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AI testing is almost here, and it doesn’t care if ODs are ready


Robot hand holding pill

The population of the world is under attack. The robots are coming, the robots are coming.

Alarmist calls abound for the end of human productivity-we are going to get replaced by “the machines.”


But it is important to recognize the pace of change for what it is and determine how to harness the technological advances that can impact you, your practice, and most importantly, your patient’s experience.

More from Dr. Rumpakis: Why medical coding is a big deal for ODs

Please note that I didn’t say the patient’s experience in your office.

Many of the technological advances that are coming to eye care may actually take place at patients’ homes or on the very devices they carry with them everywhere they go.

Let’s break them down.

Online refraction
First, let’s handle the 800-lb. gorilla in the room. Online refraction.

With the recent news of Visibly’s “Online Vision Test” getting a recall from the Food & Drug Administration (FDA), organized optometry would have you believe that you take a deep breath of relief. But I submit that the technology itself isn’t the enemy; it is how it is deployed.

Related: Visibly (formerly Opternative) recalls online vision test

So, let me tell you: Yes, it’s coming; yes, it’s here; yes, it will impact your practice. And for those of you who understand the difference between a refraction and a prescription-bonus. You get to the winners’ circle, pass Go, collect your $$$.

You see, online refraction isn’t the enemy. The technology will ultimately be a commonplace item within the next few years. Why? Simple. The consumer always wins. Convenience always wins.

How do optometrists win? That too is also simple: Learn about the technology that is out there, experience it, embrace it, and then figure out how to use it in a way that can protect and benefit your patients and your practice.

It might be helpful to remember that refraction is nothing more than another diagnostic test. 92015 is defined by the Current Procedural Terminology (CPT) as determination of refractive state. A refraction in and of itself is not a prescription. A prescription is the culmination of a physician’s experience and perhaps intuition applied to the refraction combined with specifications for lens type, lens style, materials, pupillary distance (PD), etc.

But you know that already.

So, why are optometrists so scared of this technology? Could it be because they collectively feel like they have lost control of a primary end product of their examinations? Perhaps.

Related: AI may be the answer for early disease detection

But let’s look beyond the fear, just for a minute. Imagine a different scenario in which technological advances such as this can be harnessed for the benefit of the practice, and by that, I mean your practice.

Imagine that you embrace online refraction technology for your patients. In order for your patient to perform an online refraction, the patient would have to begin the process on your practice’s own website, the same place that he completes his forms and demographic information. Once he has completed the online refraction, the results go directly to your inbox-not to some faceless doctor, but you.

And because insurance companies don’t pay for just refraction but will cover it only when paired with a comprehensive examination (CPT 920X4-which doesn’t include refraction, by the way), the patient must schedule his 920X4 with you (ideally again, online) and complete the examination in your office.

When the patient arrives at your office, you complete the 920X4 requirements and finalize the Rx that began as the online refraction. You can choose to refine the prescription if you like. And keep in mind that you booked only 10-15 minutes of time with the patient due to the time savings you realized because one of the most time-consuming aspects of the visit was completed before he walked through your door. After the examination and your issuance of his final Rx, the patient then goes to your optical just like he does now.

Think about it: If any other equipment or technology provider developed a process to save you 10 to 15 minutes per exam, surely most of us would embrace it without a thought. Increasing available capacity by 30 to 50 percent would be a huge boon to your practice.

But wait, there’s more
Other AI-driven technologies are coming to our practices as well.

Related: How artificial intelligence is changing the future of optometry

AI-driven retinal exams begin with the capture of the retinal image. That capture may come from technology that attaches to someone’s handheld device or a camera that is in the local mall, or the corner CVS, or Walgreens.

This is not “science fiction,” but the reality of medicine today. It’s not just eye care that is subject to this forward progression, but all of medicine.

To quote the CEO of CVS Larry Merlo who recently purchased Aetna in 2018, “By delivering the combined capabilities of our two leading organizations, we will transform the consumer health experience and build healthier communities through a new innovative health care model that is local, easier to use, less expensive and puts consumers at the center of their care. We will “engage consumers with the care they need when and where they need it, and will simplify a complicated system and will have people achieve better health at a lower cost by challenging the status quo with new technologies, business models and partnerships.”

Embrace the change
Optometrists, collectively as a profession, must learn to embrace, partner, guide, and positively influence the technology that is being deployed. We need companies who are willing to take the risk, ask the hard questions, push the envelope, and spend the money to develop technology that can improve our delivery of eye care and enhance the consumer experience.

Related: Why ODs should embrace new technologies in eye care

Technology itself is not the enemy-being proactive allows us the luxury of shaping our own future. However, if we continue to take a defensive posture and isolate ourselves, we may very well be excluded from the table when high-level discussions and decisions are conducted.

Just a thought…

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