Putting a premium on care

With a passion for advanced cataract and refractive procedures, Chu Vision Institute garners rave reviews.

Nic Jacobs COA, OSA, CRC (left), and Amy Buchholz, COA, laser technician (right) assist Dr. Chu with the Zeiss ReLEx SMILE procedure.

Chu Vision Institute, a Bloomington, MN, practice specializing in cataract and refractive surgery, has collected numerous patient testimonials in its roughly 20-year history. A few selections from its website:

  • “A potentially frightening experience made so easeful thanks to the extraordinary staff, each one exceptionally and genuinely reassuring and caring, and so professional ... Many, many thanks and much appreciation for their having given such attention to every detail along the way ...” – Francisca D.
  • “I trust in the staff, doctors, assistants, and all who work with Dr. Chu ... Dr. Chu introduced me to a new method of treatment for cataracts called ‘Crystalens.’ I went from having difficulty with night vision and found out later that I now have 20/20 vision. What a miracle for me.” – Bette W.

Y. Ralph Chu, MD, founder and medical director of the Chu Vision Institute and Chu Surgery Center, credits the practice’s passion for caring about patients’ complete experience and a streamlined approach to patient education for the clinics’ rave reviews. (See “An Eye on Efficiency,” p. 12.)

Streamlined approach to patient education

The more information presented to a patient during a visit, the more likely he won’t remember all the imparted knowledge correctly. With this in mind and based on some of the feedback they received from patient satisfaction surveys, Chu Vision Institute created a streamlined approach to patient education. This ensures that patients retain the provided education and, thus, are comfortable in making decisions regarding their cataract or refractive surgery.

The streamlined approach includes the following steps:

  • Educating their referral network. “Chu Vision Institute provides consistent education on the practice’s latest cataract and refractive surgery offerings via CE programs, a monthly newsletter, and a practice representative who meets with each referring doctor on a regular basis,” says Carrie Jacobs, COE, CPSS, OCS, Chu Vision Institute’s practice administrator. “This way, the patient’s optometrist can start the education process before he even presents to the practice for the surgical consultation.”
  • Sending a “welcome” packet. Once the patient makes an appointment, one of Chu Vision Institute’s patient care coordinators mails a welcome packet, which includes information on the practice’s staff, services, and related costs, says Ms. Jacobs.
  • Hitting each patient touchpoint. When the patient presents to the Chu Vision Institute for a cataract or refractive surgery consultation, staff members provide specific education at each touchpoint designed to complete a puzzle of sorts at the consultation’s end. This way, the patient doesn’t feel overwhelmed and can remember the information, says Dr. Chu. “After one of our patient concierges (front-desk staff members) helps the patient at the check-in kiosk and a clinical care nurse reviews the patient’s medical and ocular history, one of our certified ophthalmic assistants starts pre-testing and begins the patient education process by providing the basics, or ‘ABCs’ of cataracts or presbyopia, such as defining what either means.”

Technician Marche Metoyer, COA (left), scribes while Jessica Heckman, OD (right), examines the patient.

Then, the certified ophthalmic assistant introduces and hands off the patient to one of the practice’s optometrists, who reviews the pre-testing results and educates the patient on the cataract or refractive technologies that could benefit him, Dr. Chu explains.

Abby Fischer, CPSS, patient care coordinator (left), assists a patient at check-in.

“I ask the patient how he uses his eyes throughout the day, so I can match the current refractive technology with his vision needs,” says Jessica Heckman, OD. “Then, I discuss the pros and cons of those technologies to help the patient decide which technology to go with.” For example, a teacher with cataracts said she needed to be able to see far and close and switch quickly between these distances. After Dr. Heckman talked with her about her matching options, the teacher decided on the TECNIS Symphony IOL (Johnson & Johnson Vision) and says she can now clearly see her students’ faces and work on her computer.

Before the patient decides on the cataract or refractive surgery option, however, a patient care counselor presents to the exam room to provide education on financial responsibility so the cost does not distract and interfere with the patient’s ability to retain the information, says Shari West, CPSS, director of refractive services at the Chu Vision Institute. “There are preliminary financial conversations that occur on the phone before the patient comes to the practice. We also come in midpoint in the patient’s journey to provide this education and, if needed, financing options such as Care Credit, which many patients take advantage of with premium choices.”


Nic Jacobs, COA, OSA, CRC (left), and Jessica Trevino, CST, COA, prepare for cataract surgery.

