Practice Management Archives - Eye Care Business Canada

Why Hearing Care Makes Sense in an Eyecare Practice

Trevor Miranda Hearing and Vision clinic article image

If eyes are the windows into the soul, perhaps ears are the doorway to the heart. Both vision and hearing play huge roles in enjoying life. Whether it is the ability to read or the ability to participate in conversations, both are central to day-to-day connection and independence. Like vision, hearing deteriorates with age. Early detection and timely intervention can improve long-term vision and hearing health and overall wellness.

One Stop for Vision and Hearing Care

At three of our five clinics at Cowichan Eyecare, we have integrated hearing services. My brother is a Doctor of Audiology and leads our hearing care division.

Our first instinct was to operate in a silo and simply share space. Some of that may have stemmed from a fear of being viewed as nepotistic if we more closely integrated the vision and hearing offerings. Over time, we have continued to integrate both services in a more intentional way, and patient feedback has been overwhelmingly positive. The convenience of addressing hearing needs in a place you already trust for eyecare, or vice versa, has quelled our initial reservations about joint care.

There are also real economies of scale that create efficiency and cost savings with hearing and vision integration. We share a front desk and a call-answering system, which streamlines communication and scheduling. We use a common Practice Management System (PMS) for billing and recalls, which helps us keep patients on track with follow-up care. Shared restrooms and lunchrooms allow for efficient use of space, leaving more room for special testing or retail areas in the clinic.

One of the key differences between vision and hearing is that there is often a significant lag between the onset of hearing loss and the time a patient seeks corrective help. Increasing awareness in both disciplines, and cross-educating our teams, is a practical way to reduce that lag and get people the support they need sooner. In our experience, simply having both services under one roof creates more natural conversations about overall sensory health.

The Role of Hearing and Vision on Cognition

Hearing is inextricably linked to cognition. Audiologists often say the ears collect sound, but it is the brain that hears. There is substantial research highlighting a connection between untreated hearing loss and cognitive disorders. More recent research is also showing that improving hearing can reduce the risk of cognitive decline. Keeping our hearing healthy is an important part of keeping our brain in an optimal state.

Because we cannot fully close our ears the way we can close our eyes, the brain is constantly receiving and processing sound. This ongoing processing keeps the auditory centres of the brain engaged and “exercised.” When we hear, the brain chooses to pay attention to some sounds (for example, conversation) and to tune out others (for example, the hum of traffic). That filtering is work, and it is part of what makes hearing such an active, brain-driven process.

We all have a certain amount of cognitive capacity, or “brain power.” That resource is limited, and the amount we have available at any given time depends on many factors, including fatigue. When we have untreated hearing loss, we use cognitive resources, and often our vision as well, to fill in the blanks of what our ears are not giving us. In conversation, hearing is the first step before we can understand content. A hearing deficiency demands cognitive resources first, and whatever brain power is left over can then be used to process, remember, recall, think ahead, draw analogies, create and understand jokes, and stay engaged in the moment.

Research has shown a significantly higher incidence of cognitive disorder in people with untreated hearing loss. For example, individuals with hearing loss between the ages of 45 and 65 have been shown to have two to five times the risk of reduced cognition and dementia, depending on the severity of the hearing loss (Lin et al., 2011; Livingston et al., 2020). More recent research is beginning to show that when hearing loss is treated, cognitive performance can improve significantly (Jiang et al., 2023).

The primary advantage of correcting milder degrees of hearing loss may be the potential cognitive benefit. When missing sounds are filled in with assistive devices such as hearing aids, it reduces demand on limited cognitive resources. Those resources can then be deployed for higher-order tasks, including comprehension, memory, and social connection. In cases where vision is compromised such as macular degeneration optimizing hearing is even more important due to limited cognitive resource theory.

The Business Opportunity

Our metrics show that hearing care revenue represents about 30% of the eyecare revenue opportunity. That means that, with little added space, a significant additional source of revenue can be available in many eyecare clinic settings. A hearing booth is required, but the footprint is manageable and the impact can be meaningful. A hearing booth is simply a small, sound-treated room that allows accurate testing and fittings in a quiet environment. There are few eyecare subspecialties that can provide this amount of financial upside without major renovation.

