In a recent editorial, National Post columnist John Robson wrote about the capacity of technology to fulfill us, opening his piece with the age-old question that countless kids have asked from the back seat of the family car: “Are we there yet?” Robson wonders how we'll know when we’ve reached a level of advancement that makes our lives fulfilling. Could we have been happy in a technologically static world at some earlier point in time? He talks about “the mania of innovation” as it becomes “ever more frantic.” Consider the humble cell phone. When I was a child, “video phones” were the stuff of science fiction. Now, of course, we take them for granted: these tiny boxes that are more powerful than the computers that put astronauts on the moon.
Optometry is no different from any other profession or business in the ever-changing world of digital innovation. You need only glance at a newspaper to see how Uber has revolutionized the taxi industry. So how is it that any of us, whether professionals in practice or regulators setting standards, keep current? The College has a mandate to protect the public from the risk of harm that might come with some of these “disruptive” technologies—but can regulation keep up with the dizzying pace of change?
One need only look at how technology has evolved since 1991. This was the year of the Persian Gulf War and the break-up of the former Soviet Union—and also the year the Regulated Health Professions Act was proclaimed. A home computer had a 24 MB hard drive, a telephone answering machine used a cassette tape, and Sony Walkmans played CDs. Now there’s the Internet and the cloud, and all that comes with it, good and bad. Telemedicine and its optical cousin, Internet dispensing of eyewear; social media; and websites that let people take “eye exams from home” are just a few of the ways that the public can now access eye and vision care. From the public’s perspective, it’s convenient, and usually cheaper. But is it safe? And if not, how can we measure the harm it causes in order to seek government approval for regulation change that will mitigate the risk?
I recently attended the Association of Regulatory Boards of Optometry (ARBO) conference in Seattle with College president Dr. Thomas Noël and vice-president Dr. Pooya Hemami. The theme of the conference was “Optometric Regulation in the Electronic Age.” We learned there that many jurisdictions, in an attempt to stay ahead of the curve, are increasing the flexibility of their regulations to account for changes in technology that we cannot currently imagine. Not an easy task.
The College is working to provide our members, and the public, with guidance when it comes to new technology. The Patient Relations Committee has developed a social media policy to help members respect privacy legislation and professional boundaries when using social media for their practices. We’ve also issued an interpretive document, “Spectacle Therapy Using the Internet,” which recognizes that optometrists may use the Web as a tool when providing spectacle therapy but that they can do so only while meeting standards of practice. Members, understanding that they must provide a copy of a prescription to a patient, have asked if they might email it rather than supplying a hard copy. The answer to this question has been added to our FAQs on mandatory prescription release.
Richard Steinecke, health regulatory law specialist, wrote in the Summer 2015 issue of Grey Areas that one need only look at Uber to see how a regulator, if it doesn’t remain sensitive to emerging trends, can become irrelevant in a very short period of time. We cannot afford to be complacent about new technology and must vigilantly identify trends and forces in order to adapt where necessary. It is important that optometrists continue to provide good customer service in addition to quality care, or patients will find an alternative to regulated practitioners that is not accountable and that may present a risk of harm to the public.