Magazine Article | July 13, 2016

Optimizing The Optometry Opportunity

By Matt Pillar, chief editor

Helping clients manage mandates, inventory, and transactions drives 50 percent growth for this consultant-turned-enterprise eye care software vendor.

Sarah Dirksen, product manager of Williams Group, says her company’s software is focused on enabling compliance with Meaningful Use and helping health practices avoid penalties.

Photo By Don Shepard Photography

Since its founding in 1983, Williams Group has consulted thousands of optometry and ophthalmology practices through virtually every stage of business, from startup organization to financials management and growth to succession planning. While the company’s consultants — most of which joined the organization on the heels of working in or running successful practices — continue to thrive on practice management, Williams Group took a major leap in 2006 when it got into the software business.

Sarah Dirksen joined the company in June of that year, just four months before Practice Director EHR was launched. Today she’s product manager for one of the fastest-growing divisions of the business, and she says the software’s biggest growth is yet to come.

Evolution Of An ISV
Practice Director EHR is a modular suite of software applications designed to manage electronic health records, prescriptions, orders and inventory, patient demographics, electronic health visits, financial reporting, scheduling, business reporting, insurance claims, and most recently payment acceptance for optometry and ophthalmology practices. Like many specialty ISVs, however, the development and sale of software wasn’t in the company’s original business plan. “Through the deep knowledge base Williams Group had acquired from consulting for 30 years prior to the launch of Practice Director, Williams Group realized a void in the market for intuitive, easy-to-use practice management applications in our industry,” says Dirksen.

That need was marked by a host of business-related challenges faced by practitioners, most of whom were well-trained physicians but lacking in business management skills. “We saw a strong need for analytics to measure and track several key business metrics, including receipts, per-patient revenue, and new and established patients,” says Dirksen.

Developing those solutions was no small endeavor and required a significant investment in resources. The company sourced talent from within Williams Group and throughout the eye care industry to lead the initiative. It hired a lead software consultant who had been working in the optometry software space since 1975, as well as several software engineers and account representatives with development and industry-specific expertise. Today, the 17-associate-strong management and staff behind the Practice Director EHR solution boast more than 150 years of experience in the eye care industry.

Meaningful Use Spurs Business Growth
With its close ties to Williams Group consulting services, Practice Director grew steadily from the outset. By 2011, steady growth had turned supersonic in advance of the Centers for Medicare & Medicaid Services (CMS) Meaningful Use initiative, which sets specific objectives that healthcare practitioners must achieve to qualify for incentive programs. Central to compliance with Meaningful Use is the adoption of certified electronic health record (EHR) technology to improve the quality, safety, and efficiency of care and reduce health disparities. 2011 marked Phase 1 of the initiative, requiring eligible professionals to adopt certified systems for data capture and sharing. That put Practice Director, an EHR-certified solutions provider, in a very good place. “We saw an incredible uptick in adoption of Practice Director because of the pressure that practices felt to take advantage of the incentives offered by the CMS,” says Dirksen. Those incentives were financial, made available from federal resources earmarked in the American Recovery and Reinvestment Act of 2009. Today, they’re gone.

“Meaningful Use compliance is no longer an incentivized program,” explains Dirksen. “It’s now a matter of being penalized for noncompliance.” Beginning last year, eligible providers that had not attested to Meaningful Use of their EHR for 2014 were hit with a 1 percent penalty on their Medicare reimbursement. That penalty increased to 2 percent in 2016 and will climb to 3 percent next year.

Enabling compliance with Meaningful Use — and helping practices avoid these new penalties — are key selling points for Practice Director. One such penalty is levied when eligible practices don’t participate in the Physician Quality Reporting System (PQRS), a quality reporting program that encourages practices to report information on the quality of care to Medicare. Practice Director’s partnership with the American Optometric Association (AOA) is a key enabler of that requirement. “Our software manages the burden of that reporting requirement by feeding all of our clients’ EHR data to AOA, and automating the process of stripping protected heath information from that data,” says Dirksen.

