Tips and tricks: introducing OCT in practice

Optometrists and independent practice owners Alisdair Buchanan (pictured) and Mark Holloway took to the stage at 100% Optical to share with practitioners their experiences of integrating optical coherence tomography (OCT) into practice, as well as how they have used the tool to build their businesses.

The duo spoke to OT after their lecture to share their tips and tricks for success.

What were the key take home messages from your talk?

Alisdair Buchanan (AB): I talked about how OCT is important and how we should all be doing it. But we can’t do it cheaply for £10, £20 or £30 as it takes so long to do. You have to charge for your time.

A key message from me was to look at what it costs you to do this and make it profitable for your practice because you will need to update that kit or invest in the next thing in the future. You have to use it as a practice builder as you need to constantly be investing and building your practice.

How do you use OCT and what tips do you have to help other practice owners get the most out of the technology?

AB: OCT is really important to help you build your practice because it puts you above the practices that don’t have OCT. It helps you build relationships with your patients because they can look at the scans and they really get it. It also helps you build relationships with ophthalmologists.

We integrated OCT into our practice six or seven years ago and we have done everything with it. For me it is about getting that message to the patient that we can save their sight by doing these scans. The amount of times I do an OCT on patients who we can see no problem with during the eye examination and I get surprised that they have glaucoma or near vascular membrane, or whatever is going on. It’s really important to be doing these things to save people’s sight.

As a piece of kit, what is on your OCT checklist for what the device must do?

AB: An OCT needs to be really easy to use. It’s also got to be reliable and the quality of the image has to be phenomenal.

The key thing for me is that if you are spending money on a piece of kit, you want it to last for years. With many OCTs you buy it and that is it. The reason I chose the Heidelberg Engineering Spectralis OCT is because we can continue to upgrade it; it will never go out of date. We can keep adding modules on and we don’t need to replace the whole instrument.

As an early adopter of OCT, why did you invest in the technology?

AB: We adopted OCT fairly early on as we needed to differentiate ourselves as a business. We needed to say: ‘We are independent and we can do more for you to look after your eyes.’ OCT was the next progression for us.

We invested in OCT and additional modules thereafter so we could offer glaucoma screening and anterior eye imaging. Then we reached a plateau and wondered where do we go from here? OCT-A came about and we invested in it – it has been another great practice builder as I can diagnose more conditions. The ophthalmologists have responded to say they are blown away by the quality of these images and are surprised we are getting these images in practice without using florescein.

How do you offer OCT as part of the sight test experience?

AB: We do an awful lot of marketing so that our clients are already primed for discussions about OCT and OCT-A when they arrive in practice. When they come into the practice, our staff are all trained and happy to talk to patients about it. We have images of OCT up, we have screens playing OCT images and promoting it, and then we talk to patients in the consulting room about it. Yes, I have had to extend my testing times dramatically as a result.

We adopted OCT fairly early on as we needed to differentiate ourselves as a business. We needed to say: ‘We are independent and we can do more for you to look after your eyes

What is your experience of introducing OCT in practice?

Mark Holloway (MH): We were a fairly early adopter of OCT in 2014. I took over the business a year or two before that and I was looking for practice differentiation, as well as things that were going to make my role as an optometrist a little more varied.

Since introducing OCT into practice, how have you adapted your clinical routine and what do the patients get from the practice experience?

The OCT allows us to pick things up a lot sooner than we would have been able to before. Some of the estimates are that you can pick up glaucoma eight years earlier with an OCT than without an OCT. It also allows us to be more certain of our diagnosis.

Furthermore, OCT is great for patients who maybe don’t have pathology but have family histories of conditions, or who just want the best eye care because it’s reassuring.

Definitely consider OCT as an option. Consider it as a specialism and consider it as a practice builder

What would you say to practice owners without OCT currently?

Definitely consider OCT as an option. Consider it as a specialism and consider it as a practice builder, but make sure that you go into it with a plan. Have a plan, make sure you have looked at your local area, your demographic and your pricing, as well as the integration into the practice, and marketing internally and externally.

Has OCT surprised you in terms of the impact that it’s had on your business?

We are starting to pick up patients from further afield. Word of mouth is the best tool for getting new patients and that has definitely been the case. Patients are more reassured, they are happier with their eye care, they are more engaged, and it has been a great practice builder.

I have had patients tell me that I should charge more for it, but I have never had a patient say that it was too much money. People are savvy and understand value.