Update
on Remote Tracing
By Joseph L. Bruneni
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WECO USA's WECO Trace II is an automated scanner |
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The introduction of fashion into eyeglass frame styles following World War II proved to be a shot in the arm for the entire optical industry--one that is still paying dividends 50 years later. Frame fashions produced a side effect, however, that has plagued doctors and dispensers ever since.
Before fashionable eyewear was conceived, most frames were manufactured in the United States, then inventoried and sold by laboratories. Retail practitioners carried a small basic inventory--a few metal and zyl frames and a few rimless mountings. The only time a frame was sent to the lab was for lens-only orders.
In less than 20 years, however, direct-selling frame importers totally changed that picture, and most laboratories eventually abandoned the frame side of their business.
In this changed environment, to ensure lenses edged in the lab would fit the frame, labs asked customers to enclose the patient's frame with the order.
That seemingly inconsequential change created a major problem for both labs and retailers. Holding up production of lenses until the frame arrived at the lab created longer turn-around times and, in those cases when the proper size or color frame had to be factory-ordered, a monstrous bottleneck was created in the lab--those dreaded "frame to come" orders.
A busy lab turning out 400 jobs per day can often have 800 to 1,000 trays sitting idle just waiting for a back-ordered frame to arrive from the customer or the frame supplier.
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Briot USA's Briot Scanform Net 2 Remote Tracer unit |
IN THE MEANTIME . . .
The number of fashion frames imported into this country grew into the thousands (currently more than 500,000 different frame styles are sold in the U.S.). This created another problem for labs: They found it impossible to keep up with the enormous number of patterns required for all those styles.
Fortunately, this is when scanning devices showed up. Labs could now trace the frame and create a pattern for those frames that came in without a factory pattern. Early scanners were crude, but they did work. The frame had to be cautiously clamped in a special device with the stylus placed in the bevel by hand.
When labs installed scanners, they could make most of the patterns they used for edging (throwing them away after use). This led to the next logical step--scanning the frame without making a pattern. New edgers had been devised that required no pattern. The scanning data created during the scanning process went into a data depot in the lab's computer.
Once the lenses for that job were surfaced and ready to edge, the edger operator merely scanned the tray's bar code, and the computer called up the scanning data from memory. The digital data controlled the edger in regard to both size and shape. That was a major advancement, and, in fact, most labs (and many retail offices) now routinely use patternless edgers.
This still left retail offices with the clumsy system of having to send a frame with every Rx ordered.
That is, until the development of remote scanners that would allow the inexperienced in the ECP's office to produce accurate scans.
Once that became possible, scanning data could then be sent directly to the laboratories by modem. As a result, during the mid-90s, remote tracers were introduced by a number of equipment manufacturers.
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Santinelli's LT-900 Tracer and Barcode Reader |
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INITIAL PROBLEMS
One of the problems faced by both manufacturers and labs was lack of an industry standard language. It took a few years to develop a protocol that was acceptable to everyone. Once that was accomplished and approved by the industry, remote scanning began to grow.
Among the early problems that arose was inconsistent tracing. Initially, this was believed to come from the problem of keeping the doctor's scanner calibrated with the lab's edgers.
Inaccurate scanning data produced less-than-accurate edged lenses. The intended goal, of course, is to send the doctor a properly-sized lens that will fall into place in the frame when the lenses arrive at the doctor's office. The term for this goal is "first-time fit."
Another factor has become closely allied to remote scanning--remote ordering. There have been a number of remote Rx order-entry systems introduced that enable doctors to use the patient data already in their practice management software without having to re-enter it when ordering lenses from labs.
These programs accept orders based on what the laboratory can supply and will not transmit the order if vital information is omitted.
When frame scanning data can be incorporated with the lens order, the retail office gains the ultimate in speed, efficiency, and accuracy in ordering. Integrating these service functions into one operation requires minimal time from the doctor's staff and provides the ultimate in fail-proof accuracy.
Enabling all these systems to understand and communicate with one another requires an incredibly delicate balancing act. Practice management programs developed for doctors generally have their own closed systems and so do the incredibly complex software programs used in laboratories.
What was needed was something called "open architecture," enabling these independent and competitive systems to freely exchange data.
Accomplishing this required an expensive and lengthy time period. There is still not universal integration, but many of the leading systems can now communicate with one another.
More and more ECPs are now tied into the electronic grid of third-party transactions, product ordering, and various practice management functions. Benefits for the ECPs are multiple. They save time, provide faster service to their patients, and enjoy the benefits of more accurate work with fewer remakes.
Today's equipment is simple to operate with lower operating costs, all of which leads to increased profits.
Laboratories are also benefiting from the same technology. In effect, an electronic bond is forged in the relationship between the laboratory and the ECP.
Currently there are literally tens of thousands of orders being transmitted electronically to labs every week.
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National Optronics' LP Lens Profiler high-resolution digital tablet |
REMOTE ORDERING
Another concept is now influencing remote ordering. The process involves something called an Internet Portal. A portal Website serves much like a clearing house, providing each visitor to the site with the ability of direct connections to a wide variety of other sites (a prime example is AOL).
A number of optical portals have been created. These portals serve as a connector enabling an ECP to send frame orders to a frame vendor and lens orders and scanning data to any one of a long list of labs--all in one simple transaction.
