Eyecare professionals will not be replaced by AI, but they will be replaced by ECPs who use AI.
That is THE takeaway from a standing-room-only AI program at VEW 2024 in Las Vegas last month. The event focused on current AI tech available to ECPs along with what to expect in the future. We’ll touch on some of what was covered in the program and include additional resources to help you learn more about AI applications for your practice.
First off, when one considers AI in optometry, it’s necessary to be specific. As noted by the VEW panel, AI can be used in an optometry practice in all sorts of ways, including but not limited to:
- Scheduling
- Records management
- Insurance processing
- Patient communication (ex: language translation, chatbots)
- Marketing
- Optical sales management
- Telehealth
- Diagnostic screening
- Clinical decision support
- Disease progression prediction
- Treatment monitoring
It’s completely reasonable to take baby steps with implementation. For example, you’ll likely be more comfortable dipping a toe into AI for scheduling or patient retention strategies before you adopt it as a clinical aid.
Where Are We With AI Right Now?
VEW 2024 panelist Dr. Rehan Ahmed, MD, a board-certified ophthalmologist, relayed data from his survey of fellow ophthalmologists nationwide, noting that while only 10% currently use AI, almost all expect to incorporate it into their practices in the next three to five years.
That reminds me of a quote I read from a SECO 2024 panel on AI in optometry:
AI is everywhere and we are at the crossroads in health care. The question is how do we implement it into our practice? If you think you’re behind in AI, you are, but so is everyone else. (Source: SECO Keynote Panel Asks, What’s the Future of AI in Optometry?)
Per Dr. Ahmed, the true value of AI ultimately lies in addressing these real-world challenges faced by clinicians:
• The imbalance between supply and demand, with too many patients and too few doctors
• Rising costs combined with shrinking reimbursements
• The explosion of data and the increasing burden of payer requirements
Operational Efficiency and Economic Benefits of AI
AI can be used to streamline your practice and positively impact your bottom line without sacrificing a high standard of care.
There are now AI tools that can help with eligibility checks and claims processing, patient scheduling, and transcription aids to alleviate charting burdens. That last one uses ambient listening, which is what you’ll want to use as a search term when exploring this type of AI solution. Imagine an exam where eye contact and conversation with the patient takes precedence, and you don’t need to focus on a bunch of data entry in the moment. Early reports on AI-powered transcription indicates approximately 2 hours of EHR time saved each day.
Read about other quantifiable benefits here:
A Closer Look at AI Utilization With Electronic Health Record Systems, Optometry Times
AI Transcription Tech for Optometrists, Eyes on Eyecare
Predictive analysis is one of the more intriguing aspects of AI in optometric practice, and it can be used for inventory management, patient retention, and more:
AI provides us with a key component to human intelligence: prediction. AI takes all the information available and uses it to generate information you don’t have. Consider any decision made during a normal working day as an optometrist: When should you bring in a new product or technology? Which candidate should you hire? Do you consider a recent frame that sold a “hot seller” or was it a fluke that it sold so quickly? Is this retinal nerve fiber layer showing progressive loss indicative of glaucoma? AI could be employed to help better predict the answer to each of these questions. Increased predictive ability can reduce uncertainty in all aspects of optometry, from how the business is run, to how optometrists care for their patients. (Source: Teleoptometry and Artificial Intelligence: Opportunities and Challenges for the Profession)
Note: There is an important distinction to be made between generative AI and predictive AI, and some are quite wary of predictive AI, at least in its current form. For those interested in the big picture, check out this insightful article and book excerpt: The Need for AI Literacy, which touches on accuracy of predictive AI and the realities behind the hype.
Diagnostic & Treatment Benefits of AI
When it comes to clinical applications, it’s important to understand that AI does not replace human expertise. Doctors will be the final judges and decision makers, particularly when it comes to patient outcomes.
Digital Diagnostics is the first company to receive FDA clearance for an autonomous AI diagnostic platform. Dr. Dena Weitzman, OD, FAOO, director of medical affairs at Digital Diagnostics spoke at VEW 2024 about high-quality datasets being the only way forward when it comes to AI. Concerns about accurate, unbiased, and ethical outcomes are real, but can be achieved through high-quality data management.
AI can integrate with imaging technologies, including fundus, OCT, visual fields, ultrasound, and ERG and can offer clinical decision support for conditions like AMD, glaucoma, and cataracts.
Read more: AI Makes Retinal Imaging 100 Times Faster, Compared To Manual Method
Two interesting points — a pro and a con — about diabetic retinopathy diagnosis using AI to analyze pictures of the eye taken with a retinal camera:
One potential downside of not having a doctor do the screening is that the algorithm solely looks for diabetic retinopathy, so it could miss other concerning diseases, like choroidal melanoma, Lee said. The algorithms also generally “err on the side of caution” and over-refer patients.
But the technology has shown another big benefit: Follow-up after a positive result is three times as likely with the AI system, according to a recent study by Stanford University.
That’s because of the “proximity of the message,” said David Myung, an associate professor of ophthalmology at the Byers Eye Institute at Stanford. When it’s delivered immediately, rather than weeks or even months later, it’s much more likely to be heard by the patient and acted upon. (Source: As AI Eye Exams Prove Their Worth, Lessons for Future Tech Emerge)
During the VEW program, Dr. Ahmed also shared insights into the emerging field of oculomics, which is the study of the relationship between the eye and systemic disease. Oculomics uses scanners and imaging for non-invasive screening for neurological and cardiovascular conditions. It is also being explored as an avenue to predict conditions like Alzheimer’s, heart disease, and kidney disease.
AI has the potential to transform treatment by analyzing patient data to predict disease progression and tailor therapies, particularly in glaucoma management. VR and at-home OCTs are already being used to monitor and predict responses to treatment.
The VEW panel wrapped things up by noting that challenges will inevitably arise as we see more applications of AI in diagnostics, treatment, and practice management. Buy-in from patients, physicians, and payers will evolve. Regulatory clarity is necessary to encourage safe development, HIPPA compliance, and data security. And high standards in AI development and maintenance will continue to be critical for accurate, unbiased, and ethical outcomes.
For those who didn’t attend the VEW 2024 program and are interested in the full proceedings piece, you can download the PDF here: The Artificial Intelligence Revolution: Practical Applications in Eye Care Today.
