Technology for Access – Insights on the utility of IAPB Eye Health Technology Guide
A Q and A with Suzanne Gilbert on the utility of the IAPB Eye Health Technology Guide
1.Please describe a little about your interest in technology for eye health and why you think the Guide for Eye Health Technology is useful for your organization?
Technology is vital to scaling services to reach the people who need them most. This past year, I contributed toward development of the Guide with a multidisciplinary IAPB member Task Force. For several decades, my work with Seva Foundation has involved developing and/ or introducing technology to improve service delivery and quality. Working on the Guide helped sharpen my own thinking about integration of tech into patient care and what would be useful to us in Seva and across IAPB and global eye care.
2. Have you used the Eye Health Technology Guide? Please describe how you have used the guide and how it was helpful.
The process of developing the Guide coincided with development of new tech within Seva Foundation including the Vistaro ultra-wide field retinal camera. The Guide offers a shared vocabulary and road map for envisioning an entire project while working on it step by step.
3. Can you think of an example of an eye health technology that really stands out as having created a big impact in the way services are delivered or increased uptake of eye care services?
For 15 years, Seva’s Aids Eye Initiative has worked to prevent blindness due to opportunistic infections (IOs) among people living with HIV. Seva workshops have taught indirect ophthalmoscopy to detect IO signs on the retina in more than 10 countries. However, this diagnostic approach is not scalable. Seva is now working with Remidio Innovative Solutions/Bangalore to develop the Vistaro ultra-wide field retinal camera to meet the demanding specifications of AIDS programs: small, lightweight, durable, affordable, easy to use by non-eye care personnel, seamless image capture, storage, and display, and more. Programs using the device today consider it to be a game changer in early detection of blinding CMV retinitis and life-threatening TB. The Vistaro also is an effective tool for any eye clinic or hospital seeking to detect Diabetic Retinopathy and other conditions.
4. What challenges have you faced when introducing new technology into eye care services? Do you think the Guide will be useful to help identify challenges earlier and increase the likelihood of sustained use of the technology?
The Guide’s technology for access framework came in handy during our extensive design phase and preparations for testing the Vistaro within HIV care settings. The Guide underscored the importance of understanding local ground realities and workflow in busy clinics. These understandings were translated into user-friendly training programs for clinic staff. This was particularly relevant for us when introducing an eye examination device into settings with zero eye care focus.
5. What advice would you give to eye care provider organizations or governments in adopting technology for eye care services?
Take time at the outset to understand your tech needs from the ground up. Many tech efforts fail for lack of deeply examining what is needed and the eco-system into which the tech is being introduced. Use the guide to test your assumptions systematically. Build an evidence-informed plan complete with monitoring and improvement protocols. Create local champions for the technology.
6. How can the IAPB eye health technology guide help when incorporating technology into eye care services?
The IAPB Guide first and foremost helps organizations sort through the growing array of technologies hitting the market. It offers a shared vocabulary among developers, eye care providers, funders, and others who are committed to smart tech. The Guide’s Readiness Scale (adapted from NASA) helps to gauge the stage of development of a tech product. By selecting tech that is a good fit, your organization can focus on how to introduce, sustain, and increase its impact over time.
7. What current or future developments in technology do you see as having the most potential for improving eye health services?
I’d say the most important breakthroughs will be in tech that is purpose-built with robust input from users. A top priority is to deploy tech which enables relatively lower-skilled, well-supervised staff to bring services to more people. AI is certain to have a big effect. Our challenge will be to ensure that tech fulfills its promise to close the service equity gap and not to expand it.