Optos a breakthrough in diagnostic imaging for the ophthalmic practice

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  • 1. Optos: A Breakthrough in Diagnostic Imaging for the Ophthalmic Practice 8 Shareef Mahdavi SM2 Strategic Pleasanton, CA 7Optos (Marlborough, MA) has built an ophthalmic technology from the physician and/or photographer, allowing thearound widefield diagnostic imaging of the fundus. With over physician to focus energy on interpreting data rather3,800 units installed worldwide, the Companys devices have than collecting it. The image quality is described as beingbeen used to capture over 15 million patient images to date. more than sufficient to meet the needs of a busy oph-With the recent introduction of advanced risk based imaging, the thalmology practice.Company has begun commercializing its technology to ophthal-mology to complement its strong presence in optometry. New and better information SM2 Strategic was asked to conduct interviews with a These physicians are clear that the Optos device isgroup of ophthalmic surgeons who have incorporated the allowing them to detect pathology that they would oth-technology in their practices to better understand the utility erwise miss using an indirect during the exam or taking aof Optos in an MD practice. Further, the purpose of these standard fundus image out to 30 degrees. This has led tointerviews is to help ophthalmologists understand how earlier diagnosis and treatment of eye disease and greaterthis imaging technology differs from traditional methods of preservation of vision.capturing data about the fundus.Finally, we wish to describe how Interaction with patientsthe Optos device is influencing Optos Experience Patients are better able tophysician and patient behavior. understand their eye conditions The following pages contain Patient-Centric Device Design because they can visualize whatprofiles from interviews with five is happening by looking at theirsurgeons who represent an array Clinical and Experiential optomap alongside their doc-of ophthalmic practice types Benefits tor. The optomap serves to helpsolo vs. group, comprehensive vs. validate their complaint. This hasspecialty as well as diversity in significantly impacted the quality Impact on Impact ongeography around the US. The of the discussion and the ability Practice Practiceprofiles describe how the technol- Behavior Economics to gain compliance with recom-ogy fits into the unique setting of mendations.each practice. A framework for defining the experience of Optos own- Better business modelership is shown in the figure above; six common attributes Because the company charges on a per-use basis rathercollectively described by these physicians underscore the than the traditional capital equipment sale, customerssuccess this technology has achieved in market adoption. know the company will never abandon them or their interests. If the device is down, the company and the prac-Patient-centric design tice suffer, which aligns the interests of both parties. The Optos platform was developed with the patientin mind and has succeeded in capturing high-quality ultra Patient acceptance of the feewidefield fundus images without the need for dilation. The When used with general exams, physicians are charg-data output has also been designed to facilitate the discus- ing a fee directly to the patient for the optomap retinalsion between doctor and patient, both in form and content. exam. Doctors are finding they dont have to hard sell patients but simply explain the benefits of the procedure.Consistent and reliable data capture A very low percentage of patients decline; those who Digitizing and recording the fundus image has shifted have the test find high value in knowing what the datathe burden of collecting and recording the image away mean for their eye health.
  • 2. While Dr. John Kitchens gain a wide field view by performing click, move cam- had heard about Optos era, click, move camera with a traditional fundus imag- during his residency and fel- ing device. lowship, it was only when As a result, Dr. Kitchens is able to treat earlier, not a colleague showed him the only with the primary eye but in the fellow eye as well, device firsthand that he felt which looks good upon examination but then I discover its potential. Up until then, issues revealed by Optos that can also be treated in a tar- my impression had been geted manner. For example, when imaging for Uveitis, John Kitchens, MD that the technology was he says he commonly finds peripheral vascular leakage, an Retina Associates of Kentucky an OD screening device; I indication of underlying inflammation that is persistently Lexington, KY was amazed to see fundus active but not clinically apparent on exam or with stan- Years in Practice: 4 images just like traditional dard angiography. This may result in progressive damage Focus: Retina fluorescein angiography. and eventual vision loss if not properly addressed early Having joined an and in its entirety. Drs on Staff: 4 MDs already busy group of 3 ret- Optos has really educated me about disease and the Experience with Optos: 1 year ina specialists, Dr. Kitchens impact of my treatment because I can see it, especially acquired the Optos device with laser therapy, noted Dr. Kitchens. With the opto-and says it has fundamentally changed the way he prac- map images, he can use the laser in the same manner atices medicine both diagnostically and therapeutically. chef adds salt to a recipe, allowing for optimal dosage As a diagnostic, the P200MA provided images that without over-treating the patient. His usage of the devicewere not distorted and can be accurately obtained. It has created a complete feedback loop to patients. Thiswould take a novice photographer six months or more of is where Optos really shines, as my patients can literallytraining to begin to acquire the quality of images that are see the results of their treatment.available immediately from the Optos system noted Dr. From an economic standpoint, Dr. Kitchens says theKitchens. His practice has adopted the Optos as their pri- additional information he gets from Optos is worth themary fundus camera, achieving much greater consistency extra cost relative to standard fundus photography. Hesthan the traditional method of relying on the skill of fun- taking more images now than with FA because theydus photographers. With photographer variability taken help him more. Where OCT tells me what is happen-out of the equation, the practice is achieving consistently ing, Optos tells me why its happening, commentedbetter images, leading to more effective and efficient treat- Dr. Kitchens in describing how these two technologiesment of patients. work together. With OCT helping explain the story, Dr. Second, Dr. Kitchens realized that what he was see- Kitchens says he has the data to start acting pre-emptively,ing in clinic (via indirect ophthalmoscopy and 90 diopter which has helped him treat his patients more effectively.fundus examination) was grossly underestimating whatwas happening inside the eye. As a retina specialist, I Complementary Technologiesam highly sensitive to changes such as macular edema indiabetic retinopathy patients. The Optos device is allow- for Retinal Imaginging me to pick up subtle peripheral changes much earlier OCT Optosthan before. Noting that most disease starts in the mid- (Ocular Coherence Tomography) (Wide Field Imaging)periphery, having a single simultaneous photo out to 200 View of Macula