Ted Vorster, OD, the owner of two Vision Source practices in Houston and Silsbee, Texas, faced an all-too-common challenge with staffing when his associate OD left the practice. His offices are 130 miles apart, making it difficult to cover both locations forcing Dr. Vorster to consider how technology might provide a solution.

Dr. Vorster decided to bring in the Chronos Automated Binocular Refraction System from Topcon Healthcare and integrate it into his practice workflow. This innovative refraction system allows him to reconfigure his exams, so his time with the patient is spent doing things that only a doctor can do.  

He chose to split his comprehensive exams into two parts – one part for which he must be present and one part that the staff can execute. “All I needed was a way to refract patients when I wasn’t there, without the tedious steps of a traditional refraction,” he says. The Chronos system made that possible.

Part 1 is what staff can do: conduct the refraction with Chronos, take retinal and OCT images, and help patients select their eyewear. Part 2 requires Dr. Vorster: the internal exam, the review of pretest imaging and the discussion of the patient’s visual needs. But here’s the beauty of his system, he says, “They don’t need to be done on the same day.”

If he happens to be in the office, those patients do move through both parts of the exam. But on days when he is not in the office, patients can move through part 1 with the staff. He feels so confident with the refraction achieved through Chronos that the staff schedules the patient for the second part of the exam when they come back to pick up their new eyewear or finalize the contact lens prescription.

Is it accurate?

By checking the results against his own refractions, he felt confident in the system’s accuracy. “In addition, many patients felt the Chronos refraction was less stressful than a traditional refraction. The system reduces the number of responses that the patient needs to provide. Patients appreciate not having to go through the stressful routine of wondering whether they’re giving the right information,” he says. Patients often tell me that they “hated” that part of the exam. He says that the final proof – his “tiny remake rate” – demonstrates how well the system works.

Now, when he’s not in the office, the staff can still be highly productive. “My team understands the culture here. Not only is it less costly by a factor of 10 to have the Chronos, but we also found that it was easier to maintain productivity. The staff can work toward their goals and commissions without having to rely on a per-diem doctor,” he says. The competition to recruit associate and part-time ODs in Houston is fierce, and the Chronos has been a blessing in its ability to keep the office going even when Dr. Vorster isn’t there.

Splitting the exams into two parts allows his satellite office to be “doctor-presence-independent,” meaning the staff can continue to take walk-ins and fill the schedule.

Patients appreciate responsiveness

Dr. Vorster says that patients are already accustomed to coming into the office two times – once for an exam and once to pick up their eyewear. The new process is a little different than what they’ve been accustomed to, but it’s been well received. Most patients appreciate that they can shop for their eyewear and move the process forward, even when the doctor isn’t there.

There’s a safety net built into the system, too. In those cases where a patient has denser cataracts or a very small pupil, the protocol is to have the doctor complete the refraction. But even here, “the patient can go to the optical, preselect their eyewear, and the staff can work on any insurance authorizations so that everything is in order when I see them a few days later,” he says.

Dr. Vorster says if he had not added Chronos to his practice procedure, he would have lost patients. “People who call and have to wait too long for an appointment may choose to go somewhere else. With the Chronos Automated Refraction System, we can bring them in quickly and start the process of care.”