Of course, the details matter. The revenue-sharing agreement needs to be worked out, and medical manpower needs to be accounted for, including appropriate compensation for the audiologist. When it is structured properly, the integration can be both clinically valuable and financially sensible.

Wearables as the Gateway

New eyeglasses are coming to market that will be hearing-assistive. These glasses will provide sound enhancement and refinement by cancelling noise and using directional microphones built into the frame. These hearing glasses will likely provide solutions sooner for patients with low to moderate hearing loss.

They will not replace customized hearing instruments, and they are not meant to. Still, as an entry point, hearing glasses can be assistive at a lower cost, while also delivering great vision with prescription lenses. For some patients, that may reduce barriers and normalize getting help earlier.

The Focus on Wellness

Optometry and eyecare will continue to evolve. Technological advancements in wearables, enhanced diagnostics, and individualized solutions will allow ECPs to support better overall health and wellness for our patients. Can you hear it? The future will be clear, and it sounds amazing!

If you have noticed the TV volume creeping up, or you find yourself asking people to repeat themselves more often, bring it up at your next eye exam. We can help you understand what is normal, what is not, and what the next step could be.

DR. TREVOR MIRANDA

Dr. Miranda is a partner in a multi-doctor, five-location practice on Vancouver Island.

He is a strong advocate for true Independent Optometry.

As a serial entrepreneur, Trevor is constantly testing different patient care and business models at his various locations. Many of these have turned out to be quite successful, to the point where many of his colleagues have adopted them into their own practices. His latest project is the Optometry Unleashed podcast.

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AI and EMR Integrated into an Optometric Practice: The Future of Eye Care

Human Resources

Diana Monea article AI and EMR Integrated into an Optometric Practice

Optometry has evolved from paper files to digital records, from phone calls to virtual communication, and in the future, perhaps even to robots (bots) assisting humans. Every day, innovation takes on a new dimension as artificial intelligence (AI) is integrated into electronic medical record (EMR) systems. The future of communication and diagnostics in eye care remains uncertain: will AI replace parts of what we do, or simply help us work more efficiently, more accurately, and at lower cost while improving the patient experience?

AI Reduces Office Time, Improves Documentation, and Enhances the Patient Experience

AI can capture the doctor–patient conversation and generate clinical notes automatically. Unlike basic dictation tools, more advanced systems can organize information into the appropriate sections such as chief complaint, history, exam findings, assessment, and plan.

AI can also support tasks such as:

Billing and coding support
Documenting diagnostic impressions and recommended next steps

Used well, these tools can improve the patient–doctor experience. The clinician can stay more present with the patient, while reducing clerical workload and documentation interruptions. This can also help reduce clinician burnout by making charting more seamless and efficient at the point of care, reducing the need for after-hours documentation.

2. Integrating AI and EMR

When AI outputs can be structured and integrated into an optometry EMR, the system can help identify patterns and automate repetitive, but necessary, tasks. Depending on the platform and workflow, AI-enabled EMR integration may support:

Prescriptions and documentation support
Referrals and communication templates
Treatment plan tracking and management
Patient education materials based on clinical findings
Interpretation support and clinical prompts
Revenue cycle support
Analytics and reporting

With thoughtful integration, the EMR can begin to function less like a passive record and more like an active clinical assistant.

3. AI Imaging as Clinical Support

OCT, fundus photography, corneal topography, and visual field data can be analyzed using AI models trained on large datasets. Applications may include:

Diabetic retinopathy screening
Glaucoma risk and progression monitoring
AMD risk stratification and progression tracking
Corneal irregularity detection
Automated comparison of serial scans

AI-powered support tools may also combine imaging with clinical measurements such as intraocular pressure, pachymetry, and refraction. These tools are not a replacement for clinical judgment, but they can add a layer of insight and help flag subtle changes that are easy to miss in busy practice.

