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Power Hour Optometry
AI Is Changing the Way You Practice: What Every Optometrist Needs to Know in 2025
00:48:14
In this forward-looking episode of Power Hour, host Eugene Shatsman is joined by Dr. Scot Morris and Dr. Rehan Ahmed — AI innovators and co-editors of the acclaimed AI in Eyecare journal. These aren’t theorists, they’re clinicians embedded in...
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- [00:00]
Eugene Shatzman
Foreign.
- [00:08]
Dr. Scott Morris
Optometry's biggest and longest running show. It's now in its 13th season, and I'm your host, Eugene Shatzman. So today is for every practice owner who is sick of hearing about AI hype and wants to know what is actually real. So if you're looking for something like a ChatGPT tutorial or some sort of theoretical debate that this is not that episode, today we're getting into the practical stuff. What is AI doing right now in eye care? What's coming in the next three to six months, and how will it directly affect the way that you schedule patients, run your office, and care for the people in your chair? My guest today, Dr. Scott Morris and Dr. Rehan Ahmed. They're both actively seeing patients, they're both embedded in AI innovation, and they both serve as co editors in the AI in Eye Care Journal. That means that they're not only using these tools, but they're also curating some of the biggest breakthroughs happening across the entire field right now. So we cover everything from AI receptionist, adaptive scheduling, prior AUTH automation, ambient scribes, clinical decision agents, even wearable tech that could give patients live feedback. These guys are plugged in at pretty much every level, and they're seeing the kinds of things that might just change the way that you look at the future of the way that your practice works. So. So this episode was by request because a lot of people are kind of skeptical or unsure about how AI can really deliver on all these promises out there. And I totally get it, which is why I wanted to have this conversation and why I think you should hear it, because these guys, like I said, are plugged in to exactly what's happening today because they're curating all the articles, curating all the folks who are innovating, and they're bringing it to the industry. And now you get a chance to hear them talk a little bit about what's coming up specifically and the next three to six months before we dive in. Quick reminder, if you've got a question or a comment or an idea for the show, reach out to me directly@eugene shotsman.com or through the Power Hour website. Love hearing from you. And also make sure that you're subscribed on Spotify, Apple Podcasts, YouTube, or wherever you tune in so that you never miss an episode. All right, let's get into it. Here's my conversation with Dr. Scott Morris and Dr. Rayhan Ahmed. Welcome to the Power Hour and Scott Rich Rehan. Excited to have you guys on the show. Scott, returning Guest, Rayhan, new guest. But both of you guys are doing amazing things in the industry and excited to have you guys on the show.
- [02:27]
Dr. Rehan Ahmed
Thanks for having us.
- [02:29]
Eugene Shatzman
Thank you, Eugene.
- [02:30]
Dr. Scott Morris
Yeah, so I want to get right into it because I think Scott, you and I did a show at some point last year and I certainly encourage anybody who's listening who is a little bit newer to AI or doesn't necessarily follow all of the, I'll call them kind of the initial developments of AI to listen to that because I think we defined this concept of artificial intelligence and also kind of algorithmic learning and those types of things. We talked about that previously. So what I wanted to do today was dig into what's happening now, what's on the horizon and what's real, like within grasp. And so you guys are both the co editors of the AI and Eye Care Journal and as such you guys have tons of stuff coming to you from all kinds of AI innovations and all different corners in the industry, outside the industry, that kind of thing. So I think we're going to assume a base level of knowledge of the audience for, for our audience of, you know, base level of knowledge of AI. You know, maybe they've played with chat GPT, maybe they've tried some sort of AI tools already in their practice. So let's move to the. Okay, you got a base. Where should you be looking next? Scott Rayhan, where do you guys want to start?
- [03:46]
Eugene Shatzman
There's, there's. Well, first of all, thank you. I think, you know, we, we're very blessed and that we get to talk to some of the, I think some of the greatest innovators in eye care and some of the greatest innovators in medicine pretty much on a daily, weekly basis as we kind of, you know, shoot ideas back and forth about what's out there and what's coming and what's realistic timelines. I think that's well said is there's a lot of things that are, you know, 10 years away and there's a lot of things that are five years away and then there get to be fewer things that are actually ready for really true launch, like right now, today kind of stuff. And so I think, you know, it's going to be super interesting to talk about this. I always think about, I kind of think everything about in terms of patient flow, like how does the patient experience happen? Because at the end of the day those are the ultimate clients if we don't please them, you know, we don't, we're not in business for very long. So I Always think about most of what happens in the business world actually happens not in the office. It happens before they ever get to the office. I mean, I think there's the step of understanding, hey, I have a problem right right now. Consumers are consumers because they're not patients yet, they're not in your office. Consumers go, is this something I need to learn about? Is this something I need to be worried about? And so they go to the infamous Dr. Google and search up their things and you know, they, they have everything from some East African disease that's going to kill them, even though they haven't left their state in the last five years, you know, to who knows what. Right. And so I think there's the first place we're going to see, I think we're on the rise of seeing, let's call them, healthcare agents. And I think that that's probably an 18 to 24 month window where there will be agents out there that help you, whether they're created by Google or cloud or Grok or, you know, who knows what group it's going to be. But I think we're going to start seeing healthcare agents that act on behalf of consumers to do more of a triage than Simply going to Dr. Google and asking, what is this something I need to be worried about? So I think that's the first place. And you know, Ray, on last night on our Real Talk podcast, he was talking about medjemo, which is kind of the new kind of venture into some of the large language models and how that works with medicine. So, Ryan, I'll let you kind of maybe address some of that more before we get into the next step.
