Artificial Intelligence Grading and Telemedicine in Practice

8th December 2021

This article was originally featured in OSI Magazine.

By Brian Tompkins

High-quality examination techniques and the best possible prescribing are obviously key components to any eye care professional’s long-term success but the importance of good communication to patients should never be underestimated.

How can we expect any patient to be invested in their eye health if they don’t fully understand their condition, how to best manage it and the implications of what may happen if they let things slip?

Talking regularly to patients is essential and the way we talk to them makes a big difference. Clear and concise language, outlining their eye health in a way they understand, is so important and it’s something we take particular pride in as a practice.

But it’s not just about language. It’s also about the method of communication.

Face-to-face conversations are ideal, you can gauge a patient’s reaction and understanding from their body language and reinforce any points you feel may not have sunk in straight away.

Telephone calls are useful for any follow-ups while emails and text messages can serve a purpose for written details and ‘bulletin-style’ messages or reminders.

For several years now we have used a combination of all the above to ensure our patient communications are delivered in the right way, at the right time.

As with pretty much everything in life, the pandemic changed things. Our tried and trusted methods were thrown into the air, with face-to-face appointments cancelled and our preferred method of talking to our patients disappeared overnight.

Thankfully, modern technology afforded us a viable alternative and allowed us to enhance our day-to-day practices while engaging patients in ways we’d never been able to before.

AOS is an anterior imaging software platform that helps eye care professionals deliver better patient experiences both in and out of practice.

In practice, it has a suite of image enhancing and grading tools that can be used with or without a slit lamp. Out of practice, the AOS Vision mobile app allow patients to safely and quickly capture and transfer images and video of their eyes and the tele-optometry function makes video calls between us and our patients quick, easy and secure.

We use it to triage new patients, particularly those with complex issues, prior to their appointment. It gives us an idea of what we can expect to find and puts us one step ahead.

The imaging tools enable accurate and objective bulbar and lid redness grading and also give you an exact punctuate count on fluorescein images. You can also annotate images and use the ruler for accurate measurements.

A video component and new toric lens marker tool have recently been added that we are looking forward to using as part of our contact lens management programme.

We use it primarily for management of our contact lens and dry eye patients.

Capturing base line images when a new fit is conducted is vital and if you are able to add objective, accurate grading and generate a GDPR-compliant patient report to this then patient compliance is taken to the next level.

The grading we do also plays an important part in determining how suitable the patient is for lens wear – if they have issues due to bulbar or lid redness for example, they have a better understanding of their position if they can see images of their own eyes and we have attributed a ‘score’ to their pathology.

This uniform, independent grading gives consistent across multiple practitioners and can determine if patients require pre-CL fitting management, or assess the extent of their dryness, irritation or allergy to increase the rate of successful fits.

We use the AOS video call function to assist with the first application and removal of new fits and conduct remote video calls with existing wearers to check in with them and ensure they are still comfortable in their lenses. Our dropout rates are minimal because of the protocol we follow.

Care plans are a core part of our business model and being able to offer patients access to an app where they can take a picture or video and send it through to us whenever they have a problem has been great – it’s another reason for them to sign up to a monthly subscription with us for all their eye care needs.

Patients love being able to see images of their eyes and we have seen the benefits of giving them a grade or ‘score’ they can work towards improving, while also generating reports for third party referrals. They have also responded really well to the remote video calls and are hugely appreciative of the time we are saving them.

It’s all part of the patient theatre we aim to create and gives them something to tell their friends and family about. These changes were already in the pipeline but COVID-19 has fast-tracked them into everyday practice. What was possibly five years away is here now, and we are fully embracing it. It’s here, and it’s here to stay.