4. AI’s Impact on Practice Management

Administrative inefficiencies are a major source of stress and cost in many practices. AI-enabled systems can assist with:

Insurance claim submission, verification, and follow-up
Coding support, rejection handling, and resubmissions
Appointment scheduling, reminders, and recall workflows

By reducing errors and repetitive front-desk work, AI can free staff to focus on higher-value patient service and practice operations; helping reduce administrative burden and improve consistency.

5. Patient Communication

AI can improve patient understanding and satisfaction by:

Providing personalized summaries of findings
Explaining recommendations and outcomes in plain language
Generating visuals or simplified graphics that help patients understand their results
Supporting appointment booking and capturing patient concerns ahead of visits
Providing relevant pre-visit or post-visit information for recommended procedures

Practice bonus: when patients are better informed, they are often more confident and more compliant, leading to smoother visits, fewer misunderstandings, and a stronger overall experience for patients, staff, and clinicians.

6. Standardization Through AI and EMR Connectivity

A major advantage of AI is its potential to integrate with EMR systems more seamlessly than older workflows. Historically, many EMRs operated in silos, requiring manual entry and increasing the risk of transcription errors.

With tighter device-to-EMR integration, key data, such as refractions, visual acuities, intraocular pressure measurements, and imaging results, can populate charts automatically. This reduces redundancy, improves accuracy, and supports standardization across the clinical team.

7. The Advantage of an AI-Enhanced Practice

When documentation, scheduling, coding, and routine analysis are partially automated, optometrists gain time to do what matters most: be human. That means having more capacity to educate, reassure, and build trust without sacrificing the operational demands of modern practice.

The future of optometry will be shaped by clinicians who use AI strategically to enhance care, reduce burnout, and elevate the patient experience. Practices that adopt AI, and integrate it effectively into their EMR, will be better positioned to improve efficiency, strengthen resilience, and pursue clinical excellence in the face of tomorrow’s practice challenges.

Dr. Diana M. Monea, OD

Dr. Diana M. Monea is an award-winning optometrist, author, and keynote speaker with more than four decades of leadership in clinical practice, business ownership, and professional education. Founder and former CEO of Eye Health Centres, she now focuses on consulting, mentorship, patient care, and public speaking.

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Benefits of Niche Targeting: A Clearer Path for Optometrists and Their Finances

Building Wealth, Finance|Wealth

Article by Roxanne Arnal Niche Focus What Boutique Eyecare Can Teach Us About Better Financial Planning

Walk into a boutique eyecare practice and the difference is easy to feel. The environment is considered, the offerings are curated, and the experience reflects a clear sense of purpose. These practices are not designed to meet every possible need. Instead, they focus intentionally and that becomes their defining strength.

This idea of niche targeting has reshaped how many optometric practices operate. Less obvious, but just as important, is the way the same concept can shape financial decision-making.

Clarity in Decision-Making

A well-defined niche can simplify the way decisions are made.

When a practice has a clear focus, choices around equipment, staffing, and continuing education often align more naturally. Instead of weighing competing priorities, optometrists can evaluate whether a decision supports the core direction of the practice.

This does not make decisions easy, but it often makes them clearer. Financially, that can lead to more deliberate capital allocation, with investments reflecting strategy rather than circumstance.

More Predictable Revenue

As a practice becomes known for a specific area of care, patient demand often becomes more defined. Referral patterns can strengthen, and marketing efforts tend to be more precise. Over time, this can create a steady flow of patients seeking your particular services.

More Intentional Growth

In a generalist model, growth can sometimes feel reactive, shaped by opportunities as they arise, even when they pull the practice in different directions.

While no practice is fully predictable, greater consistency can make it easier to:

Plan reinvestment in the clinic
Structure financing decisions
Manage cash flow with more confidence

The result is often more disciplined growth, with fewer competing priorities.

With less variability, financial planning can feel more grounded.

A Clearer Approach to Risk

Narrowing focus can initially feel like adding risk. There may be concern about relying too heavily on one area of care.

In practice, the trade-offs are more balanced.

While niche targeting concentrates certain aspects of the business, it can also reduce risks tied to inefficiency, overextension, or inconsistent demand across multiple services. Risk is not eliminated, but it becomes more defined.

