Opternative

[ocularis]

How do you guys think this Opternative start up will effect Ophthalmology?

http://www.cio.com/article/2971263/...he-cloud-do-it-yourself-online-eye-exams.html

http://techcrunch.com/2015/07/27/online-eye-test/

I think Optometry will hurt more as this is their direct replacement, however, a lot of Ophthalmology clinic revenue is via eye glass sales from their respective optometrist's and from referrals from Optometry so I think it will effect Ophtho, too. My gut thinks this is going to take off, it's the kind of technology that is disrupting all industries and in the big picture makes money sense. The doctor in me despises this idea, true pathology is going to get overlooked when patients & the general population start thinking they are in the clear just because they have a prescription and 'eye exam'. I have some strong ethical concerns about this and feel that it needs to be strongly opposed to protect the field.

 

[LightBox]

Definitely going to affect all of us. I'm sure we will see a dent in "routine eye exam" revenue and glasses sale. <sigh>

 

[ocularis]

And secondary to that, all respective pathology coding as there will be less identification of pathology and therefore decreased referrals to the right specialists. I am sure there will be some lawsuits on their hands when serious diagnoses start getting missed.

Our academy needs to a do a better job protecting the field to not allow this kind of non-sense and to continue protecting our numbers (in all ways), Derm figured it out.

 

[LightBox]

I doubt there will be many lawsuits. I'm sure their website/software/etc will have many disclaimers stating that their software is not to be used for "medical diagnosis", etc etc. It's basically going to be like how everyone gets their contact lenses from 1800-CONTACTS now. I'm sure they will partner up with one of the online glasses makers as a referral gateway. Great for the owner(s)/inventor(s) of that website... but very bad for the rest of us!

 

[ocularis]

I bet that it will be disclaimered-up too ... but with enough ethical concerns it could become an issue no doubt. I don't think they will be sued out of business, but perhaps pushed out from approval boards. It's tricky, as technically there is nothing to not approve by the FDA, they aren't doing anything invasive or directly harmful, just insanely misleading and the average person will definitely not see through this.

I don't know, it really doesn't sound good on behalf of the field that's for sure, but also appears to be a huge liability and I can't believe that isn't accounted for. There is no way physicians would get away with this 'tool' in clinic without still carrying all the liability, I can see it being as an adjunct for diagnosis but not a replacement for full accountability. We wouldn't just be able to disclaimer away our liability, but I guess technology can? Doesn't make sense.

For the smart patients who aren't brainwashed, I could maybe see this as a partnership with ophthalmology so that pathology screening isn't missed .. but I'm not sure how optometry will survive.

 

[LBizzy]

I guess if your practice sells a lot of glasses it may dent that revenue-- although that's very unpredictable. Yesterday alone I saw a woman with dense vitreous hemorrhage in one eye and severe PDR in the other who didn't know she had DR, as well as a woman with a RRD who happened to have completely cupped out discs who didn't realize she had glaucoma (a short note from the her outside provider said she had glaucoma, she was pretty with it about her health generally and swore she never knew--she should have been referred out years ago). The first had been getting yearly eye exams at a commercial eye shop (Wally World) for a decade, the second had been followed by an optom at a very heavy glasses selling optom/optician practice. I think we all see people like this quite regularly. These type of people may get funneled into our clinics sooner if healthy eye refractions vs ophtho referral tele systems like this are used.

Larger academic ophtho depts are already developing teleophtho programs. I think larger, integrated eye practices (with ophtho, optoms, opticians) using teleophtho systems will be the future and patients will get better care. I'm sure there will be issues with transitions in practice patterns as there always are with any change. I think we will catch more pathology, not less--- a major function of these tele systems is to get people who need actual eye exams in to get them. Look at their site, you'll see it excludes basically everyone except a young, completely healthy person who has had a relatively recent eye exam. Everyone else gets referred. Private practices should be able to adapt, grow, and take advantage as well, I think. We shall see.

 

[peter2013]

I've seen a few articles cite a randomized, double-blind study looking into the accuracy of opternative, but haven't found anything on a quick search of pubmed and google. Has anyone seen this study?

 

[ocularis]

If you look on their website they have the clinical trial summary report: https://www.opternative.com/clinical-study

That's all I've seen. I don't think the study is overwhelmingly positive or has a large enough sample size, but I guess good enough for the FDA!