Eyeworld

Name of Ad Page number 7 7 We try to schedule consults within 1 week of referral and treat within 4 weeks after that. — Derek DelMonte, MD We identified a technician in our practice who really takes ownership of the process. She gets every patient who is recommended to schedule cross-linking, tracks when they are approved, tracks the Photrexa inventory, and assists with the procedure. — Zaina Al-Mohtaseb, MD When we schedule the first eye for cross-linking, we always schedule the second eye for one month later, if eye is also progressing. Having that appointment on the calendar dramatically increases the number of needed second-eye treatments that are successfully completed. Otherwise, patients will put off making that appointment or be lost to follow-up. — Jack Parker, MD, PhD #04 BEST PRACTICE SE T UP T HE SCHEDUL E T O MINIMIZE TIME TO TREAT Strong cross-linking prac- tices may perform between 10-30 cases per month and can complete as many as 5-10 cases per day with a single iLink system. Achieving such a high volume may require 2 rooms and 1 or 2 dedicat- ed technicians, with patients receiving their drops in one room, then being moved to the second room for the light therapy. There are many success- ful methods for scheduling cross-linking, depending on the doctor's practice and typ- ical mix of cases. Many prac- tices mix cross-linking proce- dures in with LASIK and other of fice procedures, while others prefer to schedule cross-linking intensive days several times per month. In any case, it is typically most efficient to start each morn- ing and each afternoon with a cross-linking procedure while other patients are being worked up. KC c o n s u l t s should be pri- oritized to avoid unnecessary delays. In par- ticular, consultations and treatment of patients young- er than 18 should have high priority. Clinicians should consider empowering staff to open up spots on the schedule for young patients so that they can be evaluated and treated within 6 weeks of referral. An approach taken by one practice to avoid hav- ing a wait list for cross-link- ing was to protect specific time slots in the schedule for cross-linking. No one except the doctor could override the block on those slots earlier than 1 week out. Schedul- ing staff must be educated about the reasons for pro- tecting cross-linking slots. ■ #05 BEST PRACTICE Ensure sufficient s taff resources Most cross-linking practic- es have at least 2 or 3 tech- nicians trained to assist with the procedure, but some have 6 or more quali- fied techs. Staff turnover, call- outs, and sched- uling are all rea- sons provided for having mul- tiple technicians who can assist with cross-link- ing. Staff personalities and work styles should be carefully considered. The individu- al who is chosen to "champion" the process and track patients' progression from referral to treat- ment may be a refractive coordi- nator. These individuals can leverage some of the same counseling skills they use with LASIK patients. How- ever, refractive counselors may lack needed experi- ence with insurance bene- fits, pre-authorization, and handling rejections/denials and so may need addition- al training in this area. Technicians who enjoy a high level of patient interac- tion and offer great atten- tion to detail are often a good match for cross-linking sup- port in the clinic setting. The ideal technician to assist with cross-linking is someone friendly, talkative, conscien- tious, and can eas- ily develop a rap- port with patients. They should be empowered to t a ke s te p s to e n h a n c e t h e patient's experi- ence, such as pro- viding blankets, letting the patient choose their pre- ferred music, and preparing take- home kits for the patient. Having specific staff members take ownership of the iLink process can also be a great opportunity for staff leadership and advance- ment within the practice. ■ #06 BEST PRACTICE E s t a b l i s h a p r a c t i c e protocol for 2nd eye evaluation and treatment if needed Although it can often present asymmetrically, keratoconus is a bilateral disease. Staging the treatment of both eyes, while working around the patient's schedule and need for visual rehabilitation, can be challenging. Cross-link- ing providers should work

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