The latest on AI and optometry

From chatbots to diagnostics, artificial intelligence (AI) is changing the face of health care, including optometry.  

Three members of the AOA’s Quality Improvement and Data Committee, which oversees and provides recommendations to the Board of Trustees on data collection efforts needed within optometry, share their answers to the questions many optometrists are asking. 

How do you think AI will impact health care overall and specifically eye care? 

Zachary McCarty, O.D.: Some optometrists fret that AI will seek to replace them. Rather, AI will become an augmentative assistant in both the administrative side and the clinical side of the practice. As an assistant, AI will (and already does) aid in diagnosing patients and streamlining some of the practice operations. In a time of declining reimbursements and increasing physician retirements, AI should offer the promise of being able to do more with less resources at our disposal. 

Easy Anyama, O.D.: AI primarily will help deliver the initial promise of EHRs, which were originally thought to save providers time and improve information transfer. After that, l can see it helping to reveal subtle health signs that might otherwise be missed, leading to earlier and more accurate diagnoses. In eye care specifically, I think it will allow optometry to function at its best in terms of leveraging the large and diverse types of data involved in eye and vision care.  

Lauren White, O.D.: For the near future, it will likely be net neutral as everyone is finding their footing in the space. After that, the potential impacts are vast. It has the potential to augment the tools we already have and to create new tools to really change how we address fundamental problems in health care. It also has the potential to perpetuate problems with inequities and biases that are built into health care as a whole. The potential combined with the uncertainty is what makes it such an interesting space to watch. 

What do you think is the greatest promise in AI in eye care? 

Dr. Anyama: The greatest promise that I can say confidently would be to keep doctors practicing at or near their best consistently. Additionally, to free up much of the practice management and marketing woes. 

Dr. White: I don't want to generalize for all AI, but good AI tools will make the jobs of eye care professionals easier, more accurate and more personalized and the care patients receive better, more accessible and more understandable. 

Dr. McCarty: Ultimately, many of the gains of AI in health care will occur on the administrative side of the practice. AI will help in selecting the correct codes for billing, creating efficient, optimized schedules, ordering and tracking supplies, writing marketing emails and social media posts, and chatting with a patient to schedule an appointment, order contact lenses or triage an eye question. Within the clinic, AI will help in suggesting diagnoses for the patient along with appropriate treatment. EHRs will learn practitioner’s treatment patterns and offer suggestions when a diagnosis is made. AI scribes will assist in the clinical documentation. 

What is the biggest threat with regard to AI and eye care? 

Dr. White: The biggest threat is that we don't own this space, and other adjacent professionals are perceived as more proficient or experts in this area. Losing a seat at this table in this conversation would be devastating to the future of the profession. After that, the next biggest threat is losing human autonomy and reasoning. As AI tools improve, it will be natural for users to get used to them being accurate. Ensuring doctors are thinking and making decisions independently is going to be what prevents over-reliance and over-trust over any future technology, AI included. 

Dr. McCarty: The biggest threat to eye care is not understanding AI. Failure to grasp fundamentals of AI may lead to a false sense of infallibility of the system. AI can suffer from “hallucinations.” This occurs when AI seemingly “makes up” an answer with no credible underlying basis or material. Optometrists must be aware of the limitations and not accept every answer as fact, especially if the answer seems counter to training and experience. 

Dr. Anyama: Careless implementation of the technology in ways that might replace the careful insights and empathy that only a human doctor can offer, reducing the quality of care. 

What do you think doctors should be doing to prepare for the impact of AI on health care? 

Dr. McCarty: Become aware of places where AI exists in current practice (every practice is using AI today whether they realize it or not, especially in diagnostic equipment). Follow trends of how tech companies are using AI in our daily lives. This same AI we use in our phones and on web searches will begin to creep into our practices. Don’t be afraid to test AI to understand how it works (just be sure to avoid entering any protected patient information in an AI system that isn’t deemed HIPAA compliant). Start looking at your practice and think of ways AI could help. Can it be used to write that next social media post or marketing email? Would AI assisting in billing and coding help your practice? What about an AI-guided inventory system? Start learning if the current practice management software or EHR is planning to incorporate AI into its system. If so, how could this help your practice? 

Dr. Anyama: Doctors should learn to work alongside AI, adjust their workflows and continue honing the skills that make their patient care truly personal. 

Dr. White: At this point, just keep a finger on the pulse of AI surrounding eye care (and health care). Be open to the concept and have an idea of how to evaluate it. Lastly, when you are ready to investigate and invest in AI, find an AI tool that is a (potential) solution for the problems in your office ... don't find AI solutions in search of a problem.