How the updated position statement can help guide telemedicine in optometry

Excerpted from page 14 of the January/February 2023 edition of AOA Focus.

As technological advancements continually evolve telemedicine as a patient care tool, the AOA similarly keeps its guiding principles aligned in advocating for high-quality, high-value applications within optometry.

In October 2022, the AOA Telehealth Council presented—and the AOA Board of Trustees approved—an updated AOA Position Statement Regarding Telemedicine in Optometry, building upon a year’s worth of feedback gleaned from a joint AOA-industry listening session, known as the Patient Experience Summit, in 2021. This position statement affirms support for not only the appropriate use of telemedicine that promotes access to “high-value, high-quality eye, health and vision care” but also fair and equitable reimbursement for such services and efforts to “ensure health equity in telehealth.”

Additionally, the 2022 statement reflects several updates and changes, including:

• Updated criteria for ensuring high-quality telemedicine in optometry
• Effects on the doctor-patient relationship and the use of direct-to-patient technologies
• Wording regarding the appropriate use of augmented or artificial intelligence (AI)
• Information on use cases related to telemedicine in optometry

AOA Focus asked experts from the AOA Telehealth Council, Christopher Quinn, O.D., and Jerry Neidigh, O.D., to provide a high-level overview of how this refreshed position statement can help guide telemedicine in optometry.

What should guide our use of telemedicine in optometry?

Dr. Neidigh: No matter the setting, whether through telemedicine in optometry or in-person care, our patients’ eye and vision health needs to remain our greatest priority. This can only be accomplished by ensuring a doctor of optometry is at the center of patient care. As primary eye care providers, we can and should use telemedicine responsibly and when appropriate. I encourage my colleagues to read and use the AOA’s position statement on telemedicine in optometry and take to heart the information it contains to make the right decisions for your patients.

Dr. Quinn: We should use telemedicine the same way we use other tools in the clinical

practice of optometry. If we can make care more accessible to patients while maintaining the high standard of care we provide with in-person care, then patients will benefit. The doctor-patient relationship remains sacrosanct, and it is always incumbent on the doctor to assure that the care they deliver remotely or otherwise meets the highest quality standards.

What should guide our use of telemedicine technologies?

Dr. Quinn: The ultimate goal is to provide the patient with the best care possible. This position statement establishes some important guardrails with regard to patient consent, compliance with laws and regulations, and ultimately with the duty of doctors of optometry to make sure that the care they deliver meets the existing standard of care. Doctors must be aware that attempts to remotely deconstruct a comprehensive eye exam into components delivered separately for the sole purpose of deriving a prescription for glasses or contacts would likely not meet existing regulations or the standard of care.

How do we evaluate telemedicine in optometric products and tools?

Dr. Neidigh: The main question to ask is: Does the telemedicine platform allow you to provide at least the equivalent care you would provide through an in-person encounter? Does it allow you to perform and document all you would during an in-person encounter? Anything less than equivalent care is putting the patient at risk.”

Dr. Quinn: Doctors must always evaluate clinical tools for effectiveness and quality. They should do appropriate due diligence by reviewing scientific evidence to evaluate products and have a good understanding of how these products will improve the quality of care they provide before investing in new clinical tools.