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Click to view a PDF of The Patient Journey: An Ongoing Evolution.

Technology innovations and an emphasis on experiential concepts new to health care are driving significant changes in eyecare today, and these changes are influencing the way some patients approach eye exams and eyewear needs. Indeed, the eyecare practices that recognize what this new Patient Journey looks like—and that work toward adapting it—are better positioned to grow their practices by helping patients better understand their vision and eyewear solutions, according to industry leaders.

And while The Patient Journey was already evolving, especially along the lines of patient-provider interaction, prior to the coronavirus outbreak across the U.S., no one really knows the impact still to come because of COVID-19. For example, how will this pandemic lead to further, perhaps unexpected, changes in the delivery of eyecare? Will the sector see a growing shift toward online sales and telehealth?

The eyecare sector is certainly seeing a surge of interest in telehealth options, both from patients and ODs. Jobson Optical Research surveys in late March indicated that 19.8 percent of ECPs are providing a form of telehealth, and 30.5 percent are planning to in the near future. ECPs are using telehealth services that are mainly phone-based consultations (79 percent) and video/image consultations (74.3 percent), according to the results of Jobson’s March 28-30 survey.

The Patient Journey continues to evolve as this issue of Vision Monday goes to press. But plenty of theories are being advanced, and more changes are likely to come as both patients and ECPs react proactively, and VM will follow all of the twists and turns ahead as The Patient Journey in eyecare and optical retail continues to evolve.

In this new world of health care and retail, The Patient Journey today is all about “the new way that people want to receive their health care, and eye exams and eyecare are health care,” explained Randy Baldwin, vice president, Marketing, Specialty Industries and Retail, with the CareCredit division of Synchrony Financial. “The whole patient journey is more than just the purchase part of the process. It’s how do patients seek care from the optometric world.”

He added, “What makes up the patients’ journey and experience today can separate an ECP from the competition.”
  

Eyecare as the Year 2020 Began
As of early 2020, what had been evident is that today’s leading-edge eyecare practices were working to better understand The Patient Journey and to find new ways to interact with patients when and how they want to communicate with the OD and to provide them a more meaningful in-office experience. This might mean offering online appointment requests and/or ordering, as well as in-office amenities that are above-and-beyond the norm.

As patients adjust in response to COVID-19, ODs also need to consider the impact on general social interactions, new expectations for waiting rooms in terms of space and eyewear handling processes, and the time required to appropriately space patient appointments and the space needed in the waiting area. These are areas with greater import going forward.

Perhaps these are things that should be communicated even before the patient comes into the office, in the pre-visit period as patients schedule their appointments either online or by telephone and the practice collects vision history/lifestyle behaviors from the patient. In this way, it’s part of the total patient experience and indicates a modern, efficiently run practice.

An unchanging component of The Patient Journey is the importance of ODs taking steps to explain the medical exam process, thus reducing patient apprehension and/or misunderstanding. And many doctors and their staffs sought to clarify the patients’ vision care benefits and the payment options available.

The result of this confluence of factors in the eyecare/eyewear health sector is an evolving Patient Journey that begins with the patient’s first consideration of purchasing new eyeglasses and runs through the scheduling process, the in-office visit, ECP follow-ups and, among other factors, the post-visit review that many satisfied patients will disseminate for their favored eyecare professional.

Older ideas about shopping are being replaced by these new ideas, in part, because of the challenge around persuading patients to break out of their in-home comfort zone and visit a brick-and-mortar practice location. This is driving what many today see as a keen focus on customer-experience as a mandate at retail.
  

The Rationale of The Patient Journey
For many ODs, the rationale behind developing and understanding The Patient Journey is that it helps grow the practice by enhancing patient perception, and it also is a key factor in helping patients who want to better understand their vision solution and overcome what some see as reluctance around the comprehensive eye exam.

