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3/23/2016Financial DisclosureI have no relevant financial or nonfinancial relationship(s) withinthe products or services described, reviewed, evaluated or comparedin this presentation.Marie Francis LPN, COT, OSCFour areas of discussionRefraction and the differential diagnosis1. Refraction and the differential diagnosis2. ICD-10 A survival guide for the savvy tech3. Team work-why getting along has never been so awesome4. News you can use-certification, what’s in it for me?For the love of all things holy, blink your eyes!!Know your audienceHis StoryIs your patient a Myope?The patient will tell you what the diagnosis is Pseudophakic?Status Post Yag Laser?Diabetic?Hypertensive?Glaucoma? If you just listen1
3/23/2016Differential DiagnosisAre there changes?Definition: Process of EliminationWhich way do the changes point me?‐1.00 over refraction and positive glare test?Use the first three clues gathered CataractsHistory‐Symptoms, trauma, family history, time frameNo change in refraction, no change with blinking, letters look slanted?VisionARMDWhat was it last year? Did it change?RefractionNew onset diplopia? No fusion with prism?Can you improve the vision? Did the patient go moreminus? Plus? Increase in astigmatism? Does blinkingchange the refraction? Diplopia when both eyes areopen?6th Nerve PalsyMusical InterludeAncillary TestingWhat about a(n) OCTVisual FieldAmsler GridGlare testRed glass testKeratometryCover/uncoverWorth 4 dot ?ICD‐10 a survival guideDon’t forget Doing YOUR part for the MD!Pain ScoreFall assessmentDomestic violence screeningReview of systems (ROS)Should be filled out for problems patient has TODAY onlyBlood pressure readingMark as reviewedHover to Discover!!Diabetic MaintenanceForgetting, rushing or falsifying just delays care and paymentDon’t be that guy!If the patient is not experiencing ANY problems, you can click “all negative”2
3/23/2016How does this apply to me?Chief ComplaintI get it, we are “just techs”This is where it goes in e‐recordwe don’t deal with billing or coding or diagnosis BUT We are the front lines!Be the tech that every doctor WANTSto work with by filling out a complete record!Quick and Painless ChartingIt’s just GOOD patient careProper documentation makes a record completeSpeed buttons are a great way for the non‐typist to generate specific chief complaintsThink about YOUR experience with other offices auxiliary staffThink about YOUR own personal health recordsWouldn’t you want the most efficient visit?Better care and better documentation equals happier patients!Right click after putting in the chief complaint andscroll to “Add to speed buttons”Biggest Complaint about ICD‐10/EMRand meaningful use protocolMusical InterludeIT TAKES TO LONG!I’M FOCUSING ON THE COMPUTER AND NOT THE PATIENT!I’M JUST NOT GOOD WITH COMPUTERS/TYPING!Solutions:Average time it takes to document properly: Less than 1 minute!You can still focus on the patient, the more comfortable you arewith documentation and putting information in the right spot, the easier itwill be to turn to the patientERH and computers are here to stay, learn to type!!Websites: www.typing.com3
3/23/2016Teamwork!This isn’t a speech about how we should all get along and enjoy each otherscompany and sing kumbaya at the beginning of each work day.This is the story of three tech’s.Tina attention to detailLet’s call this a “Monday”So Tina is taking a little extra time in the exam room trying to figure outPatient A’s surgical history and Lisa is chatting up front with the secretaryabout her weekend and Wanda needs a room because she has two charts inher hand, one of Patient B who came on time and one of Patient C who camean hour early, but she will work her up anyway.Focused, impeccable, exams take a whileSo personalities collide.Lisa laid backLoved by patients, personable, forgets informationWanda work horseHard worker, can take many patients, gets overwhelmedTina doesn’t understand why Wanda just can’t waitLisa doesn’t understand why the patients all need to be worked up so fast,it’s not a race after allAnd Wanda doesn’t get why her co‐workers are being so lazy and takingforever.This is where Tempers flairRecognitionCommon bond of ophthalmologyStress is createdClinic slows downThere are many different paths to the same castleGrudges are madeHelp each other to understandAnd most of all .where patient’s can become less of our focus and more ofan audience to our grievances.Communicate differencesBe preparedSo .what’s the solution?Embrace your differences‐learn from them‐be self awareMusical InterludeWho are you?COA – Certified Ophthalmic AssistantCOT – Certified Ophthalmic TechnicianCOMT – Certified Ophthalmic Medical TechnologistThree main levels of certification from JCHAPOAdditional certificationsROUB – Registered Ophthalmic Ultrasound BiologistOSC – Ophthalmic Scribe CertificationOSA – Ophthalmic Surgical AssistantCDOS – Certified Diagnostic Ophthalmic Sonographer4
3/23/2016American Optometric AssociationDISCLAIMER: I work for the University of Rochester!CPO ‐ Certified ParaOptometricCPOA – Certified ParaOptometric AssistantHow much will I get?CPOT – Certified Paraoptometric TechnicianCOA .075CPOC – Certified ParaOptometric Certification (speciality)COT 1.25COMT 2.00Ophthalmic Photographers SocietyOCT‐C (certification)CRA – Certified Retinal AngiographerFlaum Eye InstitutePays for all certificationsCertification is not JUST about money, but about continuing to learn andgrow as a professional!BooksFlashcardsCanandaigua Eye Care CenterPays for all certificationsIf YOUR institution does not pay for certification:Breakdown example: COT multiple choice and skill test 325That’s 6.25 per week for 1 yearWhen you pass the test and skills you earn 1.25 MORE, which is 50 per week(based on 40 hours)First year you will earn 43.75 more (50‐6.25) then 50 more per week.That’s 2,600 a year!Websites – Quizlet.com/JCHAPO/TIM ROOT‐rooteyenetwork.comYour Doctors!They have years of knowledge, experience and have paid hundredsof thousands in school loans to get to this point.And you have all that knowledge, at your disposal, everyday forFREE.Each otherEncourage, help, work together.ASK QUESTIONSDog TaxFollow up on difficult casesAsk about rare conditionsWant to learn a new skill? Ask about it!Don’t quite understand that diagnosis? Ask about it!30 minutes of study a night 2.5 hrs a week 10 hrs a month 20 hrs in 2 monthsMost doctors are MORE than happy to help you learnThis may seem obvious, but how many of us ACTUALLY do this?Education is one stepLearning is a journey 5
3/23/2016Questions?Thank you for time and attention!!6
Common bond of ophthalmology There are many different paths to the same castle Help each other to understand Communicate differences Be prepared Embrace your differences‐learn from them‐be self aware Recognition Musical Interlude Who are you? COA–Certi
