Overview of size, composition and role

Overview of group

Description of professionOptometrists are primary health care providers, being the first point of professional contact for people experiencing problems with their eyes or have difficulty seeing. Optometrists are experts in: the optics of lenses, eye health and visual performance. They assess, diagnose and manage ocular diseases, injuries and disorders across a wide range of patients. Where clinically necessary, optometrists prescribe spectacles, contact lenses and devices for the visually impaired.
Number4,400 17

(2006 Census recorded 3,065)

Gender mix45% female; 55% male18

EXHIBIT 52 - Distribution by Age and State

Distribution by Age and State - optometristsD

EXHIBIT 53 - Overview of practice attributes

Overview of practice attributes for optometristsD

Education, registration and accreditation

An OCANZ-accredited university degree required. There are two tracks available:
  • 5-year undergraduate university degree; or
  • 4-year postgraduate Doctor of Optometry degree (after completing biomedical science undergraduate degree of 3 years).
  • Registration required with Optometry Board of Australia, which is one of the national boards established under NRAS.
  • Optometrists must complete a minimum of 40 points of CPD activities each year. The Optometry Board of Australia is responsible for setting criteria for these courses and approving courses offered by education providers.

Funding and referral system

  • Optometrists currently have access to 26 MBS item numbers, as set out in the Optometrical Services Schedule of the MBS<a href="#19"><sup>19</sup></a> Unlike other allied health items, no GP referral is required to access an optometrist. Due to the Common Form of Undertaking – Participating Optometrists, optometrists (unlike doctors) are not permitted to exceed the Medicare Schedule fee for any Medicare service, except in the case of a domiciliary visit or a patient being billed an item 10907 attendance.
  • In addition to the Medicare rebate, which can be claimed for the consultation with an optometrist, patients may claim a private health insurance rebate to contribute to the cost of spectacles or lenses if they hold private health insurance, ancillary or “extras” cover.

Peak National Body

Optometrists Association Australia

204 Drummond St,
Carlton, Vic 3053

PO Box 185,
Carlton South, Vic 3053

ContactTelephone: (03) 9668 8500

Fax: (03) 9663 7478

E-mail: oaanat@optometrists.asn.au

Optometrists and eHealth

Examples of relevant eHealth applications

Some example uses of eHealth that optometrists could benefit from include:
  • Electronic transfer of diagnostic scans – optometrists may send retinal scans and OCT images to ophthalmologists for assistance with diagnosis and treatment or for referral purposes. Sending these scans electronically increases speed of service for patients (particularly for optometrists based in remote locations).
  • Continuing professional development (CPD) – OAA and other CPD providers already provides CPD training courses, discussion forums and journal libraries online.
  • Electronic health records – 95% of optometrists are already using an electronic health record system.
  • Digital referrals and electronic health records – this will assist with multidisciplinary care, in particular the documentation of information flows around care plans under the Medicare Chronic Disease Management items.
  • Medicine record management

Current eHealth 'Position'

Optometrists are highly technologically competent and place a high value on having access to the latest diagnostic equipment. They do tend however to be very business-focussed as a result of competition on the sector and are unlikely to invest in anything which does not have an immediate return on investment.

Many optometrists in rural areas send through retinal scans and OCT images to ophthalmologists located in the larger rural centres or cities to assist with diagnosis and treatment or for referral purposes. For this reason they have applied to the Federal Government for access to the Telemedicine items as they feel this is a relevant service.

There are four EHR providers for optometrists – two are in-house providers for Luxottica and Specsavers and the other two are available for independent providers. The OAA are hoping that Government plans for the health identifiers and the PCEHR will be compatible with the existing software programs with minimal adjustments. They hope that the PCEHR will be accessible with a single system without the need to switch between software programs.

The OAA also assists individual practices with website development.

Key insights from eHealth readiness survey

  • 75% of optometrists see between 6-15 patients per day, 48% working from a single practice. 37% of optometrists practice at least occasionally in a rural or remote area.
  • Administrative efficiency drives the computer use of optometrists, with billing and patient rebates (76% of practitioners use), and patient booking and scheduling (65%) both prominent. Educational applications are less ubiquitous but desire to adopt is evident in the remaining population (57% access clinical reference materials online, a further 27% don’t currently do so, but would like to; 55% of optometrists access CPD online, a further 25% would like to).
  • Computers are used broadly within patient consultations, with 61% of optometrists showing patients health-related information, 59% viewing or recording patient information during a consultation and 61% entering patient information after a consultation.
  • The greatest unmet need for optometrists is collaboration. 20% of optometrists currently share health records with other practitioners electronically, while 40% do not, but would like to. 27% send or receive referrals electronically, although a further 39% would like to.
  • Telehealth use is almost absent for optometrists, with just 2% currently using any telehealth solutions. Of the 98% not currently using telehealth, only 18% expect to adopt within 3 years. Training is the only application commonly envisaged (13% very interested).
  • 19% of optometrists only use paper records, and equivalently 19% only use electronic records. Of the 81% using some form of computerised record, 61% use an EHR. 46% strongly agree that the majority of their colleagues use computers, while 42% agree computer use is expected.
  • The provision and quality of care registers the greatest benefits for optometrists, with improving collaboration strongest (31% strongly agree), improving continuity of care (18%) and the care delivery process (13%) also resonating. Patient engagement (10%) and satisfaction (9%) were expected to see some benefit, although business drivers were considered the weakest benefits (e.g., reducing exposure to legal risk, 8%)
  • The three leading barriers to adoption for optometrists are technology concerns, including the need to use established technology (39% strongly agree this is a barrier), maintaining compatibility with existing IT systems (38%) and concerns about malfunctions or downtime (36%). Selection and usability of eHealth systems do not register as strong concerns for optometrists, for example just 8% strongly agree eHealth systems are too difficult to select and implement, and only 15% strongly agree they can’t find a solution that meets their needs.
  • Optometrists indicated their most influential drivers of adoption would be financial incentives (47% strongly agree), the advice of their professional body (36%) and the recognition of practitioners who adopted technology early (30%)

17ANPHA data released 18 April 2011
18Clinical Experimental Optometry, 2010; 93: 5: 330-340.
19To access the OMBS see here: http://www1.health.gov.au/internet/mbsonline/publishing.nsf/Content/Downloads-201101