In theory, The Patient Journey begins the moment a patient is greeted by the staff. This may take place when the patient enters the practice, but for many others today it actually begins online when the patient makes their appointment. The Patient Journey continues through the exam process and handoff to the dispensary and, in some instances, continues until through the point where the satisfied patient departs with new eyewear or a contact lens prescription and subsequently helps to promote the practice via word-of-mouth or a favorable online review.

“If customer service wasn’t so important, everyone would just shop online,” said Sarah Bonizio, community relations and marketing manager at Metro Optics Eyewear, which operates four locations in New York City. While Metro Optics, in keeping with the times, offers an e-commerce site (a key element to success during the COVID-19 pandemic), the firm’s “true strength is in our compassionate, respectful and knowledgeable team—from reception to exam room to dispensing table, and everywhere in between,” Bonizio said. “All are vital to a successful practice. Walking out with a pair of glasses that looks great, fits perfectly and achieves optimal vision is a given. Nearly all of our great reviews speak of how well-taken care of the patient felt.”

She added, “In 42 years we’ve developed hundreds of thousands of relationships by providing lens education ethically, being respectful of a patient’s budget, and creating a fun, relaxed environment for choosing frames. We created training materials and resources for all levels of staff to streamline patient flow and ensure consistent messaging (prior to and during visits), including recent additions such as our new training video for ODs and techs, fostering patient education on new offerings including OCT and other special testing.”


The Journey Starts With the Appointment
The ease of scheduling, receiving reminders, and rescheduling are all important steps in the initial phase of The Patient Journey. If it’s difficult to schedule an appointment, or if there’s a restrictive rescheduling policy, it sets the tone for a difficult patient journey. ODs should consider how patients move through the scheduling process, a Hoya Vision Care guide to The Patient Journey noted.

Another key point is to make a good first impression when the patient enters the practice. This may mean merchandising the dispensary with a balanced and enticing product mix. The space should be inviting, up-to-date, well-organized and well-lit. In essence, it should feel like a center of excellence not an ancillary service.





The intake form for patients is the next major step of The Patient Journey. This survey of health and other information will set the framework for how to approach the exam. It’s important that the questionnaire isn’t only about vision, but also about lifestyle, and digital eye strain symptoms.

Once the patient has filled out their questionnaire, it’s time for the exam. This is broken into two steps: discovery and education. It’s important while you are performing the tests and evaluations that you are also asking the patient about their lifestyle to help determine their primary vision needs.

The best way to build trust and retain patients is to educate. Once you’ve gathered information about their lifestyle, tell them why you are making the recommendations you are. For example, if they spend most of their day behind a computer screen, talk to them about how a work lens or a computer lens actually helps reduce the factors that cause eye fatigue, a Hoya Vision Care guide noted.

“Communication is the most important part of helping a patient feel well informed during the exam,” said Maria Sampalis, founder of the 28,000-plus member Corporate Optometry group on Facebook and head of the recently launched buying group CODA (Corporate OD Alliance). “I always explain what I am doing and why I am doing it. The more they understand, the more comfortable they will feel. Building trust with your patients starts with how well we inform them on health care topics and why you are recommending certain tests or products,” she added.

Indeed, patients may not always know the why behind each lens, or the features it offers, but if the OD can eliminate the jargon and explain the real benefits of a recommendation patients are more likely to be convinced of the thought and science that has gone into their prescription.
  

The Role of Managed Vision Care Benefits
Under the idea that The Patient Journey is about education, there is a significant opportunity to explain to patients the benefits covered by their vision plan. Patients likely don’t understand their full vision plan, but are certainly open to saving money by using it. This is in fact a chance to show expertise and boost practice revenue.

“The term benefits can be kind of a misnomer, and they can be difficult for people to really understand,” ABB Optical Group’s Erika Jurrens, senior vice president of strategic development and commercialization, said. “There are armies of people who navigate the complexity of [benefits] every single day in offices around the United States.”