If not for the allied staff’s contributions to surgical efficiency, the Chu Vision Institute may not have the time needed to investigate new cataract and refractive surgeries or practice a streamlined approach to patient education. Their contributions include:

  • Equipment maintenance. “I oversee the operation of the instruments and equipment daily,” Mr. Jacobs says. “For example, I turn on the femtosecond laser first thing in the morning to make sure it’s calibrated. If any of the technology we use has an issue, I work with our clinical director, Vanessa, to rectify the problem prior to surgery.”
  • Eye health assessment. One of the practice’s optometrists performs a comprehensive dilated exam, topography, ocular surface assessment, and uses the IOLMaster 700 (Carl Zeiss Meditec) to allow Dr. Chu and the surgical team to continue to expand their knowledge of and focus on cataract and refractive surgery, Dr. Heckman says.
  • Surgical preparation. The practice’s nurses assist the anesthesia team in the placement of IVs if needed to improve timing of the surgical procedure.
  • Surgical assisting. Chu Surgery Center has trained expeditors. They turn down the operating room from the previous case, wipe it down, then set up and open the supplies on the table. This allows the nurses to focus on patient care and the scrub tech to focus on the cleaning and sterilization of the instruments. The expeditor saves several minutes per surgery, time that really adds up, says Mr. Jacobs.

Once the patient decides how he wants to proceed, Dr. Chu introduces himself, reviews the patient’s record, summarizes the findings, and confirms the choice. “My main purpose prior to surgery is to be the provider of that last puzzle piece of patient education before surgery,” he says. “Also, I think it comforts patients to meet the person who’s going to be doing surgery on their eyes and ask any final questions, because it puts them at ease about the decision they’ve made for their vision.”

At the consultation’s end, the patient meets a scheduling coordinator to set up his procedure time and is given educational pamphlets and links to patient-friendly videos to buffer everything that has been discussed at his visit, says Ms. Jacobs.

When the patient returns for the surgery, a clinical care nurse plays the final role in the streamlined patient education process by briefly reviewing what is going to occur and answering any final questions, says Vanessa Novak, RN, clinical director of Chu Surgery Center. “When I asked one patient prior to his surgery how he was feeling, he told me he didn’t like his eyes to be touched at all and that he would possibly pass out if drops were administered,” she says. “I was able to allay this fear by making sure we used a medication that would reduce the amount of postop drops needed after surgery, and he was very grateful.”

Fervor for the field

“When I started the practice, I knew I wanted to play a role in moving the field of cataract and refractive surgery forward,” Dr. Chu says. “So, I began lecturing internationally to get my name out and develop a reputation as someone who is a good surgeon, has a reputable practice and an interest in related research. It didn’t happen overnight, but this action built the practice’s clinical research department, enabling it to not only participate in clinical trials, but also see firsthand where the surgical specialty is going.”

In fact, Chu Vision Institute has now participated in more than 80 clinical trials related to IOL implantations, laser vision-correction technologies, and ocular treatments. As a result, the practice offers several premium IOLs, including the Crystalens AO (Bausch + Lomb), TECNIS Symfony, AcrySof Toric (Alcon), and the TRULIGN Toric IOL (Bausch + Lomb), as well as the Raindrop (ReVision Optics) and KAMRA (AcuFocus) corneal inlays for presbyopia. In addition, the Chu Vision Institute provides the Avedro corneal cross-linking procedure, the VICTUS femtosecond laser for cataract surgery (Bausch + Lomb), the complete Zeiss Callisto Cataract Suite, the Zeiss ReLEx SMILE (small incision lenticule extraction) laser surgery platform as well as the VISX Star (Johnson & Johnson Vision) and MEL 80 (Zeiss) excimer laser vision correction technology platforms.

Regarding the Zeiss ReLEx SMILE procedure, Dr. Chu says he was so excited about it that he and his lead surgical technician traveled to Mexico a year before it received FDA approval so they could train with a well-known ophthalmologist who was performing the surgery. “I remember before we rolled it [the ReLEx SMILE] out, we did several wet labs after clinic hours,” he says. “Instead of just the three or four people who needed to be there, the entire clinical team showed up because they too were curious and excited to learn about this new technology.”

Chu Vision Institute leadership team (left to right): Nic Jacobs, COA, OSA, CRC, VP of clinical research; Vanessa Novak, RN, clinical director; Y. Ralph Chu, MD; CEO, medical director; Jessica Heckman, OD, director of clinical affairs; Carrie Jacobs, COE, CPSS, OCS, practice administrator; Shari West, CPSS, director of refractive services.

Nic Jacobs, COA, OSA, CRC, and vice president of Chu Vision Institute’s Clinical and Regulatory Affairs, says the practice has become a “go-to place” for companies looking for clinical trial sites. He adds that the practice is overseeing six clinical trials, the majority of which are on the refractive side.

“We have a real passion for making our cataract and refractive surgery patients aware that they have a lot of choices for their vision,” Dr. Chu says. “For us, the motivation to ultimately offer something new comes down to being excited about the potential benefit it’s going to have on the right patient candidate.”

The proof is in the patients

In addition to the practice’s many patient testimonials, another testament to the Chu Vision Institute’s passion for cataract and refractive surgery technology and its streamlined approach to patient care is its returning patients, says Dr. Heckman.

“The patients we see don’t just come in for one procedure, and we never see them again,” she says. “For example, our LASIK patients are starting to come in presbyopic, and now we have presbyopia technology we can start to talk to them about as far as inlays and things coming down the pipeline with research that we’re involved with. Also, those patients come back for cataract surgery, so it’s nice that we are taking care of patients refractively throughout their lifespan.” OP