For optometrists who already have significant exposure through business ownership, this clarity can support more measured decisions in personal investment strategies where diversification often plays a larger role.

Supporting Long-Term Planning

Financial planning for optometrists tends to be layered and evolving. Early career decisions often centre on managing debt and building flexibility. Mid-career years may involve practice growth, partnerships, and reinvestment. Later stages typically shift toward succession and transition planning.

Niche targeting can support these transitions by providing a steady foundation.

When a practice has a clear identity and operational focus, it becomes easier to:

Plan for future capital needs
Evaluate partnership opportunities
Structure eventual exit strategies
Translate business value into retirement income

When so much of your personal wealth is tied to your practice, that added focus can make long-term outcomes feel more predictable.

A More Structured Path Forward

Niche targeting is often viewed as a practice management decision, but its implications extend further. The same principles—clarity, alignment, and intentional decision-making—are equally relevant on the financial side.

For many optometrists, working with someone who has lived through the lifecycle of a practice can change the nature of financial conversations. Rather than approaching decisions in isolation, planning can be framed around how clinical focus, business strategy, and personal finances interact over time.

We understand what it means to align personal decisions more closely with the realities of practice ownership.

In much the same way boutique practices have demonstrated the value of niche focus in patient care, a similar approach in financial planning can provide a steadier framework for navigating an otherwise complex landscape.

Over time, that alignment can support what many optometrists are ultimately working toward: not just growth, but clarity, confidence, and a greater sense of control over how their practice and financial life evolve together.

Roxanne Arnal is a Certified Financial Planner®, Chartered Life Underwriter®, Certified Health Insurance Specialist, former Optometrist, Professional Corporation President, and practice owner. She is dedicated to empowering individuals and their wealth by helping them make smart financial decisions that bring more joy to their lives.

This article is for information purposes only and is not a replacement for personalized financial planning. Errors and Omissions exempt.

ROXANNE ARNAL,

Optometrist and Certified Financial Planner

Roxanne Arnal graduated from UW School of Optometry in 1995 and is a past-president of the Alberta Association of Optometrists (AAO) and the Canadian Association of Optometry Students (CAOS). She subsequently built a thriving optometric practice in rural Alberta.

Roxanne took the decision in 2012 to leave optometry and become a financial planning professional. She now focuses on providing services to Optometrists with a plan to parlay her unique expertise to help optometric practices and their families across the country meet their goals through astute financial planning and decision making.

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Fraud Protection Needs a Slower Approach

Finance|Wealth

Most optometrists are comfortable managing clinical risk and business uncertainty. What feels different today is how convincingly fraud now presents itself, often polished, familiar, and timed to moments when attention is stretched thin.

In a recent article from Investment Executive, Canadians lost over $704,000,000 to fraud in 2025, affecting individuals across age groups and professions. The takeaway isn’t that fraud is rare or fringe. It has become routine and increasingly sophisticated.

Why scams feel harder to spot

Fraud has evolved alongside technology. Advances in artificial intelligence now allow scammers to create messages that closely resemble legitimate communications. Emails that match branding. Texts that sound conversational. Even phone calls that replicate a familiar voice.

Unfortunately, that makes traditional warning signs such as poor grammar, awkward phrasing, obvious inconsistencies no longer reliable filters. Many scams now succeed because they look reasonable and arrive at moments when quick decisions feel efficient.

Urgency is still the pressure point

Despite the technology, the underlying tactic hasn’t changed. Fraud works best when it introduces urgency: a payment that must be made immediately, an account that needs instant verification, or a problem that can’t wait.

The key to protecting you from loss is something deceptively simple: slowing down. Taking even a brief pause often creates enough distance to recognize when a request doesn’t feel quite right.

For many professionals, this mirrors clinical judgment. When something is out of pattern, it’s worth taking a second look rather than assuming the most convenient explanation.

Five habits that reduce risk without adding complexity

1) Pause before you act
If a message pressures you to act immediately, take a breath. Legitimate organizations rarely demand instant action without allowing verification.

