Improving Customer Retention and Profitability in Private Ophthalmology through Business Strategies and Operational Improvement: A Case Study of East Hills Vision Care
Advisor: Mr. Ong
Internship Location: East Hills Vision Care
Onsite Mentor: Patricia Hom
The COVID-19 pandemic has caused widespread disruption across the healthcare industry, exposing previously overlooked vulnerabilities in service delivery and management. Optometry practices in the San Francisco Bay Area, in particular, faced devastating consequences with an 81% decline in patient volume at the height of the pandemic. Such disruptions have caused financial instability for clinics, reduced access to care, and diminished patient trust. My project seeks to address these challenges by analyzing the pandemic’s residual operational and administrative effects on East Hills Vision Care and identifying strategies to rebuild a patient-centered infrastructure. Through a combination of extensive data analysis and patient surveys, my methodology aims to pinpoint gaps in the clinic’s service delivery and financial management. With the end product, I hope to take on the role of a consultant and showcase actionable solutions that improve operational efficiency, strengthen marketing presence, and enhance patient satisfaction. My research will contribute to broader efforts to fortify healthcare systems and, in particular, private practice clinics against future crises, ensuring more robust and equitable care delivery to all Bay Area communities.
Project Blog
Week 0: Project Introduction
Hi everyone! I’m Vera, and welcome to my first-ever senior project blog post! Over the next few months, I’ll be conducting patient surveys and analyzing data to explore the challenges private optometry clinics in the San Francisco Bay Area have faced due to the lasting effects of the COVID-19 pandemic.
COVID-19: a global event that may feel like a thing of the past, yet its impact continues to shape the healthcare industry. Even today, private clinics face lingering challenges in service delivery, financial stability, and operational efficiency, despite being at the forefront of patient care. Through my project, I aim to uncover the administrative and operational hurdles at East Hills Vision Care through patient surveys and in-depth data analysis. By gaining insight into the clinic’s daily operations, marketing strategies, and financial management, I hope to design practical, patient-centered solutions that enhance efficiency and long-term sustainability rather than fleeting solutions.
What led me to choose optometry over other healthcare fields? Optometry is one of the few healthcare fields that uniquely blends medical care with sales. Unlike many other specialties, optometry relies not only on clinical services but also on the sale of prescription eyewear, contact lenses, and other vision-related products. This dual structure makes optometry practices especially vulnerable to economic shifts, something that became starkly evident during the pandemic. Even today, clinics are still working to recover from the nature of optometry management, making it critical to analyze how they can rebuild stronger, more resilient business models in an increasingly unpredictable healthcare landscape.
My project aims to identify areas for improvement that may not be well-documented in existing research, particularly within private optometry groups. My goal is to understand the key factors that drive patient retention and explore how strategic adjustments to the clinic’s products and services can enhance both patient loyalty and operational efficiency. Beyond benefiting the clinic, my findings also offer valuable insights for the general public. This project highlights the importance of regular eye care and seeks to challenge the common misconception that optometric services are only for vision correction. By shedding light on the broader health benefits of routine eye exams, I hope to emphasize the role of preventive care in maintaining long-term eye health.
As I begin my work on February 18th, I look forward to sharing my insights and progress along the way. Stay tuned!
Week 1: A Quick Literature Review on U.S. Healthcare Systems and Optometry Practices
Welcome to Week 1 of my project!
This week, I focused on analyzing critical challenges in the U.S. healthcare system and how these insights can inform my future operational and management proposal for East Hills. I began by reviewing literature on the evolving demands in healthcare education and service delivery. One key takeaway from the Institute of Medicine’s report is the need for modernized health professional education emphasizing patient-centered care and inter-professional collaboration. Reading this article made me wonder whether continuous staff training is truly helpful if healthcare education is innately flawed and new technologies continue to rapidly emerge.
Additionally, I examined the role of evidence-based guidelines in improving eye and vision care delivery. According to the National Academies of Sciences, Engineering, and Medicine, there are inconsistencies in clinical practices and a lack of standardized care, which can lead to fragmented services and poorer health outcomes. One of the first things I’d like to address is to evaluate the current standardized protocols for comprehensive eye exams and follow-up care, ensuring consistency among East Hill’s practitioners. This could also involve creating patient education materials based on national guidelines to increase patient compliance with treatments and follow-up visits.
Something that piqued my interest was the lack of marketing for vision care. One of the final articles I read this week delved into marketing strategies for private ophthalmology and optometry practices, emphasizing the importance of patient-centered communication and digital engagement. By combining traditional outreach with digital marketing (maintaining an informative website, managing online reviews, and engaging with patients on social media), the study rendered increased patient retention and acquisition.
