Testimony before the Georgia House Committee on Health Human Services Regarding Expanding Access to Eye Care via Telemedicine
Taxpayers Protection Alliance
February 15, 2022
Testimony before the Georgia House Committee on Health & Human Services
Regarding Expanding Access to Eye Care via Telemedicine
Lindsey Stroud, Director
Consumer Center
Taxpayers Protection Alliance
February 15, 2022
Chairwoman Cooper, Vice-Chair Newton, and Members of the Committee:
Thank you for your time today to discuss the issue of expanding access to eye care using telemedicine. My name is Lindsey Stroud and I am Director of the Taxpayers Protection Alliance’s (TPA) Consumer Center. TPA is a non-profit, non-partisan organization dedicated to educating the public through the research, analysis and dissemination of information on the government’s effects on the economy. TPA’s Consumer Center focuses on providing up-to-date information on regulatory policies that affect adult access to consumer products.
TPA appreciates offering comments in favor of expanding access to healthcare for Peach State residents by offering the use of telemedicine for vision care. Such policies are not only necessary as the United State continues to deal with the ongoing COVID-19 pandemic, but also expand access to healthcare and reduce consumer and taxpayer costs.
Online Vision Services Would Expand Access, Impact Rural Health Care
Expanding access to eyecare health via telemedicine is popular policy in many states and has been endorsed by conservative and liberal policy organizations as such policies expand access and reduce costs to healthcare.
To date, 47 states including neighboring Alabama, Florida, and Tennessee allow for online vision testing services, including “online prescription renewal.”[1]
The Progressive Policy Institute (PPI), noted that “[o]nline vision tests address the three big problems of healthcare: access, cost, and productivity.”[2] PPI found that online vision tests help to provide “increased access to healthcare for underserved rural and urban areas,” and can help provide eyecare to persons in locations without limited access to optometrists and/or ophthalmologists.
One specific county in Georgia, Harris County, would specifically benefit with expanded access to eyecare via telemedicine. In 2018, Harris County was identified by the American Optometric Association as one county with a population of 25,000 or greater and “no eye care provider.”[3] In fact, at the time of the report, Harris County had a population of 32,024 with 96.7 percent of the “county population deemed rural.”
A quick Google Maps search doesn’t offer promising results. It seems that the county is home to very few optometrists, most which are located in the Columbus-metro region.[4]
Federal Trade Commission (FTC) Finds In-Person Requirements Anti-Consumer
The case for online vision testing has been met with opposition and many states have sought to restrict ocular telemedicine. For example, in 2018, Washington state lawmakers introduced legislation that is similar to Georgia’s current law, which requires that licensed ophthalmologists and optometrists conduct in-person eye examinations prior to providing contact lenses and eyeglass prescriptions.
In a letter to a requested comment, representatives from the FTC noted concern for the bill in that it may “reduce competition, access, and consumer choice in eye care and might also raise costs for consumers.”[5]
COVID-19 Pandemic Highlighted Need for Telemedicine
The COVID-19 pandemic affected all areas of healthcare and many optometrists relied on telemedicine to serve the need of their patients. A 2020 survey from the American Academy of Optometry found that half of surveyed contact lens practitioners had utilized “telemedicine visits with contact lens wearing patients.”[6] One respondent remarked that the “resolution on smartphones is so good it allows an examination of the anterior eye similar to a diffuse white light monocular view at the slit lamp.” The respondent noted that “telemedicine is a tool for the practitioner to provide care,” but if the evaluation is not adequate enough, the “practitioner must inform the patient and see them in the office.” Nonetheless, the survey did highlight that “[t]elemedicine will be key and [practitioners] will rely more on patient symptoms to determine the need for face-to-face visits.”
From the start of the pandemic to February 1, 2022, Georgia had “reported 27,595 confirmed COVID-19 deaths,” and it was reported earlier this month that the “average number of deaths reported each day in Georgia has been growing.”[7]
Patients seeking vision care that can safely and appropriately be delivered through telemedicine, shouldn’t be burdened with in-person requirements, especially as their neighbors to the West and North and South are able to seek out online prescriptions and reduce contact.
Growth of Telemedicine Leads to More Consumer Awareness of Eye Care
Through the growth of access to eye care via telemedicine, consumers are becoming more aware of eye health.
A 2021 study by Versant Health found that during COVID-19, “patients [were] showing an increased desire for convenient and easily accessible eye care using remote technology.”[8] This was especially true among younger persons. The study found that nearly “three-quarters of respondents younger than 40 say having access to technology and tools for virtual visits would make them more likely to schedule a routine eye exam, compared to 67% of all respondents.”
Unfortunately, the study also found that costs associated with preventative eye care visits remain a barrier to access, “particularly people in lower-income households.” According to the authors, while 81 percent of all respondents reported having received an eye exam in the past two years, only 68 percent of households earning $35,000 year had reported the same.
Conclusion and Final Points
Georgia is currently in a minority of states that do not permit patients access to routine eye care visits via telemedicine. Such prohibitions are cost prohibitive and impact consumer access but they could also lead to worse health outcomes as persons delay visits for vision care due to cost and unforeseen public health crises, including the ongoing COVID-19 pandemic. Lawmakers should support and promote policies that expand access and reduce costs.
- 47 states including neighboring Alabama, Florida and Tennessee allow for online testing services, including prescription renewal.
- Telemedicine can address issues of access to eye care in rural counties.
- Specifically, Harris County, Georgia, was identified by the American Optometric Association as a county with a population of 25,000 or greater and “no eye care provider” in 2018.
- The Federal Trade Commission has opposed other state legislation requiring in-person eye examinations noting that such policies “reduce competition, access, and consumer choice in eye care and might also raise costs for consumers.”
- The ongoing COVID-19 pandemic has highlighted the unique need for telemedicine during public health crises and has led to tremendous growth for telemedicine in eye care.
- A 2020 survey from the American Academy of Optometry found that half of practitioners had utilized telemedicine during the pandemic.
- One practitioner noted that the “resolution on smartphones is so good it allows an examination of the anterior eye similar to a diffuse white light monocular view at the slit lamp.”
- The growth of telemedicine has led to more consumer awareness of eye care. A 2020 study found that nearly 75 percent of patients 40 years or younger reported that “access to technology and tools for virtual visits would make them more likely to schedule a routine eye exam.”