Tuesday, November 19, 2013

Can Vision Care be virtualized for you?


Of course, Vision is one of the finest senses gifted to us that form real impressions about the world in our mind. Over the passage of generations, eye impairment has only increased due to varied reasons from dietary intake to lifestyle choices and prolific usage of digital screens.  According to WHO estimate, 285 million people are visually impaired globally. Nevertheless, science has advanced to address any form of impairment. Technology advancements in terms of smart contact lenses, laser treatments, robots, nano bots, smartphone apps and remote medicine is going to transform the vision care tremendously in the future. Now, the technology has advanced to such an extent that you can overlay virtual environment on real-time vision with inventions such as Google Glasses that allows for augmented reality. Healthcare has been slowest to adapt to these digital transformation but once the certain scale has been achieved, we could see profound impact on care delivery.

The proliferation of smart devices enables novel ways of communication and connecting with patients by doctors.  It is estimated that by end of 2013, 6% of the global population will own a tablet, 20% will own PCs, and 22% will own smartphones[i]. According to the latest Nielsen estimate, two-thirds of all phones owned by people in US will be smartphones[ii]. With the current developments seen across smartphone apps, it is possible for a patient to carry out virtualized services such as fixing up appointments, use virtual optical assistants to choose glasses, provide remote consultation and take self-vision screening tests before visiting a clinic. Consider this new virtual assistant named Otto, developed by VSP Optics group which is one of the largest providers of eye care plans in United States. This app has remarkable functions such as insurance information and eligibility check, doctor’s directory, web appointments, alerts and notifications, online eye-wear gallery store, vision screening and social media connect with friends and communities[iii].

Smartphone app can provide vision care access to the people in remote locations that are inaccessible to primary medical attention. Nearly 90% of global visually impaired population lives in developing countries. Peek, an acronym for Portable Eye Examination Kit, is a smartphone app that allows for an eye examiner to use camera of the smartphone to conduct basic vision screening. This app uses camera’s flashlight to illuminate the back of the eye, the retina and check for diseases[iv]. Also, all these details on the examined patients are recorded on phone and shared it with doctors over mail. This app has really been useful by assisting people in very remote places to conduct eye examination and get consultation over phone.

Smart contact lenses are developed that provides augmented reality on the lenses and also enable continuous monitoring of eye pressure that causes eye disorders. Innovega is one such company that has developed contact lens called the iOptik lens manufactured using nanotechnology to perceive both reality and information provided by the Internet or another source about the objects in focus[v]. Sensimed is another company that has developed a device that can measure the eye pressure responsible for disorders on a continuous basis which can be used to analyse and intervene immediately[vi]. Measuring the eye pressure regularly and providing early medical intervention can go a long way in preventing the loss of vision.  Smart contact lens enables the real-time monitoring without paying regular visit to the clinic for eye check-up.

With these pervasive scientific advancements, let us reimagine our eye examination routine in the digitally transformed world. Jack feels some terrible pain in his left eye and decides to take self-guided vision screening test using his smartphone application. Jack screens his eye using the camera and attends to different levels of self-test the app recommends him to do. After analyzing the picture and test results, the app diagnosed Alan with certain possibility of low vision. Jack then looks up at the doctor’s directory within the app that shows the nearest doctors with star ratings and the ones recommended by friends and insurance companies. Jack carefully chooses a doctor from the listed recommendation and fixes an appointment online with that doctor. As soon as the appointment is completed, a reminder is set in Jack’s smartphone and a message is sent to his doctor on the appointment and the doctor’s calendar is adjusted automatically for attending to Jack.

On the scheduled date, app examines the GPS location of Jack and calculates the distance and duration required based on different driving options to reach the doctor’s office. After the analysis, app automatically adjusts the reminder so that Jack reaches on time. On the appropriate time, Jack is alerted on his visit to eye doctor and the GPS system directs him to the doctor’s office choosing the best route alternative. On entering the clinic, Jack is facially recognized and greeted by a robot based on his profile and directs him to his seat. Then another robot with more advanced examining capability visits Jack wading through the hospital pathways and crossing lot of people on the way. On reaching Jack, the robot asks questions and records the input from Jack in writing. Jack informs about the self-test and the test results are shared by his smartphone app to the robot. The robot then records all these information in the Jack’s health profile. Robot then conducts advanced eye test to examine further just like the preliminary tests conducted by attendants in our current times. All these information are simultaneously stored in the Jack’s profile.

Jack is then called on meet Dr.Alan over the digital notice board. Alan wearing advanced glasses something like Google glasses runs through the Jack’s profile on his glass screen. Alan re-examines Jack for diagnosis as he scans his eyes through his glasses and after assessing the condition, glasses shows a list of recommended treatment options on his screen.  Alan then utters medicine names with dosage as the speech-to-text engine on his smart glasses converts the prescription in text format along with recommendation to wear glasses with prescribed power. The printer which is connected to the smart glasses prints out the prescription for Alan while all these information are simultaneously recorded on ubiquitous Jack’s health profile that can be accessed anytime and anywhere. All these interactions are transmitted live from Alan’s smart glasses to the screen in the next room as part of teaching classes for his interns.

Doctor’s prescriptions are stored on Jack’s smartphone app which alerts Jack for taking medication when it is due. App then sends this medicine list to the pharmacy along with doctor's prescription as Jack makes payment through his digital wallet. Pharmacy then delivers medicine at Jack’s doorsteps at the agreed time. Meanwhile, Jack uses virtual optical assistant on his app to try on different frames at the online lens store. Jack then chooses the frame that fits him well with specified dimensions and provides required input on Lens options. Once the order is completed, the online store delivers the glasses on the scheduled date. Jack then recommends this online store for his friends and community circle on the social media.   

Mobile Apps are transforming into effective consulting, marketing and communication channel from ubiquitous information search.  Patients feel comfortable that the doctors are just at their hands reach on the smartphones. With IBM’s powerful analytical machine Watson being open for public from next year, we could only see its tremendous impact with numerous applications wrapped around this analytical engine. These apps could help patients and doctors to understand the eye disorders and access relevant medical literature and viable treatment options under their nose. The technology could also streamline the eye clinic operations to a greater extent by automating processes, optimizing and utilizing resources effectively, reducing the time spent on waiting and improving quality of consultation for its patients.

Periodic eye care checking is also expected to detect the chronic medical conditions in advance which could be addressed with appropriate intervention and bring down the healthcare costs. With technology developments, we could foresee a future wherein the functioning of eye will be monitored continuously, predicted for occurrence of eye disorders and other chronic conditions and presented with real-time medical attention to avoid costly emergency visits and surgeries. Digital transformation is empowering consumers to take precautions by quipping them with tools to conduct periodic eye examinations at their home, notify doctors on their problem, diagnose problems early, prevent disorders and seek medical intervention on real-time need basis.

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