As I’m brainstorming potential areas of improvement for the clinic, my last week’s articles aided me in the following thoughts: I’d like to propose a marketing plan that includes optimizing the clinic’s online presence by highlighting patient testimonials, promoting specialty services (e.g., myopia control and dry eye treatments), and offering virtual consultations to attract tech-savvy patients. If the opportunity arises, I also hope to streamline patient flow through the use of appointment reminders and online scheduling platforms to reduce no-show rates.
That’s all for this week — I’m excited to bring you along as I officially begin my work at the clinic on March 17th. See you all in my next post!
Works Citedhttps://www.ncbi.nlm.nih.gov/books/NBK402378/https://pmc.ncbi.nlm.nih.gov/articles/PMC6626927/https://www.ncbi.nlm.nih.gov/books/NBK221522/https://www.ncbi.nlm.nih.gov/books/NBK402378/figure/fig_7-1/?report=objectonly
Week 2: A Little More Reading and a Lot More HIPAA
Welcome back! This week, I took a deep dive into three key areas: specialty services, regulatory compliance, and marketing psychology — all with the goal of improving patient retention and making clinic operations smoother. It’s been eye-opening to see how these factors intertwine to shape the success of an optometry practice.
My research began with an overview of current market trends in optometry, revealing an increasing demand for specialty services such as myopia management and dry eye treatment. According to the Vision Council, practices offering niche services have seen higher patient engagement and revenue growth, highlighting the importance of diversifying care offerings. Indeed, personalized care has become a crucial factor in patient retention, as research from the Journal of Medical Internet Research shows that “patients who receive individualized attention and tailored treatment plans report higher satisfaction and are more likely to return for follow-ups.”
However, balancing personalized care with budget constraints is a challenge. A study published in Health Affairs suggests that clinics adopting hybrid care models — integrating technology-driven efficiencies with personalized patient interactions — can optimize costs while maintaining high-quality care. This approach could allow East Hills to streamline administrative tasks through digital tools while dedicating more time to patient engagement.
Understanding regulatory compliance was another crucial aspect of my research, so I spent a larger sum of my time looking into HIPAA compliance and data security. The U.S. Department of Health & Human Services underscores that data breaches and noncompliance not only lead to financial penalties and reputational damage, but may also break patient trust (something no practice can afford to lose). My initial plan was to distribute surveys to patients when I started at the clinic to understand what makes East Hills their top choice. But before that, I need to ensure my survey design aligns with HIPAA guidelines so that I can collect measurable and significant data without any compliance issues.
To better understand the financial landscape, I wanted to explore the pricing models within optometry. This came out to be a challenge. Many private clinics, including the ones in Santa Clara County, don’t publicly share their pricing structures, making it hard to compare numbers. But with more well-rounded knowledge about the optometry field and management, I’m excited to meet the team at East Hills next week and begin my work in the clinic. My goal next week is to familiarize myself with the work setting, observe the work management, and employ the customer satisfaction survey. Stay tuned for more insights!
Week 3: First Week at the Practice!
Welcome back! This week marked my first hands-on experience at the practice, and it was exciting to finally step out from behind literature reviews and online research into a real-world clinical setting. Seeing everything I had studied come to life in a functioning optometry clinic made the transition exhilarating and eye-opening.
I started by learning how to pre-test patients, which involved using instruments such as the autorefractor, visual field test, and retinal photo assessments (That’s right — I’m now proficient in and can perform the notorious eye puff exam!). I helped with setting and cleaning up the private examination rooms, which allowed me to integrate myself into the clinic’s process of maintaining an organized and hygienic environment to ensure smooth operations. Beyond patient care, I got a closer look at the clinic’s administrative daily operations, observing how staffing, task distribution, and patient flow contribute to overall efficiency. I also helped deep-clean and reorganize the clinic’s extensive frame inventory — 21 different brands, including Versace, Ray-Ban, YSL, and more.
I shadowed Dr. Hom during a normal eye check routine, which provided insight into how complex information is broken down into sentences that are both informative and reassuring. What stood out most was the seamless transition from clinical care to retail consultations; about 70% of patients at East Hills immediately meet with an optician after their exam to update their prescriptions and, in some cases, select new frames. It was fascinating to see how opticians balance professionalism with transparency, ensuring that patients leave confident in their choices.
