The only constant is change. This is as true in ophthalmic care as in any other field. Today, changes in technology have implications inside the exam room and beyond. What do these changes mean for the future of your practice?
Inside the exam room
OCT scanning, which can detect the start of disease before findings appear under slit lamp examination, continues to evolve. For example, the recent development of OCT-angiography (OCT-A) allows for examination of retinal vasculature without need for injection of a contrast dye.1
More and better treatment options continue to become available. For example. intraocular injections now treat certain forms of macular degeneration once considered untreatable. Options to treat glaucoma are less invasive. The FDA has approved the first sustained-release, intraocular pressure-lowering implant, which may help address the problem of noncompliance in patients who until now had to self-administer eye drops.2
Evolution in technology to improve clinical care is significant but familiar territory. Changes in technology with impact extending outside the exam room are potentially more disruptive.
Better ways to communicate
Bi-directional interoperability—the ability to connect securely and efficiently with other providers who care for a mutual patient—is of great clinical value. It gives you the ability to import more complete medical information into the patient’s chart. By connecting data between multiple practices, it reduces medical errors.
Online communication is changing how patients can obtain their medical information as well. For example, patients can access test results through a patient portal. It’s best to view this development as another path to extending your reach and your connection to patients. With an aging baby boomer population and a projected shortage in ophthalmologists looming in the near future, more efficient channels of communication may become essential to running your practice.
Telehealth takes its place in eye careUntil recently, eye care practices mostly ignored telehealth. The COVID-19 pandemic taught us that telehealth has its place in ophthalmic care 3. It can facilitate more efficient patient triage. It can also help with follow-up of chronic conditions and reassessment of care plans. When patient are unable to come to the office, telehealth shows its value in eye care, as with other medical specialties.
Home testing finds a footholdHome testing devices are gaining traction. The FDA published new guidance designed to “expand the capability of remote ophthalmic assessment and monitoring devices to facilitate patient care while reducing patient and healthcare provider contact and exposure to COVID-19.5”
- Most relevant are the home testing devices which can improve convenience and compliance:
- iCare Tonometer and the Sensimed Triggerfish contact lens facilitate checking intraocular pressure at home but are expensive and not yet widely used.
- Alleye and other apps may aid in detecting age-related macular degeneration (AMD) or diabetic macular edema. These apps can also monitor progression of retinal disease at home.
- ForeseeHOME by Notal Vision is an at-home monitoring device for the early detection of wet AMD. It sends monthly reports of a patient’s progress to clinicians
- Many patients use an Amsler grid to monitor macular function; this test is now available as an app as well.
Until recently, ophthalmic practice has stayed keenly focused on what happens inside office walls. While this is not going to radically change, new technology is pushing at the borders of practice.
Don’t miss out on opportunities for expanded outreach offered by more efficient channels of communication with patients and providers. Telehealth, patient portals, and home monitoring devices will never replace the in-office visit—but they can extend your practice’s influence in the days, weeks, and months when patients don’t come in. Not only can they improve patient outcomes; they can also strengthen the ties between patient and eye care provider—and that simply makes good business sense.
1Eugenia Custo, Greig, Jay S. Duker, & Nadia K. Waheed, “A practical guide to optical coherence tomography angiography interpretation,” International Journal of Retina and Vitreous, November 13, 2020.
2Natasha Nayak Kolomeyer, MD, “Top 7 Things to Know About First Sustained-Release Glaucoma Medication,” American Academy of Ophthalmology, May 14, 2020.
3Alex Young, “Virtual ophthalmology care may assume permanent role after pandemic,” Ophthalmology Practice Management, Healio, July 26, 2021.
4Conni Bergmann Koury, “Demand for remote care soars,” Ophthalmology Management, November 1, 2020.
5Guidance Document: Enforcement Policy for Remote Ophthalmic Assessment and Monitoring Devices During the Coronavirus Disease 2019 (COVID-19) Public Health Emergency, April 2020.
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