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Disruptive technology – Sometimes beneficial, sometimes ‘scary’
NEW YORK – A panel of experts discussed the industry’s resistance to change in light of technological advances, such as remote refraction, 3-D printing and wearable technology, in a symposium here at Vision Expo East.
“We are habitual in how we do things,” panelist Paul M. Karpecki, OD, FAAO, head of the ocular surface disease clinic and director of clinical research at the Koffler Vision Group in Lexington, Ky., said. “Part of the reason is complacency. If you’re fairly successful, you don’t feel the need to change.
Paul M. Karpecki
Ed De Gennaro
“We’ve been bombarded from every angle – opticianry, ophthalmology,” he continued. “Sometimes you adopt a technology and it doesn’t do exactly what you want in the beginning, and in our profession, we feel it’s better to hold off. It’s only after it becomes fully accepted that it becomes the new norm.”
“Some innovations coming down the pike are clearly beneficial and some look scary,” moderator Ed De Gennaro, MEd, ABOM, of InFocus Optical Consulting, said. “Let’s call them disruptive.”
“Disruptive technology starts as a lesser quality product on the fringe,” Richard Clompus, OD, of Clompus Consulting, said. “As technology advances, it develops.”
“We’re slow to adopt,” De Gennaro said. “For example, after 40 years, progressive-addition lenses only have 55% penetration.”
Hal Wilson, president of MyVisionPod, explained his company’s technology.
“We provide a remote refraction system where a technician, through a teleconference system, can provide a refraction remotely,” he said. “We saw fear with online eyeglass models. If I was an optometrist, I’d be clamoring for the ability to have remote refraction instead of two offices to reach patients that aren’t being served. We should be able to work together to solve the problem of providing eyeglasses.”
Hal Wilson
He explained that the pod, which contains an autorefractor and phoropter, is located in a retail environment or rural health clinic.
“The equipment has been modified so it can be controlled remotely,” Wilson said.
The patient books a 15-minute appointment for the pod, he said.
“They’re required to fill out a vision profile, history of glaucoma, last eye exam, just like in the doctor’s office,” Wilson said.
An optical expert greets the patient via video teleconference and plays a video from the doctor that explains how only a refraction, not a medical eye exam, will be performed, he said.
The technician guides the patient through the exam, and the results are printed and also provided to an optometrist or ophthalmologist who approves them and uploads the prescription to the patient’s account. The prescription can be taken anywhere to be filled, Wilson said.
De Gennaro asked Wilson, “Why do we need to do this when there are plenty of providers?”
“It’s about convenience for the patient, and it solves their problem,” Wilson said.
An audience member countered: “We’re going to outsource primary eye care to uneducated technicians. A lot of disorders won’t be detected, such as convergence insufficiency, vertical imbalance. Are we going to lower the standards of our profession?”
“These are not untrained, unskilled technicians,” Wilson answered. “We are using the exact same protocol an ophthalmologist will use in their office. Ophthalmologists don’t do refractions themselves, for the most part.
“Ideally, we’d love to have optometrists involved with our model,” Wilson added. “They can do refractions better than anybody.”
Clompus said: “You may have a thriving business and great staff, but you need to look at what upsets your patients. Look at those things you can modify or optimize to make the experience better.”
Richard Clompus
Pia Taveras
Karpecki said optometrists must differentiate themselves.
“You can’t compete with personal interaction,” he said. “Focus on that. It doesn’t mean this doesn’t have a place in terms of efficiency for people who want that, and I believe people want the human interaction.
“The groups going this route need to make sure people know they’re not getting a medical eye exam,” he continued. “All it takes is one or two patients who go blind, thinking it was their exam, to change that model.”
“This is the first step,” De Gennaro said. “The full eye exam model is on the way; the equipment is being developed – it’s probably 3 to 5 years off.”
Another disruptive technology, 3-D printing, is being used in the frame business for prototyping.
Pia Taveras, product engineer at ClearVision Optical, explained that, traditionally, when a change was made to a prototype, the updated product would not be returned for 6 to 8 weeks.
“Now, we go back to the printers, readjust in a day and have another prototype the next day,” she said. “It’s helped us tremendously in getting products into your stores. Years and years of development can be minimized to 2 years. We’re not just sending a picture to the manufacturer, we’re sending them a file. The communication gap is completely gone.
“Next we want to move to functional prototyping, where you’re making a prototype and giving it to people to use in studies and provide feedback,” Taveras added.
“Think of this as virtual try-on,” she continued. “Frames will be printed on demand. There won’t be such a thing as out of stock. In the future, you’ll be able to have these printers in your offices.”
Taveras said she does not believe the practice of 3-D frame printing will replace traditional eye wear, but it is something else to offer the consumer.
“You can custom fit something to their face,” she said. “Traditional eye wear doesn’t work for some.”
The panel also addressed wearable technology, which Karpecki explained is technology incorporated into a patient’s daily life via clothing or accessories. Augmented reality provides greater depth of vision. Virtual reality is not really what is happening, he said.
Karpecki cited examples of wearable technology: T-shirts that measure heart and dehydration rate, baby monitors that check temperature and heart rate, jogging outfits with attachable Tasers and sunglass monitors that measure time and temperature.
“We as a profession tend to be late,” De Gennaro said. “Will eye care providers get into this, or will we miss it?”
Clompus said drawbacks to eye wear that contains technology are: thick temples, increased cost and limited design options.
“A company needs to create eye wear that looks fashionable and gives doctors an opportunity to join it,” he said. “It’s my vision that the ophthalmic industry figures out a way to take advantage of the electronic wearable industry as it grows exponentially.” – by Nancy Hemphill, ELS FAAO
Reference:
De Gennaro E, et al. Eye Care Technology That’s Emerging Presented at: Vision Expo East. April 14-17; New York.
Disclosures: Clompus is president of Clompus Consulting. De Gennaro owns Infocus Optical Consulting. Karpecki receives consulting fees from AcuFocus, Aerie Pharmaceuticals, Anthem, AMO, Alcon Labs, Allergan, Akorn, Bausch + Lomb/Valeant, BioTissue, Bruder Healthcare, Cambium Pharmaceuticals, Eyemaginations, Essilor, Eyes4Lives, Eye Solutions, Focus Laboratories, iCare USA, Johnson & Johnson Vision Care, OcuSoft, Freedom Meditech, Konan Medical, MacuLogix, Beaver-Visitech, Ocular Therapeutix, Reichert, Shire Pharmaceuticals, Regeneron, RySurg, Science Based Health, SightRisk, TearLab, TearScience, TLC Vision, Topcon and Vmax. He is on the speakers’ bureau for Glaukos and Oculus; has conducted research for Akorn, Allergan, Bausch + Lomb, Eleven Biotherapeutics, Fera Pharmaceuticals, Rigel Pharma and Shire; and has an ownership interest in Bruder HealthCare and TearLab. Taveras is a product engineer with ClearVision Optical. Wilson is president of MyVisionPod.