Another significant step forward this week was working with the clinic’s production data. I succesfully secured and began analyzing consolidated production product details and production summaries from 2020-2024, laying the groundwork for understanding long-term sales trends and patient reorder patterns. Though my analysis is still in its early stages, I’m excited to extract meaningful insights in the coming weeks.
Overall, this week was an incredible introduction to both the clinical and business sides of optometry. Next week, I’ll be refining my data analysis, further exploring administrative management at East Hills, and continuing to integrate myself into the clinic’s workflow. Stay tuned for more updates!
Week 4: More Behind the Scenes
Hello again! This week was another dynamic mix of hands-on clinical work and financial number-crunching. With each new responsibility and experience, I think I can say that I’ve gained a clearer perspective on how both patient experience and financial management intersect to keep a practice running smoothly.
I started the week observing the quality control process for display frames, an often-overlooked but essential part of maintaining a professional space. Every morning, frames are carefully arranged in designated locations to ensure patients have access to a well-curated selection. At closing, they’re taken down and secured in a storage cart to maintain inventory integrity. It’s a small but critical detail that reflects the level of care and precision required in both retail and healthcare settings.
On the clinical side, I continued pre-testing patients and even encountered my first child patient! Guiding younger patients through the same examination process requires an extra layer of patience and reassurance, reinforcing the importance of clear communication in a medical setting. A while back, I read an article discussing a common challenge healthcare specialists face: how much to simplify medical information for patients. Should certain details be omitted to ease anxiety, or is it better to provide full transparency? I couldn’t fully empathize with the complexity of this balance until I pre-tested the 6-year-old patient. To keep her engaged, I compared the eye exams to a video game and made lighthearted conversation while administering the puff test.
Beyond the patient-facing side, I also had one-on-one discussions with the manager and owner of the practice about expanding my performance analysis. While I’ve already been evaluating fees (diagnostic services, contact lenses, etc.), I’d like to investigate additional key performance units, including utility bills, adjustments/discounts, and insurance charges. Broadening the scope of financial data allows for a more comprehensive understanding of operational efficiency and cost management.
After analyzing the consolidated production summary, this week I created visual aids to break down the analysis into digestible insights. Next week, I’ll be presenting these to the practice, opening the door for discussions on optimizing business strategies moving forward. As I continue to investigate more managerial and operational facets at East Hills, I’m eager to see how these insights translate into actionable improvements. See everyone next week!
Week 5: Over the Half-Way Mark
Happy April! This week, I found myself shifting between patient interactions, inventory management, and trend analysis within the practice.
On the clinical side, I continued to pre-test patients before their examination with the optometrist, streamlining communication between opticians and optometrists effectively.
I also spent time managing the contact lens trial inventory, learning the system for tracking stock levels and understanding how lenses are stored in the clinic’s laboratory. East Hills utilizes a modular and stackable system, where the drawer front holds a large label for clear labeling of the contacts within, including brand, astigmatism axes, and more. It’s easy to overlook the logistics behind these supplies, but having a well-maintained inventory ensures opticians get what they need without clutter.
Furthermore, I observed how patient frames are packaged and delivered. Rather than shipping patient frames directly to their homes, East Hills opts to prioritize quality control and personalized service by handling frame deliveries in-house. Each day, around 25 frames arrive and are carefully processed. Orders are carefully placed into individual trays with the corresponding invoice, verified for correct prescriptions, and checked for any defects (scratches on frames, misassigned contact lenses, etc.). Once confirmed, patients are contacted via phone or voicemail to schedule a pickup appointment. This process not only guarantees that every order meets the highest quality standards but also ensures that patients receive personalized assistance when collecting their eyewear.
Another key focus this week was reviewing sales data for frames from 2021 to 2024. Interestingly, I noticed two luxury brands Gucci, YSL, and Ray-Ban remain in high demand, which, given their premium pricing, naturally contributes to higher overall sales. These findings were particularly surprising considering East Hills offers a diverse selection of frames, ranging from more affordable options (starting at $53 per pair) to high-end designer brands. The strong performance of luxury frames highlights consumer preferences and purchasing trends within the practice.
Looking ahead, I plan to begin outlining my business proposal. Next week, I’d like to designate time to understand the marketing efforts put forth by the practice. Whether it’s patient pre-testing, marketing initiatives, or financial analysis, each experience continues to highlight the balance between business efficiency and quality care. See you all next week!
Week 6: Beginning of the End
Hi again! This past week was a balance of hands-on patient care and meaningful progress on my business proposal. As usual, I’ve been managing a variety of daily tasks: pre-testing patients (and leading them into their rooms after), setting up/breaking down and sterilizing rooms, organizing patient orders, and making follow-up calls to coordinate pick-ups.
