Our previous two parts of the "Here's how to get your all-digital eye care business up and running" special generally looked at setup in PART 1, as well as a more detailed implementation with devices in PART 2. During our research, we came up with some thoughts that we don't want to withhold from you.
Overall, many benefits reveal themselves when considering a completely digital eye care practice. Technically, the setup has long been feasible. There are Electronic Medical Record systems (EMR) that allow a complete telemedical connection of the patients and a decentralization of performed examinations/imaging and medical evaluation with patient discussion and therapy planning.
In addition, more and more start-ups and spin-offs from universities and companies are developing new digital and telemedicine-ready products. These include smart imaging devices that use artificial intelligence, smartphone-based devices, home devices, and an ever-increasing number of apps that enable ever-improving patient care.
We see the main advantages of a digital ophthalmology practice as follows:
By outsourcing individual activities to the phase before and after the office visit, the actual examination appointment can be optimized and the patient journey improved in its individual parts.
In the clinical setting, the biggest limiting factor is usually you time for the individual patient. On the one hand, this leads to partial steps such as patient history or the analysis of older image data brought in by the patient being neglected. In addition, the individual time for anamnesis and doctor's consultation leads to the fact that the equipment is not optimally utilized and thus waiting times arise or fewer appointments can be offered. This also increases the time pressure in other areas, so that important aspects, e.g., of the patient history or also in the explanatory discussion before surgery, could be neglected.
Advantages of the digital ophthalmology practice
Breaking down the patient journey using digital and teemedical applications in combination with a digital ophthalmology practice could solve this problem. On the one hand, patients could submit all necessary and important documents in advance and, with sufficient time, complete the medical history and, if necessary, fill in any forgotten information before the examination appointment and the doctor's consultation. Then, after more specific inquiries by trained staff, the necessary special examinations could be added to a basic examination and scheduled. This would enable a more optimal utilization of the equipment and reduce waiting times on the part of the patients and generally enable more appointments.
The physicians would have enough time to evaluate the examinations and to respond individually to the patients. In addition, enough materials could be provided (e.g. videos, illustrations, instructions and tutorials) to support the patients in understanding their disease or in carrying out the therapy. A modern chat bot could also answer recurring questions and thus further reduce waiting times.
In addition, especially for patients with chronic diseases, the use of home devices, digital health apps and close coordination and connection to the treating physician via an integrated Patient Communication Center could significantly improve treatment.
This could also prevent a large number of duplicate or unnecessary examinations.
Another important point of a purely digital ophthalmology practice is that increasingly popular work models of the New Work such as part-time, flextime, digital nomadism, etc. can be at least partially implemented and thus make the workplace more attractive.
Nevertheless, there are also disadvantages that could accompany the digital transformation of ophthalmology and a digital ophthalmology practice.
Disadvantages and limitations of the digital ophthalmology practice
Besides many advantages, there are mainly disadvantages of a practical nature in the implementation of a digital ophthalmology practice.
Although there are a number of individual "pieces of the puzzle" that would theoretically allow for fully integrated, digital patient care as previously described, there is a major interface issue in the communication between devices, apps, EMRs and external systems. At the moment, this can lead to the need for further manual reworking, which can even result in greater effort when choosing a digital system.
An important factor that must not be ignored when evaluating a digital ophthalmology practice is the human factor, on the part of patients, assistants and physicians.
Patients are not only used to meeting a real doctor. Often it is precisely the personal emphatic contact, also called the "doctor drug", which directly leads to the fact that fears can be reduced and patients feel comfortable and build the necessary relationship of trust. In addition, many patients are tied to one and the same doctor for years, so this bond is not easy to break. With an efficient, digital medical consultation, it would probably be more difficult to organize that the same patients always consult the same doctor, but it would also not be unthinkable.
But doctors also often miss the direct and personal contact with their patients in purely teemedical setups. Often, this is even the motivation why these doctors became physicians.
It must also be emphasized that many examinations can be performed quickly and efficiently in the environment we have described, but that there are also, for example, patients who, due to their age or personal constitution, need a long time for examinations or have to perform them with personal assistance. For this reason, we decided on a setup with at least one technical assistant, as it could otherwise lead to elderly or immobile patients being excluded from the purely digital, teemedical offering. This generally applies to patients who are less digitally literate, who are likely to be less likely to use a digital service that requires files to be uploaded and, for example, a chat or video call to be set up.
Of course, the financial aspect should not be forgotten. Equipping the practice and also the use of digital and extensive EMR systems, can often cause quite high costs. Nevertheless, we believe that these will ultimately be offset by an increase in efficiency.
In conclusion, one thing is certain: In the future, it will become clear which digital and teemedical services in ophthalmology will be accepted and used by physicians, technical staff and patients, and which will not.
Further Links
Read our interview with the founder of the first digital ophthalmology practice in Germany