2) Verify independently
Never rely on contact details provided in an unexpected email, text, or voicemail. If your bank, investment firm, or service provider contacts you, use a phone number or website you already know (or one you locate independently) to confirm before responding.

3) Don’t let “perfect-looking” messages reassure you
AI has made scam emails and texts look polished and professional. Reviewing the full sender name and domain still helps. When in doubt, treat unsolicited messages as suspicious.

4) Protect personal and financial information like cash
No legitimate organization will ask for passwords, one‑time codes, or full account details via email, text, or unsolicited phone call. Once that information is gone, it can be difficult to recover.

5) Talk about scams
Fraud thrives in silence. Sharing information about new scam patterns with family, friends, and colleagues reduces stigma and can prevent others from being pulled in.

Why optometrists are often targeted

Optometrists and their clinics tend to be visible professionals, with easy to access online presence. You and your team are busy and it’s easy to “click” in the moment trying to be efficient in our day. This can create predictable opportunities for impersonation or timing‑based scams.

This doesn’t suggest vulnerability. It simply highlights why routine verification processes matter, particularly for payment requests or changes to financial instructions.

Instinct is part of risk management

A recurring theme in fraud cases is hindsight clarity. Many people report that something “felt off” but seemed easier to proceed than to question it. That instinct is worth respecting.

Fraudsters rely on people being busy, distracted, or hesitant to ask questions. There is little downside to double‑checking, especially when the cost of acting too quickly can be significant.

How strong systems reduce risk

Effective fraud prevention is less about dramatic controls and more about disciplined process. Limiting access to sensitive information, using secure platforms and trusted partners, and slowing down when requests fall outside normal patterns all reduce exposure.

Ongoing staff training and regular testing further reinforce this culture of caution. Fraud prevention works best when it’s treated as an operational norm rather than an occasional reminder.

Slow Down

As scams become more convincing, the most reliable defenses remain human: pausing, verifying, and being willing to ask one more question. Those small moments of restraint often make the difference between a routine day and a costly mistake.

This article is for information purposes only and is not a replacement for personalized financial planning. Errors and Omissions exempt.

ROXANNE ARNAL,

Optometrist and Certified Financial Planner

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Thinking of Switching EMRs? A Step-by-Step Guide for Optometry Clinics – Part 2

Practice, Technology

In part 1 of explored why data portability matters and the legal and technical challenges that can arise when switching EMRs in optometry clinics.

Now that the “why” is clear, it’s time to understand the “how.” In this article, we’ll look at how to make the data transition smooth, secure and ensure that it all safely arrives in the appropriate patient fields.

Migrating from one EMR to another is one of the most significant digital transformations a clinic can undertake. When done well, it can modernize workflows, improve operational efficiency, and strengthen patient care. Without proper preparation, however, it can lead to disruption, data loss, and frustration.

This guide outlines the essential steps for preparing your clinic for a smooth, secure, and compliant EMR migration.

Optometry-Specific Data Considerations

Optometry data presents unique challenges beyond those in general medicine. It combines clinical information, diagnostic imaging, and retail operations. Knowing exactly what data your current EMR holds—and how it’s structured—is the foundation of a successful migration.

Optometric data categories can include:

Diagnostic Imaging: OCT scans, fundus photographs, and corneal topographies often exist in large, specialized file formats (like DICOM). Without proper planning, images may be reduced to static PDFs, losing their interactive diagnostic value. It is important to ensure the new EMR can import them, or integrate with image viewers that can.
Refractive Prescription Data: Accurate migration of eyeglass and contact lens prescriptions is critical. If stored in proprietary or semi-structured fields, these values (sphere, base curve, diameter) must be carefully mapped to ensure accuracy in the new system.
Dispensing and Inventory Records: Practices that use their EMR for optical sales, lens ordering, or frame inventory must decide whether to migrate this data or archive it separately.
Device Integration: Diagnostic devices such as autorefractors, tonometers, and lensometers generate logs and measurements that must remain retrievable. Ensure that these files can either be migrated or securely archived, and verify that the new EMR supports existing device integrations.
Patient Consent and Signatures: Electronic signatures and digital consent forms are legally binding and must remain properly linked to patient files after migration.
Recalls, Reminders, and Visit History: Recall schedules, reminders, and visit histories form the backbone of ongoing patient management. When migrating EMRs, it is important to ensure that patient histories, previous diagnoses (e.g., glaucoma, diabetic retinopathy), and recall intervals transfer completely. This preserves continuity of care and supports proactive follow-up with patients.