Outside of the day-to-day, I scheduled a meeting with the manager to dive into how internal processes and patient interactions have evolved since COVID-19. I realized I’ve been so engrossed in how things currently operate that I hadn’t really considered how different they used to be — or how much the pandemic actually pushed the clinic to restructure. Surprisingly, the adjustments weren’t all negative. In fact, some changes forced the practice to confront its implicated inefficiencies and made operations smoother, like improved scheduling systems and reduced overcrowding.
For example, what was once a chronic issue of patient bottlenecks has been eased by implementing a sort of built-in pacing: social distancing requirements made it necessary to keep the flow of patients more controlled, which in turn led to more individualized service. Additionally, the calls we now make to schedule pick-ups aren’t just helpful for patients; they help staff stay organized, track order readiness, and ensure we’ve clearly communicated updates. Not every patient sticks to these schedules, but at least we’ve taken proactive steps on our end. Such conversations gave me a lot to consider as I write my proposal. I’ve outlined the main components and received some early feedback from the manager. I’m now drafting the sections on the clinic’s background, current administrative model, and the objectives I’ll address in the proposal.
One more thing! I’ve forgotten that visual aids could be included in the blog, so here’s a look at the number of frames sold by each brand from December 31st of 2021-2024 (refer to last week’s blog for more specifications!). It took a bit of experimenting with Google Sheets to get it right, but the trends are pretty telling. Some confusing spikes, like Yves Saint Laurent going from 0 to 185, were due to mid-2022 stock changes (in this case, they replaced Balenciaga). I left out discontinued brands or unique outliers like Kate Spade or Liberty Sport, which are often requested by patients transferring from other practices.
It’s surreal that I only have two weeks left in this project, but I feel more connected to the rhythm of an efficient optometry practice, and I’m excited to keep building toward a proposal that reflects that. See everyone next week!
Week 7: Little Developments
Welcome back! Greeting everyone with a shorter blog post this week :)
This week has been a familiar blend of clinical routines, inventory management, taking calls, and digging deeper into the heart of my business proposal. I continued with my usual responsibilities (checking in and pre-testing patients, packaging frames/lens, and calling patients to schedule their pick-ups). Most calls are pretty straightforward, but I did run into my first more difficult one this week. I called a patient to let him know his eyewear was ready for pick-up, but he didn’t take the news too well. In fact, it came across as more of an inconvenience to him than anything. After repeating several times that he’d come by on his own schedule, the call ended pretty abruptly with a hang-up. It was a small moment, but a useful reminder that even routine interactions can take a turn — and that strong communication skills are just as important in those moments as in any formal setting.
This week, I also attended a staff meeting where we went over new protocols to help keep things more organized between shifts. We covered small but important end-of-day responsibilities (turning off lights, clocking in and out accurately and clarifying who’s hourly vs. weekly salaried, and sterilizing patient spaces). Taking the time to delegate such tasks really cut down on the little moments of confusion, like when two people unknowingly clean the same room and thereby supplies get wasted.
Another topic that came up this week was how we’re better supporting individualized care. While I was making patient calls, the manager reminded me to check each patient’s preferred language before reaching out. Hence, I spent some time analyzing our patient demographic data and how recent updates, like assigning dedicated phone lines for Spanish-speaking individuals, have improved communication, trust, and overall service. It’s something I hadn’t considered in depth before, but seeing the impact of such a targeted change made it clear how thoughtful systems can enhance the patient experience.
Meanwhile, on the proposal front, I’ve been hard at work drafting the marketing and administrative portions of my problem statement for East Hills. This section outlines the core challenges I’ve observed and what I’m aiming to address, particularly when it comes to patient retention, communication systems, and overall workflow. I also had a call with Dr. Ngo to learn more about the financial management side of the practice, which gave me a clearer picture of how different operational choices impact the clinic's sustainability.
Looking forward to what next week brings!
Week 8: Navigating Software and Last-Minute Numbers
Hello again! This past week was yet another steady mix of familiar tasks and new learning moments. I continued with patient pre-testing and guiding them into their exam rooms (something that’s really started to feel second nature at this point). I also helped package eyewear orders and followed up with patients to schedule pick-ups (averaged ~20 calls/day), keeping everything running smoothly on the back end.
I also got a crash course in DemandForce! DemandForce is a patient communication and engagement software that’s designed to help healthcare practices stay connected with their patients in an efficient and organized way. One of its most valuable features is the ability to send automated messages via text, email, or phone, which helps reduce no-shows and keeps patients informed without requiring constant manual outreach from staff. It also allows for two-way texting, so patients can respond directly to messages — making communication feel more personal and responsive.
