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177 March 2015 EW MEETING REPORTER Advanced intracamerals and other technologies Edward J. Holland, MD, Cincinna- ti, discussed intracameral Omidria (Omeros, Seattle). "Preventing intra- operative miosis is certainly signifi- cant," he said. There are a number of unmet needs in cataract/IOL surgery, Dr. Holland said, including preven- tion of postop pain, prevention of toxic anterior segment syndrome (TASS), and reducing reliance on compounded products. Miosis is unpredictable and a real problem, he said. "We would rather have a technology or a med- ication that prevents miosis than have to manage miosis," he said. Surgical trauma releases prostaglan- dins, stimulating the iris sphincter muscle and causing miosis. Mechan- ical methods to address miosis risk injury to the iris, and OVD effect is transient, Dr. Holland said. Phar- macologic approaches also pose risks, especially because many have preservatives. Omidria contains phenyleph- rine and ketorolac. It is preserva- tive- and bisulfite-free. It is now FDA approved for reducing postop ocular pain in adult patients and maintain- ing pupil size by preventing miosis. It delivers steady-state drug con- centration to the anterior chamber throughout the procedure, Dr. Holland said. Omidria has been found safe and well-tolerated in clinical trials, with rates of ocular adverse reactions similar to the placebo group. It is also Medicare reimbursed. Editors' note: Dr. Holland has financial interests with Omeros. Retinal considerations The final session on the physician side of programming explored retina topics, with a look at case presen- tations and audience questions on a variety of topics. Keith Warren, MD, Overland Park, Kan., served as moderator, with Steve Charles, MD, Memphis, taking part in the session. It is important to be clear with patients of what the likely improve- ment in their vision will be, Dr. Warren said. Tell the patient if the likelihood of "much better" vision is low, he said. Drs. Warren and Charles also discussed their preferences for using Lucentis (ranibizumab, Genentech, San Francisco), Avastin (bevacizum- ab, Genentech), and Eylea (afliber- cept, Regeneron Pharmaceuticals, Tarrytown, N.Y.). The choice is dependent on many factors, includ- ing the anatomy of the patient and whether it is his or her first episode, Dr. Warren said. He usually starts with Lucentis if the patient can afford it, and if not, he will use Avastin. However, he noted that Eylea is better for those patients with pigment epithelial detachment. Editors' note: Dr. Charles has financial interests with Alcon. Dr. Warren has financial interests with Alcon, Dutch Ophthalmic, and Genentech. ASOA program focuses on office culture Sunday's ASOA practice manage- ment program focused on 2 aspects of office culture that are pivotal to the success of a medical practice— creating a culture of compliance and employee engagement. William T. Koch, administra- tive director, The Retina Institute, St. Louis, opened the session by offering attendees strategies for promoting compliance with Medi- care billing. To prevent Medicare fraud, waste, and abuse, physicians and administrators must integrate compliance into the office culture, he said. Compliance is not a once- a-year project, but a daily process, he added, where all members of the practice are responsible. The 7 components of an effective compliance program, Mr. Koch said, are developing open lines of communication, designat- ing a compliance officer or contact, implementing practice standards, conducting internal monitoring or auditing, responding appropriately to detected offenses, conducting the appropriate training and education, and enforcing disciplinary standards through well-defined guidelines. It is important to keep in mind that different practices have differ- ent resources, he said, so not every practice will be able to implement all 7 of these components. Physi- cians and administrators should develop as many of the 7 as possible, however, to create the best compli- ance program for their practice. The topic transitioned to creat- ing a culture of employee engage- ment with Bruce Maller, president of BSM Consulting, Incline Village, Nev., offering attendees specif- ic strategies for implementing a successful employee engagement program. Mr. Maller described the aspects of behavior and processes necessary for creating employee engagement. The behavioral side comes down to the qualities of leadership, he said. Practice leaders need to have a high level of emotional intelligence to be successful—they should be self- aware, empathetic, good listeners, and likeable. On the process side, practice leaders need to be thoughtful, disci- plined, and focused on the goal of making employees feel connected to the practice's mission and vision, Mr. Maller said. An effective employee engage- ment program starts with recruiting and onboarding of individual staff members, he said. After recruitment and training, it is important to iden- tify and develop leaders within the practice and invest in staff develop- ment. After assessing leadership skills, it is important to create a career path for employees and managers, he said, to show staff that the practice cares about them and is interested in their professional development. Next, administrators must effectively communicate employee performance. "Evaluations are not meant to be critical," Mr. Maller said. "They're meant to be a con- versation. They should be positive, uplifting, honest, and direct, but not harsh." The final piece of the employee engagement program is effectively using incentive plans. Incentive plans are incredible management tools, Mr. Maller said, that enhance job satisfaction, improve customer service and patient satisfaction lev- els, foster teamwork, and facilitate employee recruitment and retention, benefitting not only the employee but the entire practice as well. EW Editors' note: Mr. Koch has financial interests with Allergan, Genentech, and Regeneron Pharmaceuticals. Mr. Maller has financial interests with Allergan. View videos from Sunday at SideXSide 2015: EWrePlay.org Robert Weinstock, MD, Largo, Fla., describes new software that will integrate diagnostic data into the femtosecond treatment pattern.

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