- [06:01]
Dr. Rehan Ahmed
Yeah, Eugenio, thanks so much for having us. And I think your timing, the way you sort of framed it, makes a ton of sense. It's really important because there's so much hype in AI and if we get the hype cycle wrong, we're at risk of turning a lot of people off. But I do think it's true, and I think it's Bill Gates who said this, that we tend to overestimate what's going to happen in two years. We overestimate that, but we underestimate the change in 10 years. So I think three to six months, that sort of timeframe makes a ton of sense. And sort of parlaying off what Scott just said about the patient experience. And before they even come in, I'm on a WhatsApp group with tons of ophthalmologists and I'm seeing more and more people ask about, well, how can they start using AI and the low hanging fruit? The administrative stuff makes a ton of sense. So there are already clinics. There's a buddy of mine in Houston who's using a AI based perception tool. So you call his office after hours and a lot of people are doing this and, and it's very easy. You could just Google. There's many different vendors, providers that are offering the service and if the receptionist is not available, their AI agent, he calls his Anthony in Houston, they pick up and it's an. I called his office, he's like, Rick, you got to try this. So I called his office and it was fantastic. I made an appointment like next Thursday at 10:30. He could speak in Spanish and English and it was a great experience. I was on his books and they sent me an email like two seconds after the conversation was over. So I think for a lot of practices, thinking about that low hanging fruit, having an AI based receptionist to augment your own receptionist is probably the first thing that's, you know, that they can do for their patient experience.
- [07:41]
Dr. Scott Morris
So I want to talk about this particular innovation because I actually, I'm deep enough into this one that I have a lot of, I guess we'll call it like the technical knowledge side of it. So you're absolutely right. I think this is technology that's available that we've solved the latency problem, the pause between when a patient speaks and the AI speaks. Right. That was the big problem in July, June of last year, 2024. In 2025, the latency problem is gone. In most optometry practices they function off a variety of EHRs. Officemate, Compulink, Ifinity, Crystal, Revolution, all of these are EHRs that don't necessarily have a universal scheduling platform. And so I do think that step one to getting the technical capability of that is having someone with the, with the scheduling, with a universal scheduling platform, then pair it with a voice agent component which then says, okay, we'll do your stuff after hours. Now my we actually it's funny because I have a team that's working specifically on this project and because as you guys probably both know, is we have a call center in Cleveland that is based, that was requested by our clients. And the main reason I don't sell the service, we offer it to some clients who ask really, really nicely. But the reality is that we try not to do too much of it. The reason that the call center exists is to identify what's possible. And so what we've identified is that if 100 patients call your office with a. We'll call it somewhere between low and high intent of scheduling an appointment. They may be asking, what insurance do you take? Which would be some intent, not the highest intent. Or they might be saying, I need an appointment next Tuesday. Or like, hey, I have this problem with my eye. Can you get me in right now? Those would be super high intent. And then there's like, lower intent with like, do you take my insurance? Whatever.
- [09:42]
Eugene Shatzman
And.
- [09:42]
Dr. Scott Morris
And so if 100 people call, what's possible right now in our call center today with humans answering the phone is that you can get 106 appointments on the books. That's looking at the last six months. What happens in most practices is that they tend to get 64 appointments on the books. That's a giant gap, right? And it's a giant gap, and it can be solved by training and techniques and whatever. And humans right now are solving that gap in. In many practices. And I believe technology can absolutely solve that practice. Now, I'm also the guy. So this is where, like, I'm trying to design this product for the industry because we have a scheduler and we're trying to work through. Through all the nuances. But I'm also the guy, and I'm looking at you guys and you guys are going to probably laugh at me because you're both AI titans, but I'm also the guy who called my house insurance company two weeks ago because there was some sort of issue. And the second that the automated agent picked up and was like, how can I help you today? And I was. And I tried to say something and it was like, you would like a review acclaim. And I was like, crap. So then I just start saying, representative, representative, representative, representative, representative. Like, it just keep getting, you know, my level of frustration keeps growing as this thing is like, in order to route you to the right representative. And then I'm like, this is so old technology, but I'm the guy who wants to talk to a human. So trying to balance that in my head, I want to just pause on this particular innovation because I do believe this is less than six months away where it's universally available in the eye care industry. But thinking through that, what do you guys think is the likelihood that the patient is going to enjoy talking to the AI and the technical capability that will ultimately make the experience more pleasant and more successful than talking to a human?
- [11:34]
Dr. Rehan Ahmed
Scott, go ahead.
- [11:35]
Eugene Shatzman
You want to take that first. You want to shoot at that one? Because I definitely have some strong opinions on this one.
