Since the time I was in my fellowship training, Ophthalmology Management has been one of my favorite eye-care publications. At that point, I realized that managing a private practice would forever challenge me more than clinical problems, and OM has offered me countless tips and strategies to help my practice grow since that time.

So, I was particularly honored when I was asked to serve as guest editor for this issue of a publication that has been so important to me.

OUR NEW DIGITAL REALITY

In the 20 years since I started reading this publication, our specialty has changed tremendously. While we are not yet completely paperless, computers have taken over nearly every aspect of our practices.

Not all of this change has been good. Forty percent of U.S. physicians reported they were dissatisfied with EHR design and interoperability, according to an independent survey with nearly 9,000 responses done this year by the Physicians Foundation.

More than anything, that’s probably because EHR systems can put a strain on our relationship with our patients. How often have you visited a doctor only to have him huddle in the corner of the room facing a screen instead of looking you in the eye and having a face-to-face conversation? Or, if the doctor does the entire visit without a scribe and without taking notes, one wonders how accurate his re-creation of events will be in the EHR. It gives me the same feeling as when I’m in a restaurant with a large group and a waiter takes many complicated orders without writing anything down. How often do they get it all right?

The painful first phase of computerizing medicine was forcing us all to convert time-honored charting processes to digital form. This came at an enormous personal cost for doctors. A 2017 study published in the Annals of Family Medicine showed that family physicians spent more than half their workday interacting with an EHR system, and the average doctor spent 86 minutes of after-hours “pajama time” finishing chart notes.

TIME FOR SOLUTIONS

We need solutions that put the computer to work for us.

A recent AMA study showed that nearly 75% of U.S. physicians thought they could benefit from a new crop of digital health solutions, and many believe the second phase of computerizing medicine happening now will involve just that. Veracity Surgical (Zeiss) is one such application (page 22). It streamlines the process of selecting lenses for surgery, improving Medicare compliance and helping to avoid common pitfalls in the use of premium lenses. MDbackline, a solution designed to automate communication with patients, helps doctors educate patients on the benefits of premium lenses while improving CMS, MACRA and MIPS scores and reimbursement and boosting the practice’s online reputation.

Of course, other software solutions are contributing to greater efficiency and patient care. Companies like Google, Apple and Amazon are wading deeply into the health-care pond, and they have the resources to succeed (page 14).

For most of us, this second phase of computerizing medicine — in which computers work for us instead of the other way around — could not come soon enough. These new solutions will give us insights, save us time and make us better doctors.

It’s about time we had some help. OM

John A. Hovanesian, MD, is an eye surgeon in Orange County, Calif., and a clinical faculty member at the UCLA Jules Stein Eye Institute. He founded MDbackline in 2012 to address needs of patients, doctors and the health-care industry. He does strategy consulting and research for more than 20 health-care companies and has published two textbooks and dozens of journal articles in his field. Disclosures: Dr. Hovanesian is a consultant for Zeiss.