DIY refractions: Disruptive innovation that affects science, people and the economySeptember 13, 2012
By Dominick M. Maino, O.D., and Geoffrey G. Goodfellow, O.D.
Are refracting opticians the only potential threat to the delivery of optometric refractive care? Probably not. New technology like the NETRA device may also become significant in how refractive care is delivered to our patients.
I (Dr. Maino) met Vitor Pamplona at an American Academy of Optometry meeting where his poster was just down the way from mine. We chatted a bit, and then I tried a self-refraction using the NETRA device connected to a cell phone. Did it work for me? I’ll discuss that a bit later.
In a recent phone interview (and while reviewing his website) I learned that Dr. Pamplona finished his Ph.D. in computer science. He is also the chief technology officer for EyeNetra Inc. and is currently working on the next generation of NETRA (NETRA-G) (http://eyenetra.com).
He and his team are also developing a new health care app called Test2Connect. This is a new cloud-based system that connects patients and providers of services and products through a mobile app.
His website states that 2.4 billion people worldwide who need glasses do not have them due to a lack of available eye and vision care.
Even though eyeglasses can cost as little as $0.75 a pair, there are no cost-effective, high-quality, or remote refractive tools available to meet the demand.
According to Dr. Pamplona, current diagnostic tools are expensive, bulky, require significant training, and do not allow for data digitization or access to appropriate products/services from remote locations.
Should this be considered a disruptive innovation that affects science, our patients and the economy?
There is little doubt that this technology can be a significant game-changer within the health care arena!
Can you image your patients going into a mall, downloading the refractive app, renting the NETRA device, connecting it to their cell phone and generating their own prescription at little to no cost!
They could then go over to the nearby optical shop that has a 3-D scanner that takes precise facial measurements.
In few minutes, they would then pick up their new glasses that were just made by the shop’s 3-D printer (more about 3-D printers in another column).
During our phone conversation, Dr. Pamplona predicted that eventually this device (3-D printers) would not only be available at the mall but in patients’ homes as well.
Don’t panic just yet. Well maybe you should, just a little.
Dr. Pamplona told me that one possible business model would be based on Netflix. You would order a pair of lenses in several different frames, keep the ones you want, and return the rest!
He believes ophthalmologists do not want to do refractive care, but this could help them provide this patient service.
He noted the average optometrist could be at financial risk because of NETRA.
However, the optometrist could use this the same way an auto-refractor is currently being used in the office. In this scenario it would be under the doctor’s domain at all times.
So far, NETRA has only studied its use with its targeted audience of normal adults 22 to 60 years old.
Once appropriate protocols are established (more than likely in a game-like format), testing with children may begin.
NETRA has not been used with patients with special needs, amblyopes/strabismics or the geriatric population.
The newer model is a binocular version that takes into consideration the patient’s accommodation and vergence demands.
None of these devices is currently commercially available.
The researchers and business people at EyeNetra do not have a game plan to win over eye care professionals to this device since this technology (and time) will make the decision for the health care professionals involved.
They believe this will allow doctors to become patient advisers and teachers and not “data collectors.”
Dr. Pamplona even believes that within the next five years or so an optical coherence tomography-like device will be available within the home that will easily monitor optic nerve changes over time.
He suggests that similar medical devices will be used within the home with the end result being decreased visits to the physician’s office and laboratory.
Are you ready for the logical outcomes of devices like this? I predict what will happen is that after all the easy 2.00 D myopes are given their glasses, the hundreds of thousands of patients who need the doctor and not just the technology will make refractive care a true non-surgical specialty.
As you know, this speciality is one in which we as optometrists already excel.
This will allow us to be able to charge for not only the science involved in refractive care, but also for the art at an appropriate fiscal level.
By the way, since I have an Array Multifocal intraocular lens, NETRA did not accurately determine my refraction.
The future is still bright!
Dr. Maino is a professor of pediatrics and binocluar vision at the Illinois College of Optometry (ICO) and a recipient of the Leonardo da Vinci Award of Excellence in Medicine. He can be contacted at email@example.com. Dr. Goodfellow is an associate professor of optometry at ICO and the college’s assistant dean for curriculum and assessment. He can be contacted at firstname.lastname@example.org.