We have arrived at the most significant crossroads in ophthalmology that any of us can ever remember. The very future of patient care is at stake, as everything from the business models of the industry to the roles and responsibilities of its eye care professionals sit in a state of flux. Radical and rapid advances in technology and therapies are changing everything. I believe the time has come to confront these challenges and forge a shared, practical vision for the future. What will good look like in 2035?
The urgency of this imperative has prompted the CC team – led by my colleague and Head of Ophthalmology Luis Diaz-Santana – to embark on a program of activity to garner opinions and begin to shape a consensus among leading ophthalmology stakeholders. More of our plans will emerge as the year unfolds, but for now let me set the scene from the CC perspective. The perspective, that is, of a company working constantly with clients to help close the gap between extraordinary technological possibilities and real-world commercial adoption. We’ve got skin in the game for sure.
One thing we’re certainly seeing is plenty of unease. All companies operating in ophthalmology are fully aware of the ceaseless acceleration of technology innovation and the promise it offers. But many are being left with their wheels spinning as they ask themselves: ‘we know we need to do something – but what?’ Such a mindset is entirely understandable. Advances in device technologies and ocular therapies are disrupting every aspect of ophthalmology. The resulting changes will necessitate new patterns of patient engagement as well as new tools, equipment, and techniques – which in turn will likely drive changes in the job descriptions and business models for all levels of eye care professionals.
So how to make sense of it all? Our experience here at CC spans a wide range of ocular device and strategy programs – one of the reasons we are searching for a more cohesive, unified vision. Without a more transparent view for a new ideal for patient care, we risk developing solutions out of phase with the eventual reality. Crucially, this could delay better vision and better lives for millions of people. If we look past the short-term pressures of the market and the expectations formed by existing business models, I believe we can envision a different and better future for ophthalmology.
Priority one: the patient experience
Patients currently face numerous areas of friction that impede the maintenance of their eyesight and bring points of potential failure – leading to unnecessary visual degradation and blindness. The capacity to confront process complexity in any form varies from person to person. For example, one in five adults has some form of dyslexia which can dramatically affect the time needed for processing written information and instructions.
For others, the burden of travel distance, appointment frequency/cadence and costs can be intimidating or unsustainable. When you add these sorts of challenges onto all the pressures of already hectic lives, you can see that the current situation brings many challenges to the typical eye care patient. It’s obvious that lowering the threshold for proper eye care is not just possible – it is imperative.
One of the big problems with eye care – as is true for all aspects of human health – is that changes, in this case degradation of eye performance, can be very slow and imperceptible. With tiny day-by-day changes, it can be hard to know for sure if your eyesight is worse than last month, or last year. Even when someone does notice a small or intermittent concern and decides to take action, it can be hard to get an appointment that is not months away.
This creates another disconnect between the impulse to do something and a possible solution. If you are unsure there even is a problem it can be hard to justify waiting all that time, traveling to and from the clinic only to possibly find out nothing is wrong. Fixing this eye care pathway friction is within the technology capabilities that exist today, but that solution would require rethinking existing business models, reimbursement systems, incentives and so on.
Priority two: the practice of eyecare
Another set of stakeholders, ophthalmologists, are being introduced to potential new therapies that may completely transform what they do every day. As new technologies become commonplace, many of the tasks that ophthalmologists currently carry out in clinic may end up in the realm of optometrists and opticians, nurse practitioners and technicians. This would free up time for ophthalmologists to concentrate on their surgical work in the OR.
This could be good for the patients of course, because it could increase access to the new range of surgical interventions which can make their life better. But will doctors welcome these changes? Proper delivery of some gene therapies, for instance, will likely require the use of digitally assisted surgical tools (robotics), and/or a level of surgical training that is not currently the norm. When the requirements of the tasks of eye surgery change, so too will the required training and capabilities of the surgeons.
The overriding priority: a vision
So where does this leave us? Looking forward, the tools, the healthcare systems, the education of surgeons and other HCPs – as well as patient expectations – are all likely to be changing in concert with one another. Let’s take as an example two areas of human centered design. Both are of particular interest to us at CC and many of our clients. They are:
- Eliminating the unnecessary friction in the diagnostic process and eye care maintenance for patients – by simplifying the experience both at home and in the clinic in as many ways as possible
- Helping develop a common vision for the Integrated Digital (Ophthalmology) Operating Room (IDOR) of the future. Digital surgery tools need to be designed or redesigned so that all device brands/manufacturers share communication platforms
Connecting these two areas are the continual and shifting practice of the various eye care professionals (ECPs):
- As it becomes easier to offer individualized, tailored solutions to complex eye conditions through new pharmaceutical therapies and delivery techniques, it is likely that the need for time in the OR will increase
- Additionally, as ophthalmologists’ time becomes more concentrated in the OR, a greater number of routine interventions will need to be handed over to other ECPs
As I said earlier, this blog is just the start. A scene setter. My CC colleagues and I will be digging deeper into these areas of interest over the next months in future articles. We’re determined to start a useful conversation about the future of eyecare. We’ll be reaching out to as many industry stakeholders as possible to invite insights and opinions – so do please drop me a line with your thoughts. It’ll be great to hear from you.