- [11:39]
Dr. Rehan Ahmed
Yeah, I think they're going to be. Eugene, what you just described is what I go through too. When I call, like my bank or something. I know they're using an AI, but it's. There's going to be growing pains. And so I'm an optimist. I definitely think the next. It's not going to be a smooth trajectory for everyone. And some people will have better technology than others, and some people will implement it better than others. And the human in the loop, which is in a very important part of this entire conversation. Who, who knows where to place that? Strategically, that's in the best interest of the customer. Yeah. Like when I called Anthony to his practice, it was pretty good, you know, but not perfect. Right. Like, what if I wanted to have a slightly more complex thing? I didn't. I don't really know.
- [12:21]
Eugene Shatzman
And so, But I would argue, Rayhan, I don't think that the human interaction is always perfect either.
- [12:27]
Dr. Scott Morris
Right.
- [12:27]
Dr. Rehan Ahmed
100%. And so, yeah, one of his practice owner's opinion was that when he trains his own receptionist, if they say, well, I want an appointment Thursday, they'll get okay. They'll just look and they'll say, they'll go, oh, and the next Thursday available is in four months. I'm like, no, no, no, no, that's not. You know, you have to give them a couple options and say, we don't have Thursday, but we have next Tuesday available. Could that work for you? You know, and so there are ways that AIs are not there yet, but I think we're getting. I think we're getting close. But they're gonna be growing pains. There's no question about that, Eugene. There's just.
- [13:05]
Eugene Shatzman
Yeah, I totally agree. I mean, I think that, you know, like your example, I mean, there's Natural Language Processing or nlp, and then there's just Language Processing. And I think you were probably more the latter than the natural part that will get better. I mean, you look at just any Alexa, Siri, I mean, all those have just improved so dramatically. And we're going to see that happen. And I don't think that's going to take a year, two years, because there's just going to be. If you can't compete, you won't exist. And so I think that part's going to get fixed. But I think you guys both hit on, you know, the scheduling is always the big challenge. And we've been working on that in our software for a couple of years now in terms of how to really make that seamless and make through all those decision trees that an AI has to go through. And I think that in the next, I do feel like in the next year that will largely be solved. And I think you're right, Eugene, is the challenge is that sometimes we have to stop thinking of the old model. Let's use a scheduler that's in an EHR and look at for something that is maybe a new model that is a universal platform that everybody can schedule in and everybody can do everything else in too. You know, I think that we're at a, we're really a tipping point between the old model that used to exist and the new model that's going to exist. And so you know where that point will tip. I think there's numerous products being developed right now that. But I do think in the next two to three years we're going to see a tip of how that works.
- [14:27]
Dr. Rehan Ahmed
And there's a nice viewpoint in there. There's the offshore. A lot of practices using an offshore or third party scheduling versus AI only based scheduling again on this WhatsApp group there are debates on like what's better and there are going to be trade offs between the two. And I think right now we're kind of in this dirty battle. You know which one you're going to choose, you're going to choose some hybrid.
- [14:48]
Eugene Shatzman
The answer is going to be a hybrid at some point.
- [14:50]
Dr. Rehan Ahmed
It's going to be, I think so. And I think as AI gets better, it's going to, it's going to weigh more and more towards AI based solutions. I think that's just sort of the natural trend when that happens. Is that six months, is that 12 months, is that 18 months? Don't know, but it's going to happen.
- [15:04]
Dr. Scott Morris
I think a lot of people are making these or are participating in these conversations with incomplete data. I think the right step is to have an AI analysis of all the calls that come in, which, you know, I happen to have been trying to push, push on the industry. This, this premise of the optical capture rate, translate that to your phone capture rate. What percentage of calls that could potentially be patients actually turn into patients in your seat. That's the phone capture rate that I've been trying to push as a metric onto the industry. And the only way, you know, is if you have someone listening to the calls and it's inefficient for a human to listen to calls. So just have AI listen to the calls and the AI will tell you who's better. Is it Susie, is it Joanie, or is it Anthony? The AI agent who's, who's better at scheduling on the phone and what the, and what the data looks like. And at that point it's indisputable, right? At that point it's the, and I, and I agree with you that human in the loop is kind of the key, the key part to that, to that innovation is that at some point there always needs to be some sort of exit, you know, like whatever the, the, the rip cord that somebody's got to be able to pull to say, I don't want a really frustrated patient who really doesn't want to talk to the AI. I want to be able to talk to a human. But I agree with you, Scott. I listen to these calls personally for several of our clients and I just get so frustrated because I'm like, you're literally just setting money on fire. I can't, you know, I just can't see it.
- [16:34]
Eugene Shatzman
But I, you know, we were last night in our podcast, we were also talking about the changes that are coming in workforce and I think it's going to be a new opportunity for people. Maybe it's not all overseas, maybe some of it's here, but there's somebody goes, hey, I'm going to take phone calls from 2 to 6 o' clock. That's my new job. And these are all the ones that are not, you know, are from 6 o' clock at night till 10 o' clock at night. Right. That's when it's convenient for them to work. And maybe they're east coast and that's really just, you know, three to seven for them. But that's their new job and they get anything that's escalated beyond the AI and they take those calls and they have scripts based on my office or Rayhan's office or, you know, office ac, abd, cd, whatever, you know, and it becomes very integrated. I think that's a whole new workforce that's going to happen. For the escalated phone calls that maybe won't all be overseas, but I do think there'll be a hybrid model and that changes the way not just the triage of I'm going to call and schedule, but I think the triage is going to change of what do I need to schedule for? Because it's not just, oh, I need an eye exam. Well, but what's your symptom? Well, I have distorted vision. Well, okay, that's not really, that's not going to be under VSP or iMed or something like that. It's more of a medical type situation. And we got to pre program that into the schedule of knowing what it is. So I think, you know, the AI is going to help. AI agents are going to help define what type of schedule is necessary, what type of testing is going to be necessary. Because maybe you have three people that, you know CT at the same time and you're scheduling all three at once. Well, that's going to be a huge bottleneck, I think, as we get into what's called adaptive scheduling. And that's, I think that's three, four years away, adaptive scheduling on a universal platform. Then the AI is going to change people's schedules based on what the definition of their symptoms are.
