1:30min
Throughout her career in healthcare, and in her current role as the Director of Operations at the Australian College of Optometry (ACO), Kylie Harris has been a fervent advocate for the advancement of optometry, optometrists and eye health.
Kylie holds the firm belief that optometrists play a critical role in ensuring access to high quality eye care, and that the ability to prescribe oral medications is an important part of providing equitable eye care to all Australians, particularly for remote and vulnerable populations.
‘It’s frustrating to witness the limitations placed on optometrists in assisting patients who already face significant difficulty in accessing care… I think if you focus on a model of care that is affordable and high-quality then optometrists and oral prescribing is naturally a part of that.’
Kylie has held numerous leadership positions throughout her career. From 2016 to 2020, she served on the Optometry Australia board, during which she was appointed Vice President in 2018. Prior to her term at Optometry Australia, she served two separate terms on the Optometry Victoria board, and notably held the position of President for the state organisation from 2013 to 2016.
In a recent interview with Optometry Australia, Kylie shares her perspective on why she thinks enabling oral therapeutics in optometry will ultimately benefit communities in need, as well as the broader healthcare system.
What are your thoughts on optometry and oral therapeutics?
During my time at the ACO, it’s become increasingly clear to me that many of the underprivileged communities we serve struggle to access primary care, let alone tertiary care. It’s frustrating to witness the limitations placed on optometrists in assisting patients who already face significant difficulty in accessing care.
Being able to prescribe oral medications would just be an incredibly useful tool to have without putting the patient at any risk. You’re doing the reverse – you’re actually reducing the risk for the population, because you’re able to provide that service in a timely manner. If optometrists could prescribe oral medications, then setting up ongoing treatment for patients and intervening in urgent situations would be a lot easier than it is now.
I think it’s important that all eye health workers work closely together to make these decisions in the best interests of the patient, improving access to emergency and long-term care for vulnerable populations.
In your view, how do you see oral therapeutics impacting optometry and the patient journey?
As we have seen historically with any significant change to professional scope, I anticipate there’ll be a few optometrists who will extensively prescribe oral medications, and a few who may not do it much at all.
I believe we’ve done a really amazing job at upskilling our profession in oral therapeutics. When I graduated over 30 years ago, where I worked in SA, optometrists weren’t formally allowed to diagnose eye conditions, or induce cycloplegia, and we had to use puff tonometry because we didn’t have access to topical medications at all. The world’s changed a lot since then. The training and skillset of the average graduate has dramatically improved, which is incredibly important for developing the profession, and positions us well for this next step.
In terms of the patient journey, just as we saw with topical therapeutics, uptake is likely to be gradual, but the impact on patient care over the next two decades could be transformative. Australia’s population will continue to increase, and this will lead to fewer tertiary care providers per population. Someone has to deliver that care, and I think optometry should be the profession that comes forward to do it.
How do you see it impacting the relationship with GPs and other healthcare providers?
At the moment, the current process of obtaining an oral prescription typically involves interacting with a GP. This increases the cost burden to the population and to the Australian taxpayer, because a second consultation and Medicare billing is required, and delays care. At the ACO, we manage a large number of patients with complex pathologies and eye care needs, and whilst we regularly collaborate with ophthalmology to provide care, we’re working in environments where access to oral therapeutics would be an incredibly useful tool to have.
We have plenty of optometrists in Australia who have worked in countries with oral prescribing. I think if you focus on a model of care that is high-quality, but affordable, then optometrists and oral prescribing is naturally a part of that.
What do you envision for the future of optometry?
What I would like to see is that the highly intelligent and trained individuals working as optometrists are able to have challenging and rewarding careers. However, I recognise that without the funding that comes with providing a specialised skill and the Medicare items to support that, it will be difficult to get there.
Naturally, a pathway that becomes a little clearer with oral therapeutics is the hospital pathway. With access to orals, being able to broaden the settings in which optometrists consult will be an option.
Ultimately, oral therapeutics is something that will enable us to explore more options for our profession, and how we can better serve Australians and our communities.