States Consider Blocking Do-It-Yourself Eye Exam Telemedicine

Published May 17, 2016

Georgia lawmakers have approved legislation that would ban an innovative vision test allowing patients to use their smartphones, laptops, and an Internet connection to obtain a prescription for contact lenses or glasses.

House Bill 775 requires patients to obtain an in-person assessment by an optometrist or ophthalmologist in order to receive a prescription. The legislation bans a form of telemedicine offered firms such as by Opternative allowing patients to obtain a prescription for corrective lenses within 24 hours of self-administering a 25-minute eye exam.

Gov. Nathan Deal (R) had not signed the bill, which will become law if Deal takes no action by early May, by press time. The state legislatures of Indiana, NebraskaOklahoma, and South Carolina, are considering similar laws, former U.S. Speaker of the House Newt Gingrich wrote in a March 30 op-ed for USA Today.

Opternative’s technology uses a smartphone as a remote control and a computer screen as an eye chart, testing users’ vision by guiding them to the distance from their monitors at which they can no longer see clearly. An optometrist licensed in the same state as the patient reviews the results and provides a prescription for refractive correction or, if necessary, a referral for an in-person exam with an optometrist or ophthalmologist.

Founded in 2012, Opternative has signed up 40,000 patients in 33 states and aims to expand its network of providers to 46 states by the end of 2016, MobiHealthNews reported in February.

Meeting Demand

Opternative CEO Aaron Dallek says his service extends the reach of optometrists’ skills to underserved populations.

“The availability of this service over the Internet leverages the available capacity of optometrists and helps fill unmet needs,” Dallek said. “With a growing population of patients and an aging population of optometrists, the gap between eye care needs and resources will only grow bigger. Access to health care will only get worse as the disparity between patient population and doctors increases.”

Dallek says digital eye care technology meets a patient demand for greater convenience and lower prices.

“There are 67 million U.S. adults who have not had an eye exam within the last two years, due to convenience and cost issues,” Dallek said. “Telehealth technology will make eye exams more convenient and affordable for those without access to vision care.”

Access for Rural Patients

Dallek says patients living in rural areas or in urban communities with few traditional providers stand to gain the most from telehealth eye technology.

“There is clearly a need for additional eye care resources in many rural areas and even some underserved urban areas because providers don’t choose to practice in those areas,” Dallek said.

“Optometrists are not readily available in all areas of the country, because they tend to be concentrated in big urban areas, leaving children, the working poor, the elderly, and veterans in rural America without accessible and affordable vision care services.”

Digital eye exams help patients conveniently access eye care at affordable prices regardless of where they reside, Dallek says.

“Opternative technology makes doctors available to you no matter where you live,” Dallek said.

“We are making eye-care services more accessible, affordable, and convenient for patients.”  

Disruptive Change

Gary Capistrant, chief policy officer at the American Telemedicine Association, says special interests slow the spread of telehealth technology in some states.

“Unfortunately, this seems to be another case of professionals who are unable to accept disruptive change,” Capistrant said. “Patients should have choices as long as quality is there and safeguards are in place to protect patients.”

Capistrant says the U.S. Federal Trade Commission assesses whether decisions by state licensing boards promote competition, but it cannot stop legislators from protecting special interests.

“The Federal Trade Commission does evaluate the anticompetitive nature when state licensing boards take actions to limit the use of telehealth technologies,” Capistrant said. “However, state legislators, who may be lobbied by professional groups such as optometrists, are not regulated parties, and their actions really only create barriers for consumers.”

Christina Thielst ([email protected]) writes from Santa Barbara, California.

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