A PRACTICAL GUIDE TO TELEMEDICINE IN EYECARE by Dr. Harvey A. Fishman, MD PhD

  • Home
  • /
  • A PRACTICAL GUIDE TO TELEMEDICINE IN EYECARE by Dr. Harvey A. Fishman, MD PhD

A PRACTICAL GUIDE TO TELEMEDICINE IN EYECARE by Dr. Harvey A. Fishman, MD PhD

Click here for the e-book!

Tele-ophthalmology and telemedicine have been a passion of mine for the past 25 years. As a medical student at Stanford in the 90’s, I was one of the first beta users of the then famous palm pilot app, ePoctrates.

At Stanford Medical School, I tried using the palm pilot program called PatientKeeper (now a full service EMR) for tracking my patients. Too clunky. When I was doing my internship, (yup…20 years ago!), I tried to modernize resident sign-out with the Palm Treo.  Total failure.

Shortly after the release of the first iPhone (yes, there was a time that it didn’t exist), I co-founded a company called MobileDx, with an app called EyeSnapi for patients to send in pictures of their eyes with questions.  (Check out the 2001 forbes.com interview I did on EyeSnapi.) It worked well, but “way” ahead of its time. Failed again.

Then came AppVisit, my second telemedicine startup. It was well-funded and a serious attempt at tele-ophthalmology with a more robust platform. AppVisit was a really nice app for asynchronous e-visits. Unfortunately, it was text and photos only, no video and still too early in the patient adoption cycle. Closed down!

It has been said that the most successful entrepreneurs have found their success through multiple failures. Well, if true, with all of my initial telemedicine startup failures, this would make me one of the most successful telemedicine entrepreneurs in world. As rightly said by Henry Ford, “Failure is simply the opportunity to begin again, this time more intelligently.”

Let’s hope so! That now brings me to 2017 when I helped co-found EyeCareLive, the first fully functional, video based tele-ophthalmology and tele-optometry platform. This is my latest startup, and so far, it is the real deal.

Here are some excerpts from the e-book that I wrote for EyeCareLive.

Dry Eye

“Patients with dry eye require continuing treatment to avoid discomfort and worsening conditions – ongoing checkups with a doctor over the EyecareLive app make treatment easier and more convenient. Doctors will be able to better monitor a patient’s condition and any abnormal inflammation. Because treatment for dry eye has many different iterations, direct patient feedback over the EyecareLive via periodic SPEED Tests is invaluable to facilitate management of the condition. Also, doctors will have better flexibility and timeliness in treatment.”

Improved Patient History

“To say that the biology of a human being’s health is complex is an obvious understatement. The amount of information that doctors must now absorb in a patient’s health record is massive and comes from a variety of sources: new medical tests and knowledge, commercial genetic testing, wearable devices (Apple watches and FitBits), health websites, and government mandates to name just a few. Years ago, the doctor could spend 45 minutes to an hour to address a patient’s health and personal history.

“Today, the market forces of medicine and industry involvement has reduced the 45-minute doctor visit to just a few minutes of brisk face-to-face time. While the older, time-intensive medical visit was excellent for teasing out issues during the visit, it still suffered from a lack of continuity in care afterwards.”

“Moreover, patients at the time of the visit often forget detailed health information provided by their doctors and can be easily distracted from giving the doctor the relevant information. Sometimes patients do not feel comfortable with giving the information needed when they are physically in the office. A patient’s recollection of their symptoms can often change from the time of the occurrence to the time of their office visit. Physical visits can also be stressful and rushed, which makes providing and/or getting an accurate history more challenging.”

“Telemedicine visits allow patients to communicate with the most accurate and current information directly to the doctor. The physical exam is crucial, every experienced physician knows that the physical exam only provides a small component of making a diagnosis; the personal history of the patient is actually more key.”

“Telemedicine makes every step of establishing and fine tuning a patient’s history easier and more reliable.”

Better Overall Care

” Telemedicine allows doctors to better meet all of their patients’ needs in ways that connect to modern life.

“Studies show that people from all walks of life and all ages are now spending multiple hours per day on their mobile devices. These connections reach almost every facet of life – from managing our daily work routines to scheduling dinner with friends. So, why not bring that direct connection into the eyecare experience?”

“Patients are becoming more and more comfortable with digital forms of medical communications (and, in many cases, prefer it). Prescription refill requests, quick questions, test results, and requests for chart notes are already commonly delivered electronically from doctors’ offices, pharmacies, and insurance companies. ”

” Telemedicine will expand your clinic’s abilities. Doctors need every possible method at their disposal to adequately address the subtle nuances of human health. The patient’s experience should not be bound by the tight time constraints of modern medical office visits. Instead, the visit can now start before the patient reaches the brick-and-mortar location and can continue afterwards for further care.”

” Benefits to the patient extend beyond doctors getting the best history possible for evaluation. Patient
care via telemedicine can continue after the office visit. Doctors can easily and quickly make treatment iterations using telemedicine. This is especially useful in diseases like dry eye where symptoms (not physical findings) often drive changes in treatment. Using telemedicine can shorten the cycle of finding the most helpful treatment from months to weeks.”

 

Leave a Reply

This site uses Akismet to reduce spam. Learn how your comment data is processed.