Scott A. Edmonds, OD, FAAO, focuses his blog on the role of the optometrist in health care reform – moving from primary eye care to primary health care. He is the chief medical officer of MARCH Vision Care, the co-director of the Low Vision/Contact Lens Service at Wills Eye Institute in Philadelphia and a member of the Primary Care Optometry News Editorial Board. 

Disclosure: Edmonds is a consultant for March Vision.

Electronic integration is here

Growing up in the middle of the last century, I was fascinated by the discovery and invention of new things that changed the world. As a young lad working in my dad’s optometry office, we often ate lunch at the Edison Inn. This little hotel was reported to be the first building in the world to be illuminated by Thomas Edison’s electric light. I often wondered what it would have been like to witness the first light bulb. More to the point of this blog, what would it have been like to be the first person to hear the electric clicks of a radio or a voice on the first telephone? I was sure that it would have been obvious to every person at that time that these little inventions would change the world. 

Well, I was around for the beginning of the computer revolution. I struggled with writing computer programs in college that had to be converted to punch cards and delivered to the campus mainframe computer to be run during the wee hours of the night. I was unimpressed.

I struggled with the decision to buy my first home computer from Radio Shack. Whatever would we do with it? I had an early AOL e-mail address, (actually I still have the same one) and registered my domain name and wrote my first website on Microsoft’s FrontPage version 1.0. I was an early adaptor but still did not realize the way the Internet would change our world.

In spite of the lessons that I should have learned about the speed at which technology is advancing, I was not the first kid on the block to install electric health records. I did get in on the stimulus program but I was not convinced that it would change the way we practice optometry. As recently as April 23, 2014, I expressed my frustration with meaningful use with no means to transfer our ophthalmic data to another provider.

At Optometry’s Meeting in June, the light bulb of Thomas Edison finally blinked on, and I could see a glimmer of light being shed on the connectivity that will dramatically change the way we practice optometry. Once again, it always pays to attend Optometry’s Meeting! In the exhibit hall, I learned about several communication platforms that have the potential to deliver clinical data from the desktop of a private optometric practice to the electronic health record of a primary care physician. Again, this was theoretical, but the links in the communication chain were being established, and from there it would be a race by several key players to have a working model.

The fundamental elements will be ophthalmic communities that include optometrists and ophthalmologists that are organized as ophthalmic health systems and linked to a health information exchange (HIE). These exchanges are organized by state or region and are directly linked to physicians and hospitals that are often arranged as comprehensive health systems or managed care organizations.

This month, the first statewide HIE has electronically integrated with an ophthalmic health system to test the exchange of protected health information. The state is Kentucky, of course. They are organized and progressive and always a bellwether for optometry.

Like the first light, the first phone call, the first email, this is the event that will change the profession. And this time, you are there. How will you plan? How will you change? Will you be an early adaptor or will you be dragged along at the back of the pack? Will this catapult your practice into primary health care or will it be the event that closes the door on your practice? The decision is yours.