- [18:16]
Dr. Scott Morris
And so you're totally right on that front right now.
- [18:19]
Eugene Shatzman
We count on that when somebody calls in, we count on somebody answering the phone and going, oh, this is not a comprehensive, well, health eye exam. This is a medical exam with what medical insurance do you need? Blah, blah, blah. But as you're well aware, you list those phone calls. And that's not always what happens with humans either. And so there's going to be some uniformity or some consistency, some standardization of how the process works. And I think in terms of the getting somebody from I have an issue to I want to go to this practice to I like this provider and their staff or their office or whatever, to the I'm accepted on their benefit plan and we know what our coverage and eligibility benefits are to the the actual point of scheduling. I do think that's probably the most rapid transformation we're going to see in the next 12 to 24 months. And you know, I hate putting scare tactics out, but I think you have to be prepared as all of us, as per the own practices or working practices, to the fact that that's going to shift and that workforce that we're currently using now to do those things, we're going to be retraining them to help us in other areas or do other things. And so that's just completely agree.
- [19:28]
Dr. Scott Morris
It's kind of like, you know, you don't get appointment requests via fax anymore. You get them and like you have to pick up the phone when it rings. I totally agree with you, Scott, that at some point the actual patient is going to expect better service from the AI than and right when the patient says I'm ready to speak to the AI because the experience is better than waiting on hold for, you know, someone to pick up and kind of give me I a lackluster response to some of my stuff, the AI is always enthusiastic. So I want to, you know, this one's good. I like it. I think we're going to say that, you know, something is going to be available in the industry within the next six months to support optometric. And then to your point, Scott, it will evolve over the next 18 to 24 months to get to that point where it's really adaptive and super smart and whatever. But at the very least, after hours appointment scheduling for optometric practices should be available within six months. Okay, next, let's go to another, another step in the patient journey. Scott, as you were, as you were going down that path.
- [20:29]
Eugene Shatzman
Well, and I think it kind of almost is a little bit of a relationship to the scheduling piece is that, you know, right now you think about it, and I spent a lot of time thinking about, like, what do we do wrong every day? Like, what do we just accept as normal? And it's just totally messed up. And I think one of the things that's totally messed up is from the time somebody walks in the door until the time the provider gets to them, it's a disaster. And it's been a disaster in that, you know, we're counting on what tests need to be done in what order. And too many times practice practices go, well, we do this test and this test and this test and this test for everybody. It's our standard what we do. And I think that's going to be very different as the AI agents start getting into triage and helping make differential diagnoses or help listing differential diagnoses prior to a patient actually walking in the door. I mean, I see a time in the very near future that, that when the patient walks in the door, we're gonna have a list of, this is your differentials and these are the tests in the proper sequential order to shorten the differential the fastest. Nowadays, unless you have a really well trained staff who's been with you a while and knows, oh well, let's not do visual acuity and do that. This sounds like a distortion, right? I'm gonna go do an OCT first, first before we go do any of the other stuff, because challenges the chances are with distorted vision, monocular, it's probably a macular issue, a retinal issue of some sort. So why do all the other stuff? Why be inefficient when the reality is the software, the platform is going to say, hey, maybe you should do a Mac OCT first and see what the results of that are and cut a bunch of the testing off. Not just testing, but, you know, think how that changes your manpower. Now, you don't have a staff member spending 5, 10, 15 minutes doing a workup when they could have just spent two minutes doing OCT and you look at and go, I got the answer, next step, right? And so I do believe that it's going to, you know, these and we'll say agents in this point on the provider side. So provider agents, not patient agents, but provider agents helping us make better medical decisions in terms of what tests need to be done, when it needs to be done, what order they need to be done, how to interpret the results. If we don't know, you know, because just because we learned about 1 Oct 5 years ago or 10 years ago in school and now we have a new oct, do we actually understand how all that works? And I think that all of the that is going to be dramatically augmented by our own agents that help providers and their staff and their team be more efficient, more effective, that kind of stuff. And I really don't think that. I think most of that's 12 to 18 months out too. I think there's our platforms being developed that are looking at that going, how can we help in that? Maybe it won't be seamless, you know, Maybe there's some OCTs or visual fields or retinal photographs or whatever that won't interact with these platforms. But I think at some point we're going to see a aggregation of all of these into a universal platform that just everything becomes plug and play.
