ONLINE EXCLUSIVE
ASCRS News
May 2023
by Liz Hillman
Editorial Co-Director
EyeWorld had a conversation with Eric Rosenberg, DO, and John Kitchens, MD, about the Digital Ophthalmic Society (DOS), which they co-founded and launched in April 2022. The discussion covered what DOS is and digital innovation in ophthalmology.
EyeWorld: What is DOS?
Dr. Rosenberg: DOS is a multifaceted organization dedicated to the integration and development of technology into the ophthalmic sector. The pillars that DOS stands on are educating ophthalmologists and surgeons about these new and developing technologies, having peer discussions about the integration of these technologies, and looking at policy regarding the integration of the technologies into routine ophthalmic practice.
EyeWorld: What makes now the time to form such a society?
Dr. Kitchens: I think the development of DOS is the confluence of different technologies. Both mainstream technologies and technologies within ophthalmology and medicine created this progressive environment. Every time I look at my Apple news, there is something new and innovative about technology from artificial intelligence to different changes in internet protocols. From the medical side of things, medical records, digital imaging, 3D surgery … 3D surgical heads-up displays, recording, and teaching have been a key moment to say, ‘We need something that can encompass all this.’
EyeWorld: Ophthalmology is one of the most tech-enabled medical specialties. Is a society dedicated to the digital aspect of medicine novel?
Dr. Rosenberg: I think this is very novel as it relates to medical practices across subspecialties in medicine. There are other organizations that are beginning to develop as well, … but I think that ophthalmology has always been ahead of the curve with the advent of new technologies. We’re always on the cutting edge of technology. This was good to a point, but it started acting against us somewhat. Adding all of these new technologies one by one started to become a bit cumbersome for the user, the surgeon, and all these technologies existed in silos. Now that we’re starting to appreciate some of the disadvantages, we recognize a new need for interoperability thereby removing us from that intermediary. All these repetitive tasks where we’re acting as a user in between the technologies, we can now leverage technology to interact with other platforms, but it’s going to be up to us to develop what that means. By discussing this in large, public realms and having societies dedicated to integration of these technologies is only going to provide a better future for us and will allow us to maintain the patient-physician relationship.
Dr. Kitchens: Over time, ophthalmology has become more and more subspecialized. … We’ve all fallen into silos, but what unifies us is not only eyecare but the use of technology. I think what Eric saw that is so forward thinking is this—technology—is a way to unify us because we all deal with these common technologies.
EyeWorld: What has the reception of DOS in the ophthalmic field been like so far?
Dr. Kitchens: We have some very interested people, and when this is presented in front of people who haven’t been involved, there is tangible excitement. Now we need to convert people from ‘I’m excited’ to ‘I’m involved now.’ We’re getting closer and closer to a tipping point with the weekly retina rounds. … There are some people who are also very passionate on the anterior segment side of things who are driving this forward, too.
Dr. Rosenberg: People recognize that we’re going to start using technologies that are going to augment our clinical capabilities. A lot of people hear the words artificial intelligence and get concerned, but some have said that AI should stand for augmented intelligence because it’s not going to replace our thinking. It’s not going to replace our position in the patient ecosystem. We’re still going to have that, but as we go into 2030 and 2040, we’re going to find ourselves being limited by the number of things we can do based on the number of patients who need our help. There is going to be a scarcity of physicians going into the future. There are two ways to rectify that. The first way is to train more people, but training is very long. You could find the shortcut: Train midlevel providers to do what we do, but then you’re treating 98% of the problem, and by finding the shortcuts you’re going to eliminate the thoroughness physicians provide. Option 2 is leveraging technology to help improve our throughput, allowing us to screen more, triage more, and do more. All of these efficiencies are going to need to play together. We’ve maxed out in terms of what we can do as clinicians with our efficiency models. That’s where leveraging these new technologies is going to come into play.
We’re creating another parallel subspecialty, but it’s ironically something that’s going to bring us all closer together. We’re starting to appreciate that these are going to be instrumental elements in the future of ophthalmic care. You’ll hear one AI lecture in glaucoma, one telemedicine lecture in retina, you’ll hear about EHRs in cataract surgery, but there is nothing that exists that brings these together. By bringing it together, the conversation is being had in the same room by clinicians, computer scientists, engineers, physicists, biochemists, etc., and we’ll be able to move the needle.
Dr. Kitchens: I think DOS is on that tipping point where we’ve got influential people who have a lot of interest. Societies like ASCRS are interested. Tech companies like Microsoft and Google are interested. They see DOS as a group of early adopters who have a sincere interest in doing the best for our profession.
EyeWorld: Is there anything else about DOS that you want people to know at this point?
Dr. Rosenberg: I think we want it to be all inclusive. Technology doesn’t have biases, and that’s a beautiful thing, but if we don’t get a showing of all of the communities in ophthalmology, there will be an inherent bias. It’s important for everyone to get involved, otherwise your vantage point is not going to be considered.
About the physicians
John Kitchens, MD
Retina Associates of Kentucky
Lexington, Kentucky
Eric Rosenberg, DO
SightMD New York
West Babylon, New York
Contact
Kitchens: jkitchens@gmail.com
Rosenberg: ericr29@gmail.com