💡 Quick Tip: Create a data inventory spreadsheet listing each data type, where it resides, and whether it needs to be migrated, archived, or can be left behind.

Key Considerations Before You Switch

Long before signing a contract with a new EMR vendor, it’s important to ask the right questions. The clarity that is established at an earlier stage will define the success of the migration later on.

Export Formats: Ask the current vendor how data will be exported. Will it be delivered as structured data (e.g., HL7 or FHIR standards) or unstructured PDFs? Structured data allows for better integration and ongoing use.
Costs and Timelines: Data extraction and migration often involve fees. Obtain written estimates outlining costs, timelines, and the level of support included.
Security Measures: Ensure all data will be encrypted during transfer, and that storage and hosting comply with Canadian and provincial data requirements.
Validation Testing: Conduct a pilot migration using a small dataset. Compare records between systems to confirm accuracy before proceeding with a full migration.
Access to Legacy Records: Even with a successful migration, some data may remain easier to view in the old system. Ensure maintenance of read-only access to legacy records for reference.

🔒 Did You Know?
Under Canadian privacy law, optometrists remain the custodians of patient data even after switching vendors. This means the optometrist is responsible for its integrity and accessibility during and after migration—not the EMR provider.

Preparing for an EMR Migration

A structured plan is the strongest indicator of success. Clinics that invest time in preparation, communication, and testing, experience far fewer disruptions once the new EMR goes live.

Inventory Your Data: Catalogue the types of information stored in the current EMR—demographics, clinical notes, prescriptions, imaging, billing, and administrative data.
Engage Both Vendors: The smoothest migrations occur when the outgoing and incoming vendors communicate directly. Define clear migration deliverables, timelines, responsibilities, and success criteria in the new vendor’s contract.
Plan for Staff Training: Staff should be trained not only on the new system but also on how to access legacy data and verify migrated records.
Schedule Wisely: Choose a transition window that minimizes patient disruption—ideally outside peak exam seasons.
Budget Realistically: Factor in not only vendor fees but also staff time, temporary productivity dips, and any dual-system access costs.

🧭 Quick Tip: Migrate in stages. Start with a small batch of patient records, validate accuracy, and then expand. Incremental testing builds confidence and minimizes risk.

Validation and Testing

Once a pilot migration is complete, validate the data thoroughly. Compare patient records across systems to ensure accuracy of key fields such as diagnoses, prescriptions, and imaging files. Pay close attention to dates, authorship, and attachments—these are often the first areas where discrepancies arise.

Involve staff from various roles in the validation process; clinicians and administrative users often notice different types of errors. Once the pilot data is confirmed accurate and functional, proceed with the full migration confidently.

The Bottom Line for Clinics

Migrating to a new EMR is a significant undertaking, but it doesn’t have to be disruptive. By planning strategically—mapping data carefully, ensuring vendor collaboration, testing thoroughly, ensuring legal compliance, and training staff—years of valuable patient information can be protected while setting your clinic up for long-term success.

Ultimately, a well-executed migration is not just about transferring data—it’s about preserving clinical integrity, enhancing workflow, and empowering your team to deliver exceptional patient care within a more advanced, efficient system.

Maryam Moharib, BOptom, BHSc, CSPO, CAPM

Maryam holds degrees in Health Sciences from the University of Ottawa and in Optometry from Anglia Ruskin University in Cambridge, England. She has dedicated many years to working alongside ophthalmologists in refractive surgical clinics, where she gained significant experience in clinical training and in EMR implementation for various software platforms.

Maryam has also worked as a certified product owner with an EMR software company where she played a key role in effectively bridging the gap between clinical needs and technology. Additionally, her certification in project management from the Project Management Institute has equipped her with the skills to lead implementation and transformative clinic projects successfully.

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