Millions of Americans have uncorrected vision impairment, costing billions and increasing other health risks. We have everything we need to help them – if we can just get them into the eye care system
The news that Apple is forming its own network of health clinics to serve its employees set off a frenzy of speculation about how the world’s most valuable company might disrupt the archaic healthcare system.
The excitement is certainly justified. Apple has a sterling track record of revolutionizing the ways we use computers, mobile devices and music. It has the requisite ingenuity and technical skill to develop technology platforms that fundamentally improve the ways we access the health system.
That last part is critical. Because the key to improving the health of Americans has almost nothing to do with the quality of treatment. It’s about access, or the lack of it. Fixing it requires improving patients’ access to the health system and doctors’ access to patients. Sometimes, of course, access is directly tied to affordability. But Apple won’t be trying to solve that problem. Its focus on employees means it’s trying to create a better system for those who can afford basic healthcare.
And that means making healthcare more convenient and efficient. It means freeing doctors from the physical and temporal constraints that discourage their patients from engaging with providers until their health has already deteriorated.
The cost of that inconvenience is staggering. Consider eye care. According to recent estimates, up to 16 million Americans have uncorrected vision impairment. For some, that can lead to debilitating problems down the road. It can also have the immediate effect of decreasing quality of life, reducing productivity, increasing the risk of injury and depression, amplifying the symptoms of chronic disease and even slowing cognitive development among children.
A study carried out a few years ago by the organization Prevent Blindness estimated the indirect costs of vision impairment among Americans to be $139 billion, while direct costs for the under-40 population alone was $14.5 billion. Catching small problems early can create huge savings for our economy.
We have the resources to fix this problem. Optometrists have the expertise and skills to not only precisely correct vision impairment but also to diagnose and address glaucoma, cataracts, strabismus and the other common eye-health problems. The challenge is simply getting people into the system with a simple eye exam. To do that, we have to help eye doctors scale their practices to engage with busy patients who, for better or worse, aren’t willing to schedule a visit to the optometrist.
Breaking down the barriers
Issues of access across much of the healthcare system revolve around cost. But that’s not the case with eye exams, which are easily affordable for the vast majority of Americans. The problem is that Americans choose not to visit optometrists because they don’t have any eye problems that they know of. For someone who thinks their eyes are fine, taking two hours out of their day to see the optometrist can seem like a poor use of their already insufficient free time.
The struggle to engage patients in preventative care is by no means unique to eye care. And it’s precisely where we need innovative solutions. Solutions that don’t disrupt doctors, but help them do their jobs – simply by helping them engage with patients before calamity strikes. Solutions that help screen patients and bring them into the system when their diseases and disorders can still be easily treated.
Making preventative care easier, faster and less expensive for patients has to be among the most pressing priorities for any company that aspires to disrupt the health system.
Thanks largely to companies like Apple and Amazon, we have achieved new levels of convenience in many areas of life, whether it’s shopping, banking or listening to music. Many activities that once required transit time and waiting around are being eliminated our lives.
I don’t know what Apple health clinics will look like, but I’d be willing to bet the doctors who staff them will use computers and other devices for many basic monitoring and screening activities. That will minimize disruption to employees’ daily routines while also allowing the physicians to spot health problems early, and then treat them before they become more serious.
Plenty of health clinics are already integrating this technology into their practices, largely through telemedicine. They need to accelerate this shift to keep up with the disruptors knocking at their door. In the case of optometry, technology is not a threat to established practices but rather a solution to a crippling bottleneck. It can help answer the crucial question of how we get all Americans into the system.
It also allows optometrists to outsource time-consuming screenings and basic exams to focus on the treatment, procedures and advice that utilizes the full depth of their knowledge and expertise. By empowering patients to take more active roles in monitoring their own eye health through computers and mobile devices, we can provide more services at the first contact, and let clinicians focus on making patients better when there is a problem.
Across the medical field, we need to develop technology to help doctors meet patients where they are. Rather than demanding a couple hours for an eye exam in the middle of the day, we should be asking patients to spend 15 minutes with a device they already use, at any time of day.
The benefits of engaging people who might otherwise remain outside the system are immense. Diagnosing eye impairments or disease early can save individuals thousands of dollars, not to mention their eyesight. And it can save billions for our economy and our overburdened health system.
I know Apple’s health initiative isn’t about fixing our health system. But it could be about using technology to help Apple employees get more engaged with their health. And that’s exactly where I believe we need to go.
Dr. Steven Lee is the Co-Founder and Chief Scientific Officer at Opternative, an online refractive eye exam that provides a patient with a valid prescription.. Before starting Opternative, he was previously in clinical practice from 2007-2013. During that time, he focused on the areas of difficult contact lens fittings, ocular disease treatment, and dry eye management.
Image credit: iPhonehacks