We live in the Age of Innovation. The eyecare profession is changing and innovating at a rate never before seen. We are learning about diseases, diagnostic measures, and treatment methods in ways that we would never have thought possible 10 years ago. Who would have believed that we would be learning about things through social media sharing on platforms such as Facebook, or watching a video creation by a colleague through online channels such as YouTube?

When my grandfather started practicing eye care 50 years ago, the thought of having multiple exam lanes, let alone a room specifically designed for special testing or pre-testing, never crossed his mind. But today, if you don’t have at least an autorefractor box, tonometer box, and visual field box, many would think you are practicing in the Dark Ages. For others of us, we might have 10 such “boxes” sitting around our office filling every space imaginable. This current situation then begs the following question: How many boxes do I need, and when should I consider bringing a new “box” into my office?

Technology always has an upside and a downside. Before bringing new technology into your office, it is important to ask the following three simple questions.

1. How Is This Going to Improve Patient Care?

Sometimes I want to move into a new area of care for my patients (e.g., vision therapy, posterior segment disease, or dry eye), and I need a specific instrument to do that. Am I giving up time with patients to run a test or do the necessary treatment? And, if I am, does it make the patients’ lives better? If it is allowing me to speed up my visits with my patients, is that allowing me more time with them to better care for their needs?

2. Am I Ready to Implement This Technology?

Next, think about staff considerations. Do you have the manpower to operate the instrument? Are you going to need to schedule additional team time? If you are adding it to a current schedule, are you cutting something else out? If not, how do you expect to make up the residual time in your schedule? How are you going to be billing this? And, importantly, how do you present this new technology to your patients?

3. How Am I Going to Pay for It?

The financial aspect of the technology should be next on your list. What is the return on investment (ROI)? I like to realize an ROI within one year. I simply take my coverage (insurance or private pay amount) and divide by the cost of the instrument plus the extra costs (team time and operating expense) to operate it. This shows me how many “procedures” I need to perform in one year, or it can be broken down monthly. It requires me to analyze whether I actually need the machine or whether it is a luxury.


Planning needs to occur before bringing any new technology into your practice. It always has to make the lives of the team and patients better, but it also needs to bring about an improved health for the practice. CLS