to manually enter the data; VERACITY does it automatically.

EASY FOR STAFF

Because of the complexity, I used to have a specific team assigned to the planning for consistency and accuracy. These were staff in whose attention to detail I had the most confidence in. Now, we can train all of our technicians on how to use VERACITY and do not need special planners. This was a quick and easy process. Once VERACITY is set up and configured, it takes literally a few minutes for everyone to become a user as it is so intuitive.

Along with these new skills, the staff has a greater understanding of details such as when we use a certain incision or why we offset for nanovision or monovision. This extra knowledge, I believe, contributes to enhanced job satisfaction. It puts us in a better place because everyone can participate in the planning process and the patient knows exactly what we are doing, which allows us to deliver better care.

AUTOMATING OPTIMIZATION

Another valuable feature is that the system automatically customizes and optimize outcomes. When a patient pays for a premium lens, our primary goal is to deliver on their expectations. To do so, it behooves us to try to do everything we can to optimize our outcomes. Prior to the advent of systems like VERACITY, it was very cumbersome to collect the data on how close to the refractive goal was achieved for every patient and have it analyzed and optimized.

Now, it is automatic. The system communicates with the EMR, automatically pulling this data on refractive targets vs outcomes back and forth. If a surgeon was previously within 0.50 D of the refractive target 80% of the time, I believe this method can get them to 90% or higher.

ALERTS

VERACITY Surgical is highly configurable so that surgeons can continue the workflow patterns that work best for them. If inconsistencies are present, the system generates customizable alerts for maximum patient safety. These might be warnings to the surgeon if the patient has relevant medical problems, prior surgical procedures, medications or allergies that might be of concern for the planned surgery.

... AND MORE

Many surgeons may not be aware of VERACITY’s full functionality. For example, we can send patients our standard questionnaire to fill out via text message in advance of seeing them. It includes basic questions such as, “Would you like to be less dependent on glasses?” or, “Have you ever had LASIK?” The ability to have this information filled out in advance automatically drives the logic of what VERACITY will present in an efficient way. OM

Kerry D. Solomon, MD, is in practice at Carolina Eyecare Physicians, LLC, and is director of the Carolina Eyecare Research Institutein Mount Pleasant, SC.
Disclosure: Dr. Solomon is a consultant to Zeiss.