Hartford Business Journal

14 Hartford Business Journal • August 24, 2015 www.HartfordBusiness.com as accurate as one written in any eye doc's examination room. Prescriptions, however, must be signed by state-licensed doctors who contract with Opternative's doctor network. Connecticut optometrists and their more advanced counterparts, ophthalmologists, say they're approaching Opternative's launch with caution. The service is not a full eye health exam, both say (and Opternative readily admits), and can't detect diseases such as diabetes or autoim- mune conditions like a doctor could in person. But it's optometrists who have the most to lose, because Opternative is going after their bread and butter eye exam business and leav- ing them out of the process. The company is recruiting only ophthalmologists to review and sign prescriptions its test generates, which are then emailed to the customer to use at any online or brick-and-mortar retailer. Optometrists have pushed legislators in sev- eral states to ban or inhibit services like Opter- native's. The biggest example so far is Michigan, which passed a bill last year banning automated eye-exam kiosks. But that hasn't stopped Opter- native from offering its services in that state. The Connecticut Department of Public Health has already received a complaint about Opternative, but the nature of the complaint or identity of who filed it was not publicly available at press time, said DPH spokesman Christopher Stan, who cited an "investigatory process underway." Greater Hartford optometrist Dr. Erin McCleary, who is a Connecticut Association of Optometrists (CAO) board member, said her organization didn't file the complaint. McCleary, who works for Solinsky Eyec- are and her own private practice, said optom- etrists may feel threatened by Opternative, but she insists that she and her peers are more concerned about patients believing the online test — which is just the eyesight or "refraction" portion of a full eye exam — is a worthy substitute for an eye doctor visit. "It is but a sliver of the complete examination," said McCleary, who stressed that CAO members support the use of technol - ogy that improves health care. "If we separate the two, we start to have substan- dard levels of care for our patients." Opternative CEO Aaron Dallek said in a telephone interview that his company has chosen not to recruit optometrists because of liability concerns. He said the company believes laws in many states forbid an optom- etrist from signing a prescription based on a test conducted by somebody else. McCleary said her understanding of Con- necticut law is that optometrists can't del- egate certain key parts of an eye exam, such as refraction, to others. Ophthalmologist: Jobs likely safe for now Dr. Steven Thornquist, a pediatric oph- thalmologist in Trumbull and an officer of the Connecticut Society of Eye Physicians, said he has mixed feelings about Opternative, which he sees as "the tip of the iceberg" for the disruptive telemedicine technology that will come down the pike in the future. He shares some of McCleary's concerns about missed diagnoses, but said the company's refusal to accept patients outside of the general- ly healthy 18-to-40 age group, or those who have a history of diabetes or other diseases, reduces much of the risk. He thinks it's worth it to wait and see how the online service works. That limited customer base — and the fact that Opternative requires customers to get an in-person eye exam at least every two years — could blunt the economic impact on optometrists, he said. "Yes, there will be an impact," Thornquist said. "I don't think it's ready to take anyone's job yet." Would he consider becoming one of Opternative's contracted doctors? Possibly, if he was convinced he wouldn't face additional liability for doing so and the test is accurate. "It sounds like they've got data to back it up," he said. "It'd be nice to see more studies." Dallek says Opternative's own malprac- tice insurance will cover doctors who sign its prescriptions. Opternative is eager to answer doctors' questions and become accepted by the medi- cal community, said Dallek, who is planning to attend the Connecituct ophthalmologist society's January meeting for a demonstration and Q&A session. He has visited several other states for similar reasons. The company also provided a free trial of its test to the society last week, so that its officers could try it out. "We care deeply about the concerns of the eyecare community," Dallek said. "And we recommend that all of our patients get an eye exam [in person] every two years." He's also hoping his visit will hook a few Connecticut ophthalmologists interested in signing on as contractors. "It's an opportunity for them to service additional patients they might not be able to otherwise," he said. n from page 1 Technology could reshape eye care business Opternative cofounder settles suit As if optometrists' attitudes toward Opternative weren't skeptical enough, company co-founder Steven Lee, a licensed optometrist, may have made things worse. Just days before Opternative launched last month, Lee settled a lawsuit by the National Board of Examiners in Optome- try, the organization that creates the tests all optometrists must pass to earn a state license, according to court records. NBEO alleged that Lee had copied copyrighted questions from its exams and sold them along with test advice to optometry students. Lee did not admit liability or wrong- doing, but agreed to pay NBEO $181,200. He agreed to pay as much as $300,000 more if Opternative completes Round A and B funding rounds, or $300,000 in the event of a buyout, according to court records. — Matt Pilon BY THE NUMBERS 656 The number of active optometrist licenses in Connecticut at the end of last year, which has remained virtually flat over the past decade. $169,380 The mean annual wage of a Connecticut optometrist. S O U R C E S : C T D P H A N D U . S . B L S , M A Y 2 0 1 4 Aaron Dallek, CEO, Opternative Opternative does not accept health insurance for its test, which costs $40 for a single prescription. Dr. David McCullough, a Northeast Medical Group ophthalmologist in Fairfield County, tried Opternative's online vision test last week. Looking on is Dr. David Emmel, a Wethersfield ophthalmologist. 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