Biography/Disclosures
Biography: Hovanesian is a faculty member at the UCLA Jules Stein Eye Institute and in private practice at Harvard Eye Associates in Laguna Hills, California.
May 20, 2020
2 min read
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BLOG: What if you could scan a patient's mind?

Biography/Disclosures
Biography: Hovanesian is a faculty member at the UCLA Jules Stein Eye Institute and in private practice at Harvard Eye Associates in Laguna Hills, California.
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Remember Spock with his mind meld? In just a few seconds of somewhat awkward intimacy, he could understand all the thoughts, knowledge and motivations of another person. Wouldn’t it be nice if we had that kind of insight on cataract patients before we began a discussion about advanced IOL options? We would understand their lifestyle, habits and medical history enough to make an intelligent implant recommendation. More importantly, we would know whether their motivation to live a life without glasses was strong enough to justify the time required for the conversation, and we would shorten the conversation itself.

We can’t mind meld with our patients, but we can understand them better by using a software called MDbackline that interfaces with electronic health records to give us a profile of each cataract patient that contains just this information.

We need a tool like this. Market research shows that 80% of consumers would be interested in a premium implant if they understood its benefits, limitations and costs. Yet only 11% of U.S. cataract surgeries involve a toric or presbyopia-correcting IOL — far short of public demand. Most experts agree this gap exists because with traditional communication, it takes so much time to understand the patient’s needs and share information about his or her options that surgeons and their staff members don’t take time to discuss it.

This just became much simpler. For about 6 months, we have been using MDbackline’s Visual Profile Report to better understand cataract patents. MDbackline is a secure web-based software that detects events in EHR, like a scheduled appointment for a cataract evaluation. It automatically contacts patients by text message and email with the doctor’s name and picture. It invites them to verify their identity, answer questions, and view general learning material about cataract surgery and the types of refractive options the surgeon offers. It takes the fear out of cataract surgery and presents refractive options as a permanent solution that patients should understand so they can make an appropriate choice. Maybe most importantly, it gives clinicians a concise, single-page Visual Profile Report that summarizes the patient’s likelihood of choosing an advanced implant based on a variety of validated patient inputs. It also suggests what type of solutions (multifocal vs. monovision vs. other options) a patient should consider. It includes details about visual complaints, visual history, motivation for distance, intermediate and near, and history of multifocal and monovision contact lens use.

Some of our colleagues using the Visual Profile Report for their cataract practices simply won’t see patients without it. And every surgeon who has put it to use has reported significantly increased premium lens adoption because it raises surgeon and staff awareness of a patient’s true level of motivation, which is generally much higher than we would guess.

Contrary to the worry of some surgeons, discussing refractive cataract surgery options does not damage the doctor-patient relationship, nor is it viewed as an unwanted distraction motivated by surgeon self-interest. To the contrary, the Visual Profile Report has shown us it is our duty to discuss refractive options with cataract patients because most are at least moderately interested in learning their choices. And using this tool has greatly shortened the amount of time the discussion takes because we better understand our patients’ background and desires, and patients better understand their options, even before they arrive in the office. Doesn’t that sound like good doctoring?

Disclosure: Hovanesian reports he has a financial interest as the founder of MDbackline Inc.