Digital health and AI in optometry, with Christopher Law

Victorian optometrist Christopher Law is breaking new ground in the field of embedding digital health content and assessments within Deakin University’s optometry course, while also researching digital health curricula across optometry study programmes in Australia and New Zealand.

In this interview, Christopher shares some handy digital health and AI tips for optometrists, as well as his thoughts on embedding digital health into optometry courses and optometry clinics.

Christopher, what are your current professional roles?

I’m an optometry teaching scholar at Deakin University, with a focus on clinical skills and Indigenous health. I also conduct clinical trials for dry eye.

You’re exploring embedding digital health content in Deakin’s optometry course. Can you elaborate?

We’re assessing the existing optometry curriculum to identify gaps and make implicit digital health aspects more explicit for students. For example, one suggestion has been to integrate appropriate use of digital records into clinical skills and end-of-unit exams for more authentic assessment.

My motivation stems from the rapid changes in the digital health landscape. We want to ensure graduates are digitally ready but adaptable to future changes.

How is digital health currently taught, and what’s your role in its development?

Deakin’s problem-based learning (PBL) structure uses weekly case studies. This gives us flexibility to embed digital health into PBL cases, for instance cases could explore telehealth or AI-analysed retinal photographs. We don’t envision a separate digital health unit but rather integrating digital health throughout the curriculum.

What is your particular area of interest in the digital health space for practising optometrists?

I’m particularly interested in patient health records. Currently, optometrists and other allied health professionals aren’t fully integrated with Australia’s universal health record system (My Health Records). At present, there is also limited or no compatibility between My Health Records and existing optometric practice software. More accessible health records could greatly benefit patients and enable safer, more efficient care if health providers can access pertinent details such as prior/ongoing medications, procedures and allergies.

Optometrists can familiarise themselves with My Health Records by accessing it through the health provider portal, but without further integration, there’s probably little incentive to make the most of the My Health Record, unless patients demand it.

I also think there is a shift in patient expectations, with increasing demand for autonomy and control over their care, enabled by technology like app-based visual fields and home intraocular pressure (IOP) measuring devices. I’m interested in how optometry can prepare for this cultural and technological change.

What other digital health aspects should optometrists consider?

The pandemic accelerated adoption of e-prescribing for GPs, and eventually optometrists will likely be able to prescribe medicines electronically as well. This will depend on government infrastructure and software vendors.

AI in optometry is another major consideration, as it has rapidly advanced the analysis of retinal photographs. While clinical trials support its effectiveness, questions remain about long-term safety, reliability, and ethical considerations, particularly data privacy and patient consent regarding data use for training AI models.

Tell us about AI scribes, could they work for optometrists?

AI scribes listen to consultations and generate notes. This is intended to improve clinician efficiency, but accuracy verification of the output is crucial. If poor outcomes arise due to errors, liability is likely to fall on clinicians rather than software vendors, but these will likely be assessed case by case. AI scribes are more complex for optometry due to the large number of numerical fields in our records, but their development is likely. Where these tools are purely transcription (e.g. do not generate clinical/health recommendations), they do not fall under the TGA’s Software as a Medical Device regulation and therefore aren’t subject to stringent requirements to prove validity, so optometrists should consider what this could mean for safety and reliability.

Optometry Australia (OA) encourages members to ensure they are aware of Ahpra’s guidance on the use of artificial intelligence, including digital scribes. If you have any further questions or need further guidance, OA members are encouraged to contact our Optometry Advisor Help Desk from Monday to Friday at OAhelpdesk@optometry.org.au or phone (03) 9668 8500.

Christopher’s top tips for optometrists navigating the rapid changes in digital health and AI

*  Always ‘fact check’: AI applications can increase efficiency and sometimes even accuracy, but some applications, particularly large language models (LLM) like chat-GPT can ‘hallucinate’ and generate false information. AI outputs should be verified, and ideally should be explainable.

* Safeguard patient and personal data: never upload sensitive information like patient or personal data into publicly available applications like chat-GPT, as anything provided here could be absorbed and retained to train their algorithms. This would also breach privacy regulations. Ensure that informed patient consent has been obtained before using AI tools that do require patient data.

*Lifelong learning is key: digital health is advancing at a rapid pace, and in the same way online banking is now just banking, new and emerging digital technologies will sooner or later become part of routine healthcare. Keep an eye on Optometry Australia’s conference calendar and programs for a range of digital health sessions.

About Christopher Law

Christopher completed his Doctor of Optometry in 2014 at The University of Melbourne and practiced optometry in rural Victoria for 8 years before moving into academic practice. His interest in digital health for optometrists was ignited when he completed while undertaking a Master of Public Health, which he completed in 2023 at Monash University, followed by a Certified Health Informatician Australasia (CHIA) qualification.