The potential for artificial intelligence (AI) tools in primary care optometry was a key discussion point for the teams at Specsavers and Cascader at 100% Optical (28 February – 2 March).
Specsavers directors, Giles Edmonds and Paul Morris, were joined on the main stage by Dr Peter Thomas and Mike Horler from the medical AI company, Cascader, for a lecture titled: Next steps for optometry – development, digital and diagnostics with AI.
The two companies announced a partnership with the aim of investigating how AI tools could be best implemented in practice.
Following the announcement, OT met with the two companies to find out more about the partnership and what comes next.
Integration and infrastructure
Cascader is a spin-out company from Moorfields Eye Hospital and University College London.
Mike Horler, optometric consultant at Cascader and clinical performance consultant for Specsavers, explained: “We are developing clinical AI products primarily to help optometrists with their referral decisions.”
Dr Peter Thomas, chief executive officer and a founder of Cascader, told OT: “We know from the work we’ve done what the potential for artificial intelligence is, but we also know that to get it right we need to understand – what is the system we are deploying it into? What capabilities will make a difference for optometrists and their patients in community care.”
While AI holds many opportunities in eye care, there are key questions around how it can be used in practice.
For Paul Morris, Specsavers director of professional advancement, these questions include: “How does this integrate into everyday primary care? How do we get it to work with the equipment we’ve currently got? Is there a need for us to procure different equipment when we next come into our buying cycle to make things like this work?”
There are also infrastructure questions, including use of cloud-based systems or siloed servers.
“How do you make it tangible for every practice in the UK, or certainly lots of them, to be able to harness and use this technology to benefit millions of patients,” Morris said.
On the main stage, the speakers discussed an ‘AI chasm’ – a gap between when technology is working effectively and before it reaches mass deployment.
Giles Edmonds, Specsavers clinical services director, described the need to implement AI tools at scale across the whole sector, adding: “We’re hoping with our resources and ultimately our scale, we can work together with the team at Cascader to be able to transform pathways of care for patients.”
Decision support
Asked about the role AI could play in community practices, Horler told OT: “The first step will be what we call ‘decision support.’ It’s real-time advice and guidance.”
If an optometrist has a patient-related query, Horler explained, optometrists could run the AI which would analyse the information, provide a probability of what the condition is, along with a suggestion of referral.
Horler emphasised: “The ultimate decision still sits with the clinician.”
With the development of these technologies, Morris suggested there is a role for optometrists to share what is acceptable for them.
“We’ve all worked with tools that do a great job but were a terrible thing to use. We want to make this as painless and easy as we can for colleagues in primary care to use,” he said.
Morris added: “Within Cascader there are decades of experience, but working with the wider profession, working with optometrists and other colleagues within practices can only help to make that even better as a solution to implement.”
Also noting the importance of engaging with the optometry profession as AI tools are developed and introduced, Thomas said: “When you just try and implement a technology without understanding what the service transformation is, you’re bound to fail.”
Discussing the place for AI in optometry, Morris emphasised: “It’s not about taking optometrists out, it’s not about doing things quicker. It’s making sure that the patient sees the right person, with the right urgency, and receives the right level of care. We are the gatekeepers of that – we play an enormous role.”
“How we then integrate that into existing funding streams and systems, we don’t know. But the first challenge is; let’s prove it works, and then let’s put it to do good,” he added.
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