Teleoptometry and the Rise of AI

Artificial intelligence (AI) is touching every industry and eyecare is no exception. It's pretty wild to think about how much potential AI has to change how we get our eyes looked after, especially with telehealth becoming such a big deal. While there are many in-person applications for AI, we need to anticipate how service delivery will grow to meet shifting market expectations, including the future of telehealth.

A Look Back at the Evolution of Telehealth

Thinking back, telehealth really became an option when we were trying to serve healthcare deserts. Then in 2020, as we faced a global pandemic, it grew rapidly as a solution for delivering essential health services when physical locations faced closures. The continued demand from both providers and patients has now solidified telehealth’s ongoing role within the contemporary medical landscape. Nonetheless, this remote modality of treatment and services has been a subject of ongoing discussion in both eyecare and healthcare.

While some maintain that telehealth cannot fully replicate in-person care, others embrace its potential to provide care for patients with limited access or those who may not otherwise seek in-person consultation. My own experience during the pandemic involved a transition to a remote medical professional, and even when in-person services resumed in 2022, I opted to continue with telehealth for its convenience. Beyond personal preference, many individuals in remote healthcare deserts still rely on telehealth offerings to receive necessary services. Furthermore, regulatory changes, such as allowing a broader range of clinicians to bill Medicare for telehealth services and permitting telehealth from any location (including patients' homes), have significantly expanded patient access and provider willingness.

Receptiveness to AI

So what role does the emergence of AI play in telehealth? AI is a broad field of computer science focused on creating machines that can perform tasks that typically require human intelligence, like learning, reasoning, and problem-solving. It involves designing algorithms and systems that can learn from data, adapt to new situations, and make predictions or decisions based on that knowledge. While the concept used to be part of science fiction, technological advances and intelligent AI training have allowed nearly anyone to access AI tools in their daily lives. What used to be feared is now becoming more acceptable.

According to the Journal of Optometry, optometrists reported an increase in their inclination towards incorporating AI into practice, from 53.3% before the COVID-19 pandemic to 65.5% afterward. Optical providers are demonstrating increasing receptiveness to utilizing AI in telehealth due to its capacity to not only enhance patient access to care (the goal during the pandemic) but also to improve diagnostic accuracy and streamline practice workflows (bonus!).

Applications of AI in Teleoptometry

AI-driven teleophthalmology platforms are software and hardware systems that use AI to enhance how patient services are delivered. These platforms leverage AI algorithms to analyze images of the eye, assist with triage, and even automate administrative tasks.

• Image Analysis AI algorithms possess the capability to analyze images of the eye, such as fundus photographs and optical coherence tomography (OCT) scans, to identify indicators of various ophthalmic diseases, including diabetic retinopathy, age-related macular degeneration, and glaucoma. A 2024 publication by the National Institute of Health (NIH), indicated that the application of AI algorithms for the interpretation of retinal images, when compared to clinical data and physician expertise, presents an innovative solution. They report demonstrated accuracy in detecting numerous ophthalmic and non-ophthalmic disorders.
  

• Remote Triage AI can also facilitate patient triage through the use of chatbots and questionnaires to ascertain the urgency and type of care required based on initial assessments. This can potentially alleviate the demands on in-person consultations. A relevant example of earlier AI applications in ophthalmology is detailed in a study comparing the responses of large language models to patient queries in an online medical forum with those of ophthalmologists. The study compared responses from ChatGPT with those provided by ophthalmologists affiliated with the American Academy of Ophthalmology (AAO). This comparison revealed that the AI's guidance did not significantly differ from that offered by human ophthalmologists in terms of accuracy or safety. To me this means that AI has the potential for reliable patient engagement in non-critical informational contexts.
  

• Automated Tasks The integration of AI within EHR platforms enables the automation of tasks such as appointment scheduling, documentation, billing, inventory management, and the generation of patient education summaries. AI assistants can manage clinical note-taking, update patient histories and streamline billing and coding procedures. AI-driven systems can also manage appointment scheduling, verify insurance eligibility, and process claims.

Implications for Patient Care

The integration of AI into teleoptometry is poised to significantly reshape ophthalmic care. By automating routine administrative functions, enhancing diagnostic precision, and improving patient access, AI is streamlining workflows and enabling ophthalmologists to dedicate more focus to the delivery of high-quality patient care. It’s been a long time coming but as AI technology continues its advancement, its role within ophthalmology will likely expand, further transforming the provision of eye care services and contributing to improved patient outcomes. I can’t wait to see what the future looks like.

Written by: Holly Gough