Tackling the Quadruple Aim in Eye Care

Changing Patient Outcomes for the Better

By Kortnee Virus 

I believe the United States healthcare business system has become just that – a business.

AdaptDx Can Start a Revolution 

Despite the incredible advances in technology and a higher standard of clinical education in the past 100 years, the U.S. has a health care system that could benefit from reform. Currently, the system is plagued by poor patient outcomes, lack of quality patient care, high costs, and negative clinician experiences. The business of healthcare has been the subject of countless conversations about the cost of instruments, reimbursement rates, revenue growth, and practice profitability, yet, I cannot help but think what we would all do if our loved ones sat in our exam chair every day. Would we do something different?

In my opinion, it is important we find a way to balance patient care with profitability in order to truly succeed. One of the best ways to put your patients first is investing in new technologies that can detect chronic diseases early, so you can begin proper treatments to improve patient outcomes. The AdaptDx dark adaptometer is one such technology that has been making a splash in the eye care industry and is being used for early detection of age-related macular degeneration (AMD). This tool has the power to help start a revolution in eye care and the U.S. healthcare system. The eyes are the windows into our soul and overall health.

Taking a Page from the Orthopedics’ Playbook

Before I started working in eye care, I partnered with orthopedic surgeons. At the time, many orthopods were looking for ways to create a better inpatient experience and capture additional revenue streams outside of the OR to make up for Medicare-driven bundled services (declining reimbursement). Increased pressure from hospitals to standardize care limited physician choices, and in some cases prioritized profitability over patient care. In addition, many young surgeons were entering their careers with mounds of debt from their student loans. Health Systems quickly figured out they could employ those in need of a reliable salary, new patients, and ongoing support on the business side of medicine. This sparked a fury of consolidation, but ultimately better patient care. Business and clinical were forced to merge. Managed care, vision plans, vertical integration, private equity, retail and online competition, and telehealth – oh my! Raise your hand if this sounds familiar?

How the U.S. System Has Changed

So why all the change in U.S. healthcare as a whole?

• Aging population (and increased life expectancy) driving up Medicare costs
• A large amount of unhealthy U.S. patients requiring costlier medical care
• Increasing number of chronic age-related medical conditions
• Incentivized medical providers putting a strain on finances
• Amazon, Uber, Spotify, Apple disrupting consumer demands to drive down costs and increase technology within retail

These changes have had a huge impact on how eye care practices operate but there is a huge opportunity in front of you. Every practice wants to fulfill their “Quadruple Aim” of better patient outcomes, lower costs, improved patient experience, and improved clinician experiences. From what we’ve seen with customers across the country, AdaptDx is proving to be an instrument of change in eye care to help you achieve:

1. Better Patient Outcomes – We know early detection of any chronic disease leads to better outcomes. Active management of AMD allows patients to enjoy additional years of good central vision, enhancing the odds of a better quality of life. Diagnosing the disease as early as possible offers time to take measures that may slow progression. Monitoring AMD more closely with objective, functional data points allows primary eye care to preserve the best vision possible for each patient. A 2017 study published in JAMA Ophthalmology estimates there are currently 14 million patients with AMD in the U.S. But even with regular exams using current imaging tools, an additional 25% are undiagnosed. AdaptDx can help you change these numbers.
2. Lower Costs – Uncle Sam is running out of money. Currently, intravitreal anti-VEGF agents are mainly used to treat exudative AMD, but they are an extremely costly option. A real-life patient with AMD receives an average of about 4.4 injections within the first year and about 2.2 in the second year at about $1,850 per intravitreal dose. AMD is the leading cause of blindness, which can cause a larger economic burden. In 2014 and 2015, Medicare claims show Ranibizumab in the top 10 drugs paid by ASP. Ranibizumab ranked 5^th in ASP spending just after drugs used to treat cancer and auto-immune diseases! Early diagnosis will help prevent or delay the progression to CNV and ultimately decrease the number of injections needed.
3. Improved Patient Experience – Educate, educate, educate. AMD is personal. Patients can live for years without noticing symptoms of AMD before they suddenly lose vision in one or both eyes. Have a discussion sooner with your patients,  especially when the earliest symptom of decreased night vision is present. Impaired dark adaptation is an early biomarker for AMD, allowing primary eye care practitioners to catch the disease earlier and act. Once AMD is diagnosed, eye care practitioners can proactively monitor the disease and prescribe lifestyle changes and enhancements to help slow disease progression, including:
   • Mediterranean diet
   • Regular exercise
   •  Nutraceuticals
   • Smoking cessation
   • Blue light blocking lenses
   • Protective sunglasses
4. Improved Clinician Experience – The AdaptDx takes the guessing game out of diagnosing AMD. It makes dark adaptation testing affordable and accessible for any optometry or ophthalmology practice so you get a clear, objective measurement of retinal function with 90% sensitivity and 90% specificity for the presence of AMD. Diagnosing AMD early allows you to offer patients a course of action to delay or prevent blindness from AMD. Let us support you to ease the administrative burdens and give you shortcuts to success to take better care of your patients.

Achieving Your Financial and Organizational Goals  

Achieving the Quadruple Aim in eye care is no easy task. It takes a high level of organization, a knowledge of past occurrences in the industry, and a commitment from a doctor, patients, and staff. Breaking it down into smaller segments and using the right technology, you can see a large return on your time and monetary investment. Working towards Quadruple Aim goals can help your practice achieve financial and organizational success from enhanced staff focus and patient satisfaction.

MacuLogix can provide the technology to give you the clinical starting point to start treating AMD sooner and fulfilling your Quadruple Aim. We need your help with the patients you see every day to change outcomes for the better. Will you become part of the MacuLogix family and join us in the fight against AMD?

Best wishes,