Commitment to Comprehensive AMD Care

OD Talk: How the AMD Excellence Program makes it easy to live up to our ethical responsibilities as eye care providers

The goal of any healthcare professional is to prevent and manage disease. When it comes to diseases like age-related macular degeneration (AMD), that’s a daunting task — and it starts with early detection. As a profession, optometry is just not doing a good enough job at finding this disease. My patients and my community deserve to know about their risk for AMD, and they deserve the chance to find out about this much earlier. That’s why we implemented dark adaptation technology in our practice, starting with the original AdaptDx^® tabletop device.

Even with our investment in the technology to test dark adaptation speed, our space and time constraints kept us from doing what was truly best for our patients. When MacuLogix^® introduced the AdaptDx Pro^®, we couldn’t wait to get our hands on one. The portability of the device and its built-in dark room feature made it easier to conduct a test, but after a few months, we realized we still weren’t optimizing its use. It wasn’t until we participated in the AMD Excellence Program^® with our MacuLogix Practice Management Consultant (PMC) that we really discovered the keys to success.

From 15 to 90 Tests in One Month!

Before we jumped on board with the AMD Excellence Program, our utilization of the AdaptDx Pro was inconsistent. We would run 15-20 Rapid Tests per month, but the number of weekly tests would change based on whether the issue was top-of-mind. For instance, after our monthly staff meetings, when we would talk about the importance of early AMD detection for our patients, we would do a better job of testing. We wanted to do right by our patients, but we just couldn’t figure out the best approach on our own.

While participating in the AMD Excellence Program, our PMC was able to teach us some small tips that went a long way towards helping us achieve our goals. For example, she introduced the simple concept of smart scheduling to make sure we aren’t scheduling our 50+ year old patients back-to-back or clustering them in the morning or afternoon. She suggested our technicians “huddle up” every morning to review the day and create a game plan. By knowing exactly which patients would be tested, when and by whom throughout the day, dark adaptation has quickly become the norm rather than the exception. 

Our biggest “aha” moment of the program came during our first week of this new model. Patients began failing the Rapid Test even though they were in their early 50s, with no family history of AMD or even other health problems—they had no risk factors, but AMD was still there, and we were catching it. By changing our standard of care to include an AdaptDx Pro Rapid Test for every patient over 50 as part of our pre-exam protocol, every OD in our practice is armed with the patient’s Rod Intercept^® (RI^®) when they walk into the exam room. When we need to order an Extended Test, patients are comforted by the fact that we caught the disease so early. We can tell them that we have time to do the right thing and pull out all the stops to preserve their vision.

In that first month, we tested 90 patients—six times more than the previous month—and are now averaging nearly 100 tests per month. As a result, we’ve identified so much previously undiagnosed AMD that we could never even consider going back. Testing every patient over 50 is something we always aspired to do, and now we are. Unless you’re a pediatric practice, you have a lot of AMD in your patient base. With this technology and the tools offered to implement it, how could you choose not to look for disease?

After a few months of testing 100 patients on average, it became clear that we needed a second AdaptDx Pro. Now, with two devices, we are even more confident in our ability to deliver a superior standard of care for our patients.

Tech Talk: The Right Recipe for Early Detection

When Dr. Lagunas brought the AdaptDx and AdaptDx Pro into our practice, he called an office meeting each time to stress the importance of detecting AMD early so that we can try to slow the progression of the disease. However, every time he requested a test, it would throw off our day and workflow. Plus, we weren’t using the device frequently enough to be experts.

In January 2021, Dr. Lagunas told us that we would be participating in MacuLogix’s new AMD Excellence Program. We had made a promise to our patients, and to ourselves, to do everything we could to diagnose and manage AMD.

This was our chance to make dark adaptation testing part of our standard of care for patients over age 50!

Over half of our patients are in that 50+ age group, so our commitment to the AMD Excellence Program was no small feat. With guidance from our PMC, the transition to testing every patient 50+ was fairly smooth. Because we have so many patients in need of this test, we know it’s up to us techs to collaborate to ensure every patient has time for their Rapid Test.

Having a portable device has been huge for us, because we can pass the device back and forth to test patients at the best point during their appointment.

Having Theia™, the on-board technician, is like adding another member to the team. Once we get the patients started, Theia takes over! We are always keeping an eye on the patient, but we can also chart and prepare for the next patient. The AdaptDx Pro is easy to use, and all of our techs participated in device training, but when we began using it on a daily basis, our confidence and skills grew.

About a week into the AMD Excellence Program, we really found our groove and routine testing became more comfortable. Even though we knew why dark adaptation testing was important, the true significance didn’t really hit us until we started testing every patient over 50. As more and more of our patients took the Rapid Test, we saw our failure numbers grow. These patients needed to come back for their Extended Test, and some patients even wanted to come back the very next day, because they too understand the importance of early detection, and we want to give them the best possible care.