- [23:30]
Dr. Scott Morris
And I have to ask, because I hear about this type of technology, it's kind of one of the more obvious points in technology is to say, okay, well we've got this imaging and we have this testing that we do and we can use that testing to learn from it and to help the doctor make better decisions. But what I hear all the time from guys who are not in kind of our environment where we're so excited about the new technology. I hear all the time, every and rehan, maybe you can speak to this as an ophthalmologist too is like, do you want the help? Like do the doctors actually want the help or do they feel like, oh you know what, like I don't need a machine telling me how to treat my patients.
- [24:10]
Dr. Rehan Ahmed
Yeah, that's exactly the point I was going to bring up. I definitely agree with Scott that AI based sort of clinical decision support systems and that's sort of the category that we're in. It doesn't make, I mean it's like so obvious. It's hits you in the head, of course they'll help, but exactly right Eugene, like the, the pushback I hear is not that it won't provide value because I think it would. I mean, if I don't have to memorize every single random retinal photograph, that's great. But would I pay extra? But I, presumably I'd have to pay someone to get access to this. Would I pay extra in a world of declining reimbursements, in a world of higher costs, would I pay extra when I'm not necessarily deriving sufficient value out of that? If I get a retinal photograph that tells me that there's diabetic retinopathy. Great. You know, fantastic. Thank you for showing me where that dot blot hemorrhage is. Do I need it? No, I don't need it. Would I pay extra for. No. But if there's other value, if there's a reimbursement mechanism, I think we get a lot closer. So that's what I'm really looking forward in the next 6 to 12 months is AI based companies that are in this space really demonstrating how, how this is going to create value for the optometric or opthalmic practice either by improving efficiency, maybe there's a reimbursement mechanism, some way that I could demonstrate to a practice owner that there's value.
- [25:37]
Dr. Scott Morris
But it's a dollar. Let's just say would you pay. I have to ask the question. Do. Would you pay a dollar to get your image read by an AI so that you walk into the like, let's just call it like the lowest number of dollars you possibly can. 1. Would you pay $1 to walk into a room and have AI have pre, pre reviewed your, your imaging?
- [26:02]
Eugene Shatzman
Well, Eugene, I want to take that one because I actually, I'm working on a paper right now that talks about exactly that. Is that, you know, I think that we always think of we're gonna have to spend a dollar, but we're spending five or ten dollars doing testing. That's not necessary, right? I mean if you think about the work, the workflow, efficiency and what the changes will be. If we skipped 10 minutes of pre testing and you had your staff to do other things, that's worth way more than the dollar you're going to spend to have it read. You know, so I think we get caught thinking what's our expenses? But we don't think about what's our losses, which are still our expenses, just under that vague gray veil that oh, it's not a loss. Well, it is a loss if we're doing it inefficiently.
- [26:45]
Dr. Scott Morris
And so I totally agree with you. But I'm not firing Susie, the front desk lady.
- [26:52]
Eugene Shatzman
Hiring Susie's replacement though.
- [26:54]
Dr. Scott Morris
Right, right.
- [26:56]
Eugene Shatzman
I think that Ray honey hit it really well in terms of the clinical to support decision making or clinical decision making support. You know, I think that, you know, and I'm a little older than you guys and so I remember when I was a resident and a fellow SO octs, I was fortunate enough to have one of the very first OCTs in, in the United States when I was a resident. And I remember sitting and lecturing about this, going, this is the greatest technology ever. You know, it's going to change the way we manage glaucoma and retina. And retina specialists and docs from all the country are like, but I, I'm great at this. I don't need it to manage glaucoma. I already understand how to manage glaucoma. I look at pressures, I look at visual fields and I know whether they have glaucoma or not. Well, now we almost laugh at that and go, you're kidding, right? I mean, that's not the way it works. But it took time to develop trust and acceptance that a technology could actually provide us better information to make better clinical decisions. Now I don't think it's going to take 10, 15 years like Oct did. I think AI is going to take 10 to 15 months for a lot of practices. But there is going to be some trust issues, some reliability issues that we have to sort through. And this is why the makers and developers and innovators that are building these things as Rayon started and said the hype cycle, something we got to control is we all have to make sure what we build is very reliable and very trustworthy before we get it out. If we're going to have rapid adoption and adaptation to this, and that's the onus is on all of us as developers. But I do think that the trust cycle will be much faster because we're all just technology as a general rule. We're believing in it and accepting it more and more as long as it has good outcomes.
- [28:38]
Dr. Scott Morris
Okay, I'm gonna give you a different, one more perspective on this concept, which I think is probably one thing to consider. I would pay more for something if my patient would pay more for something. Right. So if a patient would pay more money for an enhanced experience in some capacity. Right. If you could create, if you could not just make it a Dr. Agent, but a doctor agent that supports the patient experience in some capacity, there's some beautiful Thing it can bring up on a screen. And it says, yeah, AI looked at this and this and this, and we're a fully technologically enabled office that the guy across the street is not yet. That makes me want to say, oh, I'll pay the dollar for that. Because that patient's going to be way more loyal and probably be more impressed with their experience, probably come back more often, probably tell their friends to come to me, that kind of thing.