Retail Optometry Market Booms
While the penalties levied on noncompliant practices continue to drive business to EHR-certified solutions providers like Practice Director, Dirksen says the longtime trend toward retail-oriented eye care is a more sustainable trend for optometry and ophthalmology software solutions providers to follow. It’s a trend that mixes fast-fashion with healthcare and, as such, demands a special mix of enterprise software attributes. “Before Phase 1 of Meaningful Use went into effect, there was significant growth in the retail eye care market,” she says. “While the pursuit of compliance created a temporary catalyst for the growth of enterprise software in our market, the continuing retail trend demands some of the features we offer.”

Chief among those features is inventory management, which has attracted eye care clinics ranging from multilocation clinics to single locations with a handful of employees to the likes of Costco and Walmart. “Our inventory management module allows our clients to track their prescription contact and spectacle lens inventories by power and provides instant access to their availability,” she says. However, because eyewear is also a fashion-focused business, frame inventory management and availability are also major concerns for Practice Director clients. “We integrate with Frames Data, which offers a product called SPEX UPC that gives practices full access to every frame on market,” explains Dirksen. “Practices can import that data directly into our software, which eliminates data entry and helps to automate inventory management.”

Retail Model Drives Payments Integration
A recent Cost Survey Report for Multi-Specialty Practices from the Medical Group Management Association revealed that healthcare providers typically collect an average of only 54 percent of their outstanding receivables. That translates into billions of dollars in potential lost revenue across the industry. A combination of the retail prescription eyewear trend and the shift toward healthcare plans with high deductibles is only exacerbating this issue for optometry practices.

Payment reconciliation is so important to eye care practitioners that Practice Director clients began to clamor for its integration within their enterprise software platforms. “Many insurance providers have begun paying practices by credit card instead of traditional checks and electronic funds transfers, and our clients have had to adapt to that as well,” says Dirksen. “They obviously want to get paid, and they began asking us for help finding a seamless approach to posting and receipt.” Until 2015, Practice Director did not offer a direct integration with a payment processing partner. Fielding increasing calls for payment services, the company chose to partner on an integration project with Total Merchant Services last year. That integration project has recently wrapped, and the Total Merchant Services/Practice Director integration is currently in beta with select clients.



“While the pursuit of compliance created a temporary catalyst for the growth of enterprise software in our market, the continuing retail trend demands some of the features we offer.”

Sarah Dirksen, product manager, Practice Director



Sell More By Embracing Change Management
Between federal mandates and an evolving retail model, both of which demand advanced software, eye care practitioners have faced a steep learning curve in recent years. “Our client base spans from new, young doctors who are accustomed to doing things digitally to those who are still having a tough time transitioning from paper to electronic records,” says Dirksen. “For those providers, change management starts at the very beginning of the sales process. We stress that Practice Director allows clients to move at their own pace — they get the entire platform, but they can implement it one module at a time.” Clients are assigned an implementation specialist at Practice Director who serves as a guide through the six-to-eight-week implementation to go-live process. They’re then outfitted with more than 30 hours of training videos for continued support as well as phone and online support.

Practice Director is made available via the cloud for those who desire a hosted platform, but Dirksen says the vast majority of the company’s clients choose to deliver the applications from a local server in their office. “In our industry, there’s still a prevailing concern about the stability and speed of the internet and the resulting performance of hosted applications,” she says.

Dirksen stresses that there’s great reward in helping clients discover the power of tracking, analytics, and reporting. “Our partnerships with TriZetto and Cognizant have been very powerful, particularly for the independent practitioners who haven’t had access to that level of business reporting and revenue cycle management,” she says. “Everyone loves their dashboards to track their daily business.” The business intelligence reporting features of most interest to Practice Director clients include gross sales, receipts, and volume of appointments kept versus scheduled — all of which are key performance metrics for eye care practices.

The AOA assesses the eye care market at 40,000 optometrists and 18,000 ophthalmologists strong. The number of optometrists alone is pegged to grow by more than 6,000 by 2022. Those professionals serve the nearly 200-million Americans who need corrective lenses via nearly a billion appointments annually. What’s more, a whopping 81 percent of optometry students aspire to be self-employed within five years of graduation. That’s a robust and growing market, and one that Practice Director plans to leverage as it achieves the 50 percent growth it forecasts this year.