“Value based care as a concept is to say that you want to provide cost-effective care and understand outcomes,” Dr. Related: Drug availablility, pricing negatively affect the practice of glaucomaValue-based care Over the last decade or so, trends have moved from paying for care because it has been delivered to understanding the quality of care that is provided. Rivers noted that automation and software design for drug inventory is critical to the retina practice. Through the automated systems, drugs are billed correctly through insurance. These efficiencies can help physicians operate more efficiently and spend more time with patients. Patients benefit from anything that helps the physician work more effectively. “Even a few percent loss can add up to a tremendous amount of money.” Automation can be key to successful inventory practices, and can ensure efficient flow. “That is a tremendous amount of money,” Dr. A retina specialist may buy $500,000 in inventory each year. Drug inventory management is a large burden for any practice. Optical and ASC inventory also are key for physicians. “Drug inventory software is a very important part of the documentation process with electronic health records,” Dr. The physicians have to purchase medications up front and track it and ensure it is assigned to the right patient and billed correctly. Inventory management Drug inventory is key for a retina practice and the drugs used to treat wet macular degeneration and diabetic issues are expensive. “We also have a patient portal and additional patient engagement tools such as automated appointment reminders and surveys.” This will lead to an increase in information for both patients and physicians and improved communications. “Information can be printed out and handed to the patients,” Dr. It also allows physicians to communicate with patients. The software allows physicians to focus on diabetic retinopathy and wet macular degeneration. “We also try to provide as much functionality as possible so that the software learns what types of things you do and presents information to you so things are easier,” Dr. “We also want to get them more information.” Physicians can operate more efficiently with software that is easy to use with an app that is graphically oriented. “Everything we do is to make it easier for clinicians,” he said. Rivers, is to make it easy to enter data into the company’s system and also to deliver data back to the clients. The company was founded in 2010 by Daniel Cane and Michael Sherling, MD, MBA. Rivers left his practice to join Modernizing Medicine, which offers physicians solutions to many of the problems connected to the daily operation of a practice. “You have this burden of documentation for the federal government with software that isn’t designed to help the physician as a provider,” he said. Rivers, has been the advent of electronic health records (EHR). Related: Laser cataract surgery making complex cases more routineGoing electronic Another change, according to Dr. “It is a real change if you have moved to a surgical practice with a few patients to a tremendous number of patients,” Dr. “They have no control over their lives.” Some physicians may take more vacation, but when they return from vacation, the patients still need to be seen. “This contributes to burnout because it is not intellectually challenging,” he said. The visits do not require a lot of decision making. Rivers recounted a physician he recently visited who sees more than 120 patients a day. These patients that you would normally see once a year and you wouldn’t have any treatment for them, you were suddenly seeing them once a month.” As a result, the volume of patients began to increase almost overnight. “That was a huge change for retina practices. “Along came the ability to treat wet macular degeneration,” he explained. Rivers, director, EMA Ophthalmology, at Modernizing Medicine, noted as retina practices have become larger, an increase in patient volume has become an issue as physicians have seen their practices change. This phenomenon is not unique to retina specialists. Rivers, MD, retina surgeons often see 90 to 100 patients a day, making it extremely difficult for them to take time off, or even keep up with other practice needs. With so many balls in the air at the same time, retina specialists become susceptible to burnout. Physicians have to manage their practice, and this includes inventory management, and providing value-based care. Seeing patients is only a part of the process. As retina surgeons become increasingly busy, operating their practices more efficiently is a key to success. Burnout is a problem that is not going away.
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