The Connecticut legislature is currently considering legislation HB 6012 that would radically restrict emerging telehealth technologies and would set a dangerous precedent by legislating standards of care. Physicians go through rigorous schooling, training, licensing, and certification, and ultimately, we trust doctors to make the best treatment decisions for their patients. In the case of HB 6012, optometrists, who are not medical doctors, are trying to use legislation to dictate how doctors treat their patients.
The issue behind HB 6012 is an emerging telehealth technology that solves a simple problem: 79 percent of the time a contact lens user visits an optometrist to renew a prescription, they leave with the same prescription they arrived with. These trips, and the accompanying examinations, are costly and time-consuming, causing many patients to wear their lenses beyond the recommended time frame. Over-wearing contact lenses is one of the leading cause of eye infections and other eye health issues for contact lens wearers.
But with today’s mobile technology, patients have the chance to refill their contact lens prescriptions in a more efficient and cost-effective way. As an ocular surgeon and professor of ophthalmology, I can attest to the power of telemedicine. We use telemedicine to communicate with colleagues regarding serious ocular trauma cases and triage, often determining who needs to go to the operating room immediately without seeing the patient in person.
Mobile app platforms such as Simple Contacts use that same technology to administer a basic vision test and anterior segment assessment. The test is recorded and reviewed by a Connecticut licensed ophthalmologist who can renew the patient’s existing contact lens prescription. The physician cannot change or modify a patient’s prescription, and cannot issue a patient’s very first contact lens prescription.
This is not a replacement for a full eye exam, instead, it is a way for physicians to treat low-risk, asymptomatic patients in an efficient, safe way. And no physician would ever stake their reputation, license, or the safety of the patient if they did not believe that the technology worked. These are the types of decisions we trust physicians to make every day.
However, like other entrenched industries facing new competition, optometrists are using scare tactics and misinformation to vilify their competitors and have appealed to the legislature to intervene. The result, HB 6012 would effectively shut these technologies out of Connecticut, denying patients the choice on how they refill their contact lens prescriptions and taking treatment decisions out of the hands of physicians and putting it in the hands of a special interest group.
Opponents of the technology have done much to muddy the waters, claiming that automated kiosks or a smartphone app are issuing prescriptions and that patients have been harmed through using our technology.
Both could not be further from the truth. Every patient in Connecticut that uses Simple Contacts is reviewed by a Connecticut licensed ophthalmologist and to date, not a single one of the thousands of our customers have reported any issues.
HB 6012 is nothing short of protectionism dressed up as patient protection.
In addition to not allowing physicians to use technology platforms, the bill also dictates that patients must receive a comprehensive, in-person eye exam every year. This requirement is not grounded in any current medical guidelines, but is instead driven by the economic interests of a special interest group.
The American Academy of Ophthalmology currently recommends comprehensive, in-person eye health exams for healthy adults that do not have risk factors for eye disease every 5-10 years for patients under 40; 2-4 years for patients 40-54; 1-3 years for patients 55-64 years and 1-2 years for patients 65 years and older. Requiring healthy patients to receive an in-person exam when a more affordable, medically sound alternative is available is unnecessary, and particularly burdensome for patients that cannot afford the higher cost of an in-person exam.
Ensuring patient safety is of the utmost importance, and that is why everyone can agree that creating common-sense regulations that would ensure that an initial prescription and fitting be done in office through an in-person exam and that only licensed physicians or optometrists are using technology to renew a contact lens prescription is valid and worthy of cementing in law. As an alternative to HB 6012, the Connecticut legislature should consider enacting such requirement while allowing innovation to continue and ensuring patients have choices and physicians are trusted to treat their patients how they deem best.
Dr. Saya Nagori is a board-certified ophthalmologist who is subspecialty trained in glaucoma and diseases of the anterior segment and the Chief Medical Officer of Simple Contacts.