Refocusing the Patient Experience—AI and Team-Based Care in Ophthalmology

About 15 years ago, I began offering cataract consultations twice a week for 2 hours in my office. In my cataract consultation pathway, I saw how positive patient experiences could support practice growth, but I also recognized that this system contains friction that affects patients, staff, and physicians. My central question then became: How do I redesign the cataract pathway so that patients can have a smoother experience and be better prepared for surgery?

Reimagining the Cataract Consultation Pathway

The key complication was that the traditional process was not optimized for a one-pass system. Missing patient history information resulted in additional testing, repeated physician encounters, or patients moving backward through the workflow. These complications then resulted in friction across the clinical pathway. Therefore, I wanted to create multiple touchpoints across the cataract pathway, rather than concentrating everything into one intense, often overwhelming visit. However, staffing and hiring challenges made it difficult to rely solely on additional human resources to provide those touchpoints. The goal was to preserve the value of the physician-patient conversation by shifting routine preparation earlier in the pathway.

Building Digital Touchpoints Before the Visit

To cut down on exposure risks during the height of COVID, I recorded 2-minute videos explaining the process and expectations of a cataract consult to patients. This way, patients could absorb that information without the immediate stress of having me in the room, while I could use my face-to-face time to address what was actually necessary and meaningful. Patient feedback was positive, so I have now extended these videos to 4 minutes, and they play during the dilation process. Following the positive experience of this new digital workflow, my next thought became: What if I can use AI to obtain key information before the visit?

Introducing DORA

I was looking for a way to increase efficiency in my workflow, without stripping the critical need for human judgement and meaningful shared discussion. This led to my partnership with a company called Ufonia that uses a large language model called DORA. This system contacts patients via phone call before their visit and gathers information using questions I help define (Figure). Following DORA’s implementation, I have found that patients arrive better informed on their consult day, and most importantly, they feel that their experience of care is more personalized.

AI as Support, Not Substitution

I understand people have their reservations about AI. I want to stress that I do not see AI as making clinical decisions or replacing human connection. Instead, I see this application as a meaningful shift; AI is making its way into the clinical pathway rather than remaining on the periphery in areas like scheduling, patient education, or revenue-cycle functions. For me, the opportunity is not to remove the physician from the process, but to use technology to make each patient encounter more prepared, personal, and efficient.

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