Fast forward to the year 2028 – The age of electronic medical records will be solidly entrenched. The sharing of your health information between you, your doctors, and all of your health care providers via the internet will seem common place. We will all have patient portals to communicate with everyone involved in our health care. The creative advances that are well underway today will become standard of care. Technological advancements will all be available to individualize your care, including: the mapping out of our individual DNA, the use of cellular level digital imaging systems, the use of artificial intelligence to aid in diagnosis and treatment, and the use of implanted biochips to monitor vital signs.
So, I can try to predict what my area of expertise (optometry and eye care) will look like in 2028. Rumor has it that at that time, you may only have an encounter with a virtual eye doctor. Using telemedicine and data collected by a technician, the doctor may be in another office. I’m hoping the norm is that the patient-doctor encounter will still be face to face. Here at Johnson Optometric Associates, however, we will always pride ourselves on the personal patient-doctor relationship!
Since the human genome sequence (DNA) was completed in the year 2000, by 2028 our office might have a copy of your individual DNA. This can already be collected via buccal smear of your cheek to detect a gene variation associated with Age-Related Macular Degeneration. Many other genetic eye disorders and systemic disorders that lead to eye disease will also be detected by an individual’s DNA.
Back to your visit at our office… Technicians, using sophisticated automated refractors and topographers, will measure and collect your refractive data necessary for glasses or contact lenses. In addition, digital real-time images will be taken of your retina by the latest technology of imaging sensors by high quality retinal cameras. Abnormal retinal or optic nerve findings can be further imaged at almost the cellular level by laser scanners and optical coherence tomography. At present, this technology exists but is constantly improving. The use of artificial intelligence (AI) to recognize and interpret these images is being studied. The concept of artificial intelligence is to learn, interpret, and draw conclusions. As I see it, this is one of the biggest challenges of advancing technology, especially when the welfare of our patients’ vision is at risk. Is the artificial intelligence computer reliable and reaching the correct diagnosis?
Another aspect of health care in all doctors’ offices, including Johnson Optometric Associates, is the monitoring of your vital signs. Biosensors embedded anywhere in the body can monitor any vitals 24/7 from your doctor’s office or even on a patient’s iPhone. In addition to blood pressure, I see us in the future monitoring eye pressure possibly using microscopic biosensors implanted within a wearable contact lens or even embedded in the front chamber of the eye. The problem with monitoring any vital function is that these measurements fluctuate throughout the day. Twenty-four hour monitoring of eye pressure is important in diagnosing glaucoma. At times the eye pressure may be within the normal range when measured during daytime hours in the office. But studies confirm a diurnal fluctuation in intraocular pressure, sometimes much higher after midnight while the patient is sleeping. This increase would be detected using an implanted biosensor.
Our present healthcare system focuses on evidence-based guidelines and data collection that treats a population with the same disease pretty much the same. By transforming the future of health care, these creative advances allow doctors of all specialties to customize treatment to the individual patient. I encourage you to stay informed and empowered to deal with the future transformation of our health care system. I hope this change can be positive and continue to improve the quality of care while promoting more preventive care and improving efficiency to ultimately reduce costs.
-Dr. Rick L. Hartman
