A statewide ban in search of a problem?
Some Connecticut residents are using new technology to save money on their eyeglass or contact prescriptions, but a bill pending before the Connecticut legislature threatens to put a stop to their frugality.
The proposal to restrict contact and eye glass wearers from using telemedicine technology to get prescriptions passed out of the public health committee 23-3 on March 27 and may be heading to a vote in the legislature.
The issue revolves around the ability for consumers to use online technology to obtain or renew contact lens or eye glass prescriptions. The exam is made via computer or smartphone and is reviewed by ophthalmologists licensed in the state who can then write the prescription.
Because the process does not require an actual visit to an optometrist’s office it is cheaper and more accessible for consumers.
The bill – An Act Concerning Consumer Protection in Eye Care – claims to protect the public from “dubious technology that can compromise well-accepted standards of care and place a patient’s health at risk.”
But the law may be a new Connecticut regulation in search of a problem.
Although ocular telemedicine is fairly new, so far there have been no reported injuries or complaints due to the technology, only concerns about potential risks.
But that hasn’t stopped a number of states from passing laws restricting the use of telemedicine for contact prescriptions under pressure from professional optometrist associations. States such as South Carolina and Indiana have banned the use of telemedicine for contact and eye glass prescriptions.
The bill proposed in Connecticut would be a blanket restriction and not allow for doctors to decide whether or not the technology might be useful for their patient.
The practice has come under fire from optometrists whose business would likely be impacted by the technology.
Optometrists are not medical doctors but are healthcare professionals who specialize in vision tests, eye exams and treatment for changes in vision. Ophthalmologists, on the other hand, are medical doctors specializing in eye and vision care.
Instead of returning to the optometrist to refill their contact lens prescription at the price of a doctor’s visit, customers can now obtain their prescription and order contacts or eyes glasses from online sources at much lower prices.
But the testing process used by the online applications have not yet been evaluated or approved by the U.S. Food and Drug Administration.
Dr. Brian T. Lynch, the legislative chairman for the Connecticut Optometrists Association, testified that the process enables patients to obtain prescriptions and contacts without having a prior relationship with a doctor and without examination of the patient’s medical records.
“This is clearly a level of care that does not meet the benchmark established in our telemedicine statutes.”
State Rep. Kevin Ryan, D-Bozrah, an optometrist, proposed the legislation which would require an in-person examination for a contact prescription.
In an op-ed for CT News Junkie, Ryan said “in person eye exams often catch more serious conditions and ensure overall health of patients.”
Ryan argued “we shouldn’t let unproven technology put those patients at risk.”
Proponents of the new technology say that it is not meant to replace eye examinations, which are supposed to be done every two years, according to the American Optometry Association.
Testifying against the bill, Dr. Saya Nagori, an ophthalmologist and chief medical officer for the telemedicine company Simple Contacts, pointed out that guidelines already prevent people with a history of eye disease, diabetes and glaucoma from using the telemedicine services.
“Strict guidelines allow only the lowest risk patients to renew their prescriptions via telemedicine.”
Similarly, Derek Brown, a representative of 1-800 Contacts, testified that Connecticut should not issue a blanket restriction on innovation, particularly in light of the fact that there are no actual cases of injury. Brown argued that the technology should be available to physicians if they want to use it.
“We believe that any language placing limitations on the use of ocular telemedicine, or any area of telemedicine, should—first and foremost—be supported by the physicians, and ensure that the physicians licensed here in Connecticut be empowered to make the healthcare decisions on behalf of their patients.”
Virginia passed legislation this year which allows doctors to use ocular telemedicine with a few safety precautions, such as having updated medical information for the patient and mandating that the ophthalmologists be licensed in the state.
Unlike Connecticut, the Virginia law was supported by the Virginia Association of Eye Physicians and Surgeons who helped craft the precautions in the bill.
The Virginia Optometric Association tried to initiate bills to outlaw ocular telemedicine altogether.
This article was updated to reflect the FDA has not approved the testing process and Lynch’s comments.