An effective way for ODs to address the initial stages of The Patient Journey, she noted, is to communicate with patients the scope of their benefits—and the insurance coverage timeframes—while they are in the stages of considering an eye exam and/or the purchase of new eyewear or contact lenses.

The ideal situation for the OD is to be in position to proactively message to the patient the eyecare components that are covered by their specific vision plan benefits, and to recommend that they visit the practice to fulfill those benefits. This is a way to significantly reduce the patients’ unused benefits and for the patient to stay in compliance with eyecare, while helping the OD to schedule appointments for the practice.

“This is a win-win for everyone,” Jurrens said. “It’s a win for the doctor because they are able to get the patient back in the door to maximize their benefits and it’s a win for the patients because they are able to maximize the benefits that sometimes they didn’t even know that they had. This is a huge opportunity for patient retention and … for practices to build longstanding relationships with their patients and to reinforce their value to the patient.”

ABB Optical Group introduced ABB Verify late last year to help ODs more effectively manage the benefits process for their patients via a unique managed care verification technology. The initial results in just this limited time have shown “a huge return for offices that have invested in the platform,” Jurrens said. The longevity and the customers’ lifetime value—the fact that they are likely to return to the ODs’ office because of the value it provided—is an addition to increased revenue that can be tied into the ABB Verify tool,” she added.
  

Smooth Moves: Going from Exam to Dispensary
Handing off from the exam room to the optical is where the OD can show their patient journey in a strong light. When handing off to an optician, give an overview of the prescription, your recommendations, and why you are making them. Do it in front of the patient as well so they can hear it reinforced. Make sure you include the relevant information, and even go back to why you are recommending what you are. If you aren’t prescribing a specific lens type, make sure you explain the features that the patient needs.

Note that ODs who introduce how eyecare and eyewear can enhance a patient’s lifestyle help preset patients to explore options within the dispensary. This carries over to the point after the exam when the OD transitions the patient directly to an optician/sales associate and does this while explaining the benefits of specific eyewear or lenses.





By doing an informed handoff the OD creates a complete, seamless experience.

Rachel Maas, assistant vice president, specialty marketing, CareCredit, agreed that the patient experience begins with the initial contact with the provider and brings in every point of contact along the way. Important factors for the OD, she noted, are: how does the patient find the appointment process, whether it’s online or by phone; how do they feel upon entering the practice; and what is the overall experience you are providing them?

“Do you go above and beyond and offer different things that maybe other [practices] might consider more of a luxury experience?” she asked. “Put yourself in the customer’s shoes and view the patient experience that you are giving to them from the start to the finish…. Customers may make a purchase decision quite differently based upon how you approach the entire process,” she said. Maas noted that when a patient is comfortable and confident at the end of their journey, and they have been at ease throughout the process, they are more likely to move forward and act upon the OD’s purchase recommendations.


Looking Ahead to a Post-Coronavirus Environment
In time, the coronavirus pandemic will give way to a more conventional, yet changed, consumer and patient environment. While it’s too early to predict just what all of the changes will look like, there are key steps and ideas that ODs can work toward now to be better prepared for whatever the future brings.

This was one of the thoughts put forward by New England College of Optometry chief executive officer Howard Purcell, OD, FAAO, in a recent industry teleconference organized by The Power Practice founder Gary Gerber, OD. (The teleconference is posted online at the PowerPractice.com.)

“What you do now matters,” Purcell noted. “We have to start now with planning, looking at all the different ways to address things. What you do now will have a big impact on how things go when patients do come back.”

Purcell recommended a number of initiatives that ODs can focus on as they prepare to transition to the post-coronavirus environment. These include becoming an important source of health information and education for patients, preparing for a “change-on-the-fly” approach to business and operations as patient preferences evolve, expanding hours to accommodate the social-distancing inclination and working to “be clear and loud about how you are protecting your staff and your patients” as they come and go from the office.

Purcell added, “We market differently in tough times vs. good times. In good times, it’s about what’s easy—desire and leadership. In tougher times, it’s about comfort and affirmation.”