- [29:25]
Eugene Shatzman
And if you can convert the experience for me, you know, we've done time studies over the years and look at, you know, the average experience from the time a patient walks in the door till the time they're at checkout is ideally 48 minutes. But the reality, most of the time it's an hour 10, hour 20. And I think patients, if you said, hey, we can shorten this to a half hour where they pay an extra dollar to have 40, 50 minutes of their life back without even has. Now you can't make it 20 bucks or 30 bucks or 40 bucks, but you say two, three, four dollars. I absolutely think the augmented patient experience will. There'll be something. You know, there's legality and rules. We gotta get around. But I do think that that's a great. That's a great thought process, Eugene. My head's reeling. Like, how do I turn that on? You know? But it's a great opportunity.
- [30:11]
Dr. Rehan Ahmed
Yeah. That monetization strategy, where you're sort of putting some of that on the patient or the consumer, to me, makes a ton of sense, Especially in a world where FDA approval and clearance of devices may be slower than we think. And you're actually already seeing examples of this, especially in the world of oculomics, I think, where. Where there may be a patient that just pays out of pocket to get a further analysis of the retina photo. Looking at other type of neurodegenerative or cardiovascular diseases where there's no necessarily like, there's not a reimbursement. We're not clear that Medicare commercial insurances are going to pay anything for that image. But the patient sees value in it, the provider sees value in it. And that may be the strategy that's going to be sort of winning out in the next this. Especially in the near term, for sure.
- [31:03]
Eugene Shatzman
Love that idea. Love that idea. It's almost like you're adnning it, but for a different reason. Yeah.
- [31:10]
Dr. Scott Morris
Okay. When we come back from break, what I want to do is I want to jump in and talk a little bit more about actual things on the horizon. Three to six months from now and that are coming into the office. And if you're not paying attention, you're missing out. Be right back on the power hour. All right, we're back on the Power Hour with Dr. Rehan Ahmed and Dr. Scott Morris, co editors of the AI and Eye Care Journal. And again guys, I am just so excited to hear more about the stuff that you're seeing coming out soon. So let's go again. Three to six month timeline. What are innovations that are coming to practices that we really need to be paying attention to?
- [31:51]
Dr. Rehan Ahmed
So we started a little bit about the patient experience but I want to turn the table a little bit and talk about some of the stuff that the patient may not actually see right away. We're talking about some of the more back end support to my colleague. If you're not doing this, you may be missing out is all the AI work that's being done on prior authorization, which is a big pain point. I mean if you talk to any optometri it's like this is the worst part about practicing. But there are amazing AI tools coming out. I mean easy Google searches, there's some that are actually ophthalmic specific. There's something called Acadia based in the east coast that's working on prior authorizations and insurance approvals. Really a bane in my especially for surgical procedures and getting documents. And they'll have the air agent called insurance company and literally talk to them as an avatar voice. And they have a great. And companies have a great human in the loop model where they're going to trigger when the human needs to sort of pick up the phone.
- [32:51]
Dr. Scott Morris
That's great. And I just, I think about both billing and prior authentic the processes. It's. There's so much friction. It's so repetitive. It requires a high amount of algorithmic skill set. If this, then this, if this, then this, if this but not this and this. And like there's smart humans who have to do that skill currently practice across.
- [33:15]
Eugene Shatzman
The country maybe starting to centralize some of that stuff.
- [33:20]
Dr. Scott Morris
Right. So I totally see that. I completely agree with you. That's such a obvious opportunity that and I'm glad to see that you guys are. You guys are talking about actually solutions.
- [33:31]
Eugene Shatzman
That are happening and that's a really big one. I agree Rehan. I mean if I was to prioritize the single biggest pain in the booty in practice it is by far the front side authorization and eligibility and the backside actually getting paid for what you do and processing and all that kind of correctly those are problems one and two, without a doubt. So one of the other new technologies that we're starting to see pop up everywhere is scribes, you know, and I think that scribes have a lot of advantages of listening to conversations that many times we as providers, we put the Cliff Note version into our ehr, if we put anything into our EHR other than our diagnosis. And there's a lot of very important data that goes on in that discussion between a provider and their patient. And the scribes are going to catch that, be able to interpret it, be able to use it, be able to store it. Once again, I think we're still stuck with, we're using kind of old technology as a storage mechanism in terms of EHRs with this new technology of autonomous listening, or NLP. And I do think we'll see some changes in there, but I do think scribes are going to be an important piece to make sure we capture data. And that data is what's going to feed large language models and small language models that are going to feed the AI and help us learn more in the future. So I think that data that we're still, as I said, very much in infancy stage. I think that data is going to become really important down the road to harvest that data, curate that data, and use that data as training data in a supervised learning mechanism.
- [35:03]
Dr. Scott Morris
And three to six months now, I would say if I'm an EHR company and I have talked to, I've even had some EHR companies on the show. But if I'm an EHR company, what I need to be thinking about is how do I improve the patient experience so that I don't get taken out necessarily. And so and as both the patient and the provider experience. And I completely agree with you, if I'm an EHR company, the number one thing I'm working on or thinking about is making that interaction in the room way better for both the provider and the patient. And that definitely happens with an ambient scribe type of technology. So I totally, you know, I'll ring the bell on that one. Totally agree. Three to six months from now, we should be seeing a lot more of that technology in the exam room. And I've seen, you know, I've actually seen practices go from $700,000 per provider to $2,000,000 per provider simply by the adding the process of a virtual scribe, like having a virtual, like, you know, somebody on Skype or whatever, or a scribe that walks in with them. And I've seen practices just add so much revenue to their, to their Top line, which a lot of that revenue actually ends up in the bottom. Your rent's paid, your staff's paid, you know, whatever, and it's not very expensive. But now think about everybody having access in the entire industry to an ambient scribe type of model where it just becomes the standard. The notes are better, the patient, the conversation between the provider and the patient is better, the interaction is better and it's probably shorter.