It’s a small piece of the operations’ puzzle, but learning how the system works behind the scenes gave me better context for how the clinic stays connected with its patient base and keeps no-shows to a minimum. Not just to confirm appointments, but to foster long-term relationships, encourage return visits, and provide a more seamless patient experience overall.
Talking about software reminded me: I definitely need to gather a few last-minute numbers that I initially overlooked. There are still some key financial figures I haven’t been able to collect yet, especially related to the practice’s spending on things like software systems, supplies, and equipment maintenance. I’m jotting this down now as a personal reminder to follow up by Tuesday next week. I think getting a clearer breakdown of these categories (rent, tech systems, insurance, etc.) will give me better insight into how the clinic allocates its budget and where its financial priorities have shifted, especially post-pandemic. It'll also help round out the business proposal with a more informed look at how administrative and operational decisions are being funded.
Finally, I spent some time refining the writing I started on the 22nd, tightening up the language and structure of the proposal section I’ve been working on. I expanded my outline of the operational changes that were introduced to the clinic during the pandemic, especially the ones that have stuck around and actually improved efficiency. It’s interesting to see how certain adaptations, like adjusted scheduling and patient flow, became long-term solutions even after the immediate need passed. Each small revision brings me a little closer to a complete and cohesive draft!
Week 9: Approaching the Finish Line
Happy May! This week marks the second-to-last of both the third trimester and my senior project — it’s hard to believe how quickly the time has flown by. As the finish line comes into view, this week was about balancing daily responsibilities with polishing my business proposal.
My tasks at the clinic remained steady: opening new frames and soft lenses, packaging them, and making follow-up calls. I also continued pre-testing patients and spent several hours organizing a new shipment of contact lens trials into our inventory system. I realized I haven’t shown you how the storage drawers are set up; each one is categorized by manufacturer and whether the lenses are for astigmatism or standard vision. I’ve included a photo below so you can get a glimpse. Each drawer contains rows and columns of lenses arranged by power, cylinder, sphere, and axis. It usually takes me at least two hours to go through all 40 drawers and restock them with the latest order. (If you look super closely in the image, one of the trial lenses is from the wrong brand. Can you spot it?)
On the consulting side, I made some headway this week. I fleshed out my proposed solutions in greater detail and scheduled a meeting with the manager to discuss feasibility. Our conversation turned into a valuable exchange. She shared insights from past strategies that aligned with some of my ideas, and we explored how to build on those experiences. Her feedback was incredibly helpful in shaping a more practical, well-informed proposal. I spent the rest of the week refining the written portion and translating our conversation into a more actionable plan.
One last thing — a quick confession. Last week, I mentioned I’d be gathering numbers on the clinic’s spending across software systems, equipment maintenance, utility costs, and more. Unfortunately, I’ll have to push that task to next week. The doctor I need to speak with hasn’t been in on the days I’ve been scheduled, so I’ll be adjusting my hours to catch them. I’m looking forward to reviewing those outstanding financial figures next week so I can round out the proposal with a more complete picture of the clinic’s resource allocation. See you all next week!
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Week 10: That's a Wrap!
Hello again (and for the last time)! This week I focused on wrapping things up with the project.
On Tuesday, I ended my last day in the office with good closure! Everything seemed to fall into place — almost every patient picked up the phone when I dialed them to schedule/confirm an appointment, the eye pressure exam and other pre-testing went smoothly, and I had warm, meaningful conversations with the staff and doctors before they sent me off.
Alongside my regular responsibilities, I went back onto the web throughout the week to read up and understand the breadth of effective business proposals. Throughout this analysis process, I realized the importance of balancing professionalism with empathy and precision in healthcare-management-related business proposals. A respectful and knowledgeable tone reassures stakeholders, such as hospital administrators, clinicians, or investors, that the proposal is ethical and aligned with patient-centered values. Striking the right tone reflects a deep understanding of healthcare priorities and strengthens the proposal’s appeal to both clinical and business-minded audiences.
Over the course of this project, I’ve gained a deeper understanding of what it takes to work in both a private optometry practice and a research-driven consulting role. I learned to analyze real data, identify patient trends, and communicate recommendations in ways that reflect both the values and operational goals of the clinic.
Thank you for accompanying me throughout these last ten weeks. Goodbye everyone!
P.S. I did end up gathering the data I promised to collect two weeks ago. Excited for everyone to see the end product on Symposium Day!