Eyeworld

traditional health care model December 2016 • Ophthalmology Business 7 that health care is pursued, Dr. Saxon thinks. As every health institution aims to cut costs further, a digital system should help physicians to concentrate on where their work is needed most, she added. The power of digital already has changed the preferences of many people of the younger generations who prefer a digital interaction, Dr. Saxon said—and she's surprised by the number of elderly patients who feel better taken care of with a digital connection. "They tend to feel taken care of even though they don't see me. They almost attribute too much to the remote care, even beyond what's there," she said. The exposure that patients will have to reliable health information also can help improve health literacy, Dr. Saxon said. The connection between patient sensors and the VCC has a role in preventing disease, Dr. Varma thinks. With USC's location in the movie industry town of Los Angeles, Dr. Varma likens the role of the VCC to the movie "The Minority Report" with Tom Cruise. There is a pre-crime division in the movie that aims to anticipate crime before it occurs. "This is going to be more of a pre- disease anticipatory unit where if we're beginning to see things not go- ing right in the individual based on sensor data, we can intervene early," he explained. "If we have sensors telling us things are going wrong in the eye, we can prevent people from losing vision and going blind. That's a huge accomplishment." OB Contact information Saxon: sherri.snelling@med.usc.edu Varma: rvarma@usc.edu Why ophthalmology? Of all specialties available, why is the VCC rolling out first in ophthalmol- ogy? Aside from Dr. Varma's personal enthusiasm for the project, there's a logical reason that any ophthalmolo- gist would understand. "It was a matter of which specialty was more technologically interested and savvy. We in ophthal- mology love devices and all kinds of gadgets. We're more technologically inclined, and the next generation of treatments is going to come in the interface between digital aspects, en- gineering, and medicine," Dr. Varma said. The university's background in these areas—for example, with the development of the Argus II retinal implant (often called the bionic eye) and an on-demand pump to provide medication to patients with age-relat- ed macular degeneration or diabetic macular edema—also make ophthal- mology's leading role a natural fit. The big picture It's no secret that there's a huge investment in digital health right now, and the VCC is part of that, Dr. Saxon said. Yet there are several other motivations behind the VCC. As more institutions from devel- oped countries build campuses in de- veloping parts of the world, the VCC would like to reach more patients digitally versus via bricks and mortar, Dr. Varma said. There are definite hopes and plans to reach patients in remote areas of the U.S. and around the globe with the concept. As health care becomes more complex, the desire for high quality but less expensive care has increased, Dr. Saxon said. Much in the way that mobile technology has transformed the media and music industries (and many other businesses), concepts like the VCC can change the way from a son or daughter, that makes a big difference," Dr. Saxon said. This same feature can be used for patients to obtain information they may have forgotten, such as drug precautions or how to instill eye drops—important information but not something that requires the physician to be involved. The VCC will also be used to track health information from patients and intervene if something is abnormal. USC is partnering with companies that make sensors that provide health information digital- ly. For example, for a pilot study, the Center for Body Computing has teamed up with VSP Global's innova- tion lab called The Shop and the USC Roski Eye Institute to measure the physical activity of 300 USC employ- ees wearing eyeglasses with a digital sensor. Eventually, health tracking such as this could sync with the VCC and provide feedback to physicians and alert them if something is wrong with a patient. In ophthalmology, there is the potential to use eyeglasses with sen- sors, sensors that track IOP around the clock, and even IOLs with sensors to track health information via the VCC, Dr. Varma said. To get the VCC underway and create the physician avatars, provid- ers have had to visit the Center for Body Computing and have images of themselves taken from many different angles and cameras. The physician also says certain words, and the system can then use artificial intelligence as well as augmented re- ality and virtual reality to enable the avatar to speak for the actual physi- cian. "Once you create an avatar, it becomes very easy for the physician to sit wherever they are and provide interaction and information through the avatar," Dr. Varma said.

• Cover