- [36:36]
Eugene Shatzman
It's not real, it's more real human.
- [36:39]
Dr. Scott Morris
Experience than exactly right. Turning away, turning away, turning away, turning away, which then cuts the conversation, makes it longer and creates an imperfect experience for both. So I absolutely agree. Three to six months, it needs to be, and it will be, I think at least for some people in the industry will be easily available. Great. And you know, going back to the billing point, it's a really good example. So the scribe component, the billing component, the prior auth, these are repetitive tasks that are done currently in practices that create friction. If we can use technology to eliminate friction, these are absolutely low hanging fruit. Like I absolutely love, you know, Scott and I didn't want to necessarily take it there, but I absolutely love the possibility that somehow the devices that we wear on our bodies, including our glasses, including our ring, including our watch, all of those are somehow communicating with some amazing health agent that's, you know, pre diagnosing me and creating, you know, this amazing workflow. But like it's real. It could happen, but it's not happening.
- [37:43]
Eugene Shatzman
It's not gonna happen. It's already happening. I mean, I know there's quite a few platforms out there that already starting that integration process, you know, which one will survive and become the universal platform. Who knows, you know, I think you'll end up with two or three, you'll end up with a Google and an Apple and whatever, but there'll be two or three different platforms. But that biometric feedback, that's 24,7 from your contact lens, your watch to your ring to your virtual reality headset, that goes both directions. You know, looking at what you're looking at as well as looking at what you're looking at, you know, all of that, that's all going to become integrated. And I don't think that's, I mean that process has already begun. I think we're going to look back, I was talking with my oldest son the other day, I think we're going to look back five years ago and go, how did we ever work when we didn't have all that information? You know, but right now there's so much Information that if we don't have AI to help us process that the human brain just can't do it.
- [38:34]
Dr. Scott Morris
Yeah. And I agree with you. I think we're living in. Our healthcare is going to become much more personalized. Right. The supplements I take every morning will not be the supplements that everybody in my household takes every morning.
- [38:49]
Eugene Shatzman
It will not be the same one you take every morning. Your feedback loop may say, oh, today you need a little extra magnesium and tomorrow you need a little less caffeine. I mean that feedback loop is going to get real tight to how we all perform. I feel like I'm a performance coach, you know, about. We all perform on an optimal level, not just physically, but mentally. You know, I mean, how are, yeah.
- [39:12]
Dr. Rehan Ahmed
These smart connected devices. I work with a company called Blink Frames and they have frames that will monitor a kid's myopia and help with myopia management. So they'll tell the parent, hey, they're not going outside enough or they're what? They're too much screen time or not enough activity time or look, you know, you need to move your head more often. So I think it's, you know, we, as an optical, we have the, we have the first wearable. Right. And now that we're finally sort of getting into the game, so I'm excited about that sort of possibility of these smart connected AI driven devices.
- [39:45]
Dr. Scott Morris
Are you guys seeing, I mean obviously there is the large commercial projects that we've seen from, you know, places like Slur Exotica, whether it's Nuance Frames or the Ray Ban metas or whatever like, and there's, you know, plenty of, plenty of competing technology that exists to kind of drive the smart glasses component. But the feedback which you just mentioned, Rayhan, just, just a minute ago, the feedback component of behavior change for the wearer, is that something that you're seeing three to six months from now?
- [40:16]
Dr. Rehan Ahmed
I am, I am. The company I'm working with that's, I think they, they are within a couple months away. They've already initiate some pilots, they had studies based in China. So yeah, I think we're within, definitely the six month horizon.
- [40:29]
Dr. Scott Morris
Okay, that's interesting. So feedback to the patient coming from the wearable that, that they've gotten interesting. All right, what else, what else are you guys seeing? That's that, that's right there. Three to six months from now.
- [40:44]
Dr. Rehan Ahmed
I think further enhancements in sort of the pre customer, pre shopping, pre visit, pre patient experience and then the post patient experience. I think AI is sort of built for those types of workflows where you're going to enhance, and we sort of mentioned this, but where they're going to enhance their experience further.
- [41:04]
Dr. Scott Morris
Yeah, and I, I love that idea because I think what it does is, you know, something like that where a patient can interact with an AI tool before their exam and to improve their experience at the exam. I think, you know, again, we have to retrain the patient to some extent. But just like any innovation curve, there's always going to be early adopters and there's always patients in every patient database that are willing to jump on board and say, I want to try this, I want to try this, it'll be fun. And I don't know what percentage that's going to be, but I think something like that will absolutely help.