Portal sites--such as Eyefinity and VisionWeb, for example--are, in effect, an eyecare tool for the practitioner. It requires no special software to be downloaded on the user's computer.
It's an Internet-based system that allows the practitioner to instantly communicate with a lab management system through a user interface or an Internet-based order entry system.
Most portals allow practitioners to access other functions for their practice, i.e., news and education. All this is done with a click of a mouse.
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Gerber Coburn's Envoy II Frame Tracer |
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CALIBRATION ISSUES
The term "calibration" always seems to conjure up a problem area for tracers. For the most part, tracers are self-calibrating, so the real issue is calibration between the remote tracer and the edger used in the laboratory.
Any method by which the calibration procedure can be standardized would be a great improvement.
Many people equate remote tracing with "edge to fit" more than they do with the jobs that are uncut or have the frame sent to the lab. However, these do not require such close calibration, whereas, for the lab to edge a lens that will simply drop into place in the doctor's office, totally accurate calibration between the remote scanner and the lab edger is required.
The industry has scanners that can trace frames very accurately, and edgers that edge the lenses with equal accuracy, but there is no precise way of measuring the edged lens once it comes out of the edger other than putting it in the frame and determining if it fits.
It seems, therefore, that what the industry needs is a sizing instrument with measurements that meet a standard. With this, it would be easy to edge a lens in the laboratory, measure the precise circumference of the lens, and know it would fit the frame.
There has been debate that the hesitancy on the part of some laboratories and eyecare practitioners to get involved with tracing has been due to their concern that the technology they buy today might be obsolete in a few years. When this question is posed to companies involved in remote tracing, most agree that the accuracy of today's tracers will be difficult to improve upon.
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Topcon's TOPscan Software captures frame data and transfers orders to the lab |
There has already been a series of steady improvements. The first scanners were only concerned with two dimensions--length and height. Later, 3-D became the standard, accommodating for the normal six-base curve of the groove in standard frames. One current model boasts 4-D technology, with the fourth dimension adjusting for the width of the frame rim itself.
Most scanners are now capable of tracing a frame to within .1 millimeter, which is 4,000ths of an inch--the width of a human hair. Some mention the possibility in the future of a laser technology or establishment tracing libraries that would eliminate the need for scanners. However, development of a better technology that could supplant current tracers is assumed to be at least four to five years off.
One recent development has been an inexpensive high-resolution digitized pad. The dummy lens from the frame is mounted in the center, and the operator manually traces the lens with an electronic stylus. It's a way to produce tracing data for the lab to use in thickness control or for uncuts, and represents a less expensive alternative to a full-featured scanner. Available in two configurations, the digital pad emulates a tracer and works with all third-party software programs.
CONTROLLING THICKNESS
There is another advantage when a laboratory receives scanning data with the lens order. It permits the lab computer to calculate thickness of the surfaced lens to more precise dimensions.
Without scanning data, all the computer can do is use an average thickness based on the "A" and "B" measurements of the frame shape.
This becomes even more important with the growing use of progressive lenses, many of which, because of add power, end up with plus powers in the lower half of the lens. The cosmetic appearance of plus lenses is greatly enhanced when the lab computer has the advantage of frame scanning data upon which to base its thickness calculations.
It's estimated that the number of retail offices ordering uncut lenses from labs represents about 30 percent of the market. With a good tracing of the frame, the lab can surface a lens exactly right in thickness. Digital
pads and scanners provide missing information. The result is better, more cosmetically attractive lenses.
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AIT's Delta-Scan 3D |
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Even when the frame is sent to the lab, most labs do not start the job until the frame arrives for tracing. This ensures it is able to calculate thickness more precisely. Labs can surface better lenses when they have a reasonably accurate tracing.
When the lab receives a tracing, it can begin surfacing and have it surfaced and ready to edge when the frame arrives. This can really save time when the lens is to be AR coated. Often the surfaced lens with AR coating is ready to edge when the frame arrives. This is another reason for scanning in the doctor's office.
Frame tracing to a lab is what a set of blueprints are to a machinist. Tracers have rapidly become an essential tool in the delivery of modern eyewear.
Remote Ordering & HIPAA |
In this modern "HIPAA" age, there are some concerns about patient privacy that need to be considered in computer ordering of lenses. HIPAA stands for the Health Insurance Portability and Accountability Act and is a government initiative to standardize the way products and services are ordered and sent to insurance companies electronically. This particularly affects prescription products where a third party is paying for them. If an order is sent to a third party that has a personally identifiable label on it so that someone could figure out that the prescription belongs to a specific individual, it has to be protected. It's an area that has not yet been well defined, but is one that will need to be considered in the future. |
For more info... |
Following are Websites for equipment companies that carry remote scanning products. Other sources for information on both remote scanning and ordering include lens companies, lab operations, major managed care and practice management companies, and Internet portal sites. AIT Industries: www.aitindustries.com Briot: www.briot-usa.com Gerber Coburn: www.gerbercoburn.com Lab-Tech, Inc.: www.lab-tech.net National Optronics: www.nationaloptronics.com Santinelli: www.santinelli.com Weco: www.weco-usa.com Topcon: www.topcon.com |