Visit to a Eye practice

Thanks to Dr. Harris, we were visiting a pretty large eye practice in United States, to understand the day to day operations.

At the start, we had a perception that a set of tests are done by Technicians in various rooms and collated for the doctor to prescribe the medication. As Dr. Harris took us from room to room giving a brief explanation of what that tests are and how they are done, we were taken back by the speed and efficiency in which they operate a eye clinic.

A common clinical scenario enacted was:

One of our colleagues volunteered to be the patient. He was taken to the front desk where he would register his arrival as per his appointment.
The patient would then be given a small electronic token, which will aid as a directing device too.

So as per the directions of the device, the patient will be waiting in the area mentioned. A paper would be printed in the technician desk automatically which will inform the arrival of the patient.

The technician will then meet the patient take him to the room where he registers his primary eye problem and other medically relevant details.

Then the technician takes the patient to the dilation room from where after few minutes will move in to the exam/ test rooms.

The technician then performs the exams, records the details too in the same paper booklet where previous details are captured. Then the technician leaves the records in his desk, in the designated area “For Dr. Review”.

Dr. Harris once he completes the previous patient, comes to the technician desk and takes the next record available and goes into the corresponding exam room where the patient is waiting.

Dr. Harris does additional exams as necessary. In our clinical scenario, Dr. Harris did about 6 exams on the patient, in less than 40 seconds. Based on clinical findings, a technician stepped in to help the doctor on checking the corneal thickness. This test was also completed before we(as viewers) could assimilate them.

Upon completion of the exam, Dr. Harris prescribed the glasses prescription in the same record and coded the service which he rendered to the patient.

For readers benefit, Coding is the process by which doctors select pre-defined billing codes for each of the service they rendered. This is a standard followed across US, for medical insurance claims.

Then Dr. Harris places the record in the designated area named “visit completed”, from there the technician/administrator takes care of the post visit activities.

One of the most startling thing was the speed in which doctors and technicians capture the data is beyond our imagination. A patient visit will be taking anywhere between 20 mins – 30 mins (actual time spent with doctor and technician). Getting a system to work on these highly efficient practices will be a extremely tough task.

The final question that remains in my mind is:
Can technology bring more efficiency in these environments ?
Without real innovation, I doubt.

However, Technology can improve the quality of health care by:
1. Increasing the legibility of the medical records.
2. Data mining to analyse effective and ineffective practices.
3. Doctors can easily browse through historical data to understand and provide best care possible.
4. Can enhance communication between medical professionals.
Ex: E-Prescribition tracks the patients medications and allergies.
5. Aiding medical professionals to reduce errors

About Dr. Jeff Harris
Jeff Harris is the Vice President of Integrity Digital Solutions and has served on the faculty at the Scott & White Eye Institute for more than eight years. He is actively involved in resident education and lectures regularly on optics and contact lens topics. He provides primary care services and has extensive experience managing common ocular diseases such as glaucoma, macular degeneration and diabetic retinopathy.


A very worried Indian

As the day passed by today, a very important thing happened in the country. Army was called in to control the worsening security situation in Kashmir.

This was clearly one of the toughest decisions for the government with respect to J & K. Already the situation is heated up due to the spate of violence and clashes between civilians and the security forces.

Even though i am not directly on ground, I am able to sense that the emotions are running high in the valley. When the loss of civilian lives occur for whatever reason, it brings in more worries and problems to tackle.

I wish the presence of the army is short and the sentiments and emotions are brought to normal. Once that is reached, the longer term political solution and the discussion process to rebuild confidence has to be undertaken swiftly.

If institutions/people are guilty, they should also be brought back to book.

A peace in the kashmir valley allows a peaceful india to march forward. With issues of naxalism running in parts of the country and Kashmir valley back in troubled waters, it is a very tough time for the nation in the internal security front.

It is one more challenge which the nation will overcome soon and march towards building a stronger nation.

What is important?

How many times, you have been in situations where there is a dilemma of whether to confront the issues or problems and become a bad guy or just live with it, so that you remain in good books ???

I am able to hear a”YES”. I have been in many times in the same situation.

I decided to do a deep dive of myself and find out what is the thing that i want to do in the future when such a situation occurs.

The first doubt that comes to everyone is whether there are any issues or problems in the current situation. And the next is whether to make your views known to the environment.

I hear… What can i do now? I am also here…….

  1. Accept the reality and live with it.
    • Problems still prevail
    • As you continue living with it, the sensitivity starts diminishing and then sensing itself can become a far fetched dream
    • Poor decisions and poor results will be praised as great achievements
    • Dispassionate relationship to the environment starts creeping in.
  2. Understand the environment and situation
    1. Realize that you have everything to change and change the situation
      • Problems are solved
      • Sensitivity and passion increases urging you to reach better heights
      • Confidence and belief on meritocracy slowly convert themselves in to convictions.
      • Will hurt few people along the path of change
    2. Realize that you have minimal influence and decide that this situation has to be confronted. With that collectively you can bring change
      • Problem solving process is started
      • Sensitivity and passion increases definitely
      • Learning increases and bonding with the environment increases
      • Confidence and belief systems remain intact
      • Confrontation is a hard stance and hence it affects people around you. It earns you a bad guy image

These are not the only ways to approach this situation. surely there are enough minds and ideas which will work out in context.

I want your support in this exploration. Before closing, I just want to quote a small story:

Admiral Jim Stockdale was the highest ranking US military officer imprisoned in Vietnam. He was held in the “Hanoi Hilton” and repeatedly tortured over 8 years. Stockdale told Jim Collins, author of Good to Great, “You must never confuse faith that you will prevail in the end, which you can never afford to lose, with the discipline to confront the most brutal facts of your current reality, whatever they might be.”

Lets keep exploring and help me with your views on how you handled these situations…….