- [41:37]
Eugene Shatzman
The eye care experience is not going to be the hour, 20 minute once a year. It's going to be all the time like, hey, I'm outside. My glasses say, hey, you've got 14 hours today of sunlight. Are you wearing the right kind of lenses to protect your eyes against this? And it'll train them and they'll go, oh, I need to go get this. You know, I think that the healthcare experience, not just eyes, but the healthcare experience is going to become. And we're already starting to see with wearables. My wife does that. She's like, man, I only slept seven hours last night, I need to take a nap today. My watch is yelling at me because I didn't sleep right. And I'm like, your watch is yelling at you. And I think that we're going to see that in our industry, in all parts of the medical industry, is health and prevention. And medicine is going to become an all life experience. And we, because we have the ultimate wearables. And the wearables may go from cell phones to these. We are sitting in the driver's seat of helping change the way healthcare works.
- [42:33]
Dr. Scott Morris
Yeah, and I think you're so, so spot on with that point is that we are going to watch a consumer transition over the course of the next, whatever, 18 to 60 months. We're going to watch consumers transition into greater level of comfort with wearables, greater level of comfort with taking advice from AI agents and communicating with AI agents. I'm going to give you guys one more category and I would just want to hear your reactions to this is practice management data. Right now, running a business is hard. Everyone who's running a business will say, you know, it's probably one of the hardest parts of what I do. And seeing patients may Be pleasant. Running a business or dealing with some issues in my business may be unpleasant. And so when I think about the possibilities in this category is we have all the business analytics, right? We, we. When I say we, we, we think.
- [43:33]
Eugene Shatzman
We do in the way the current system works. We have all the business analytics, but we may find out none of them are right anyway.
- [43:39]
Dr. Scott Morris
Well, exactly. It's. I think the reality is that the way that we have the core elements of the data and right now we're relying on some maybe outdated reports to try to make sense of that data, to try to make business decisions. I believe that there is a function for the AI space to say, hey Scott, you own a practice. How can I make you a better practice owner? How can I make your business work better for you? How can I take the information that I'm getting here and maybe combine it with some information that I see elsewhere in the marketplace and do some analysis whether it's on your patient database, maybe it's on your, maybe it's on the way that you know your revenue per patient. Maybe I can do some analysis on trends within your practice, trends within the industry compared to your practice. And it just, I think takes one person to say what would I really want to know if I'm running a business and what decisions could I make and to train that AI agent because the data is already there, right? And so I think that's one area where we could all be better business owners if we had an AI coach to.
- [44:45]
Eugene Shatzman
I've been kind of trying to coin this phrase lately. We're all going to have MBAs, Masters and Master business agents that help us and run scenarios. What if we did this and what if we did this and what if we did this and then we get to be the supervised. At the end they go, let's try that mechanism. I think that we have, we haven't even scratched the surface of how to run a better business in healthcare. Haven't even scratched the surface.
- [45:08]
Dr. Rehan Ahmed
Yeah. I think two points there, One, AI, wherever there's data and preferably big scalable data, that's AI sort of perfect zone of support. And business analytics totally makes, you know, a ton of sense. And two, this sort of democracy, I know that word is overused, but sort of democratizes this type of support. I mean big practices probably, you know, private equity based practices may have this type of that. You have a person who could do this for you. But for, you know, a small to medium sized practice now it scales, you could, you could have a tool that does this Stuff that sort of allows you to compete with the larger practices and get the same insight in your practice that, that a larger practice may already have. So it really levels the playing field, which I think is good for everyone.
- [45:53]
Dr. Scott Morris
Yeah. And I think, you know, and, and you guys are innovators. It's always fun to talk to guys who are both in the, on the front line of innovation as well as getting, getting to see, getting kind of a private exposure to a whole bunch of innovation that's happening in the industry. So I really enjoy these types of conversations. Hopefully we gave the audience a little bit of rapid fire, a little bit in depth. How else can people find you guys and talk a little bit about the AI and eye care journal before we sign off here?
- [46:24]
Eugene Shatzman
Yeah, I'll cover that. So to all of your viewers, if you have an opportunity, Rehan and I have, we do a couple different things. So we're the, as you mentioned earlier, we're the co editors of AI and iCare.com that's an e journal that you can have and there's articles written by some of the best innovators and thought, you know, forward thinkers in our industry in the field of AI and what different technologies are out there and how they may impact us. We also do an innovators podcast series of which Eugene's been on, where we interview these different people and say, where is there? Where's the opportunities? What should we all really be thinking about? And Those are usually 35 to 45 minute podcasts that you can listen to in your car on the way home or on a trip or you know, who knows where you want to listen. And then we also do a weekly, what we call Real Talk, which we kind of COVID news of the week. What's new and interesting, what are some knowledge bites, like what's technology? What definitions do you need to understand? So when you talk, you sound like, I know what I'm talking about. And then we also pick a subject every week and we kind of do a little deep dig on different concepts and you can get all of those on AI and iCare.com just look for podcast section or you can read the articles.
- [47:37]
Dr. Scott Morris
Yeah. Thank you guys for participating in the Power Hour today. Always fun to talk to both of you guys. I know I'll be sharing the stage with both of you guys in the coming months. Exciting to continue to kind of help ICARE interpret all of these innovations in AI as we all plow forward into all of this. I'd say like really life changing things for both practices. And patients. Thank you guys for coming on the show.
- [48:08]
Eugene Shatzman
Sam.