By Dr. David Cockrell, Chairman, Health Care Alliance for Patient Safety

As Chairman of the Health Care Alliance for Patient Safety (HCAPS), I have spent my career advocating for patient safety and ensuring that medical devices, particularly those used in eye care, do not put individuals at risk. One issue that has continued to concern me—and one that I believe must be addressed immediately—is the ongoing use of robocalls in the verification of contact lens prescriptions. Despite significant advancements in technology, the practice persists, causing costly and unnecessary risk.

Contact lenses are officially recognized as complex medical devices. This designation is not arbitrary; it reflects the fact that these devices sit directly on the eye, influencing both vision and eye health. Improper lenses, or those that do not match the shape and or needs of the specific eye, can lead to a host of serious issues, including eye infections, corneal damage, and even permanent vision loss. The verification of these prescriptions is therefore an important step in the process of ensuring that the right lenses wind up in a patients eye.

Yet, despite these inherent risks, the Federal Trade Commission (FTC) continues to permit robocalls for contact lens prescription verification— a practice that was allowed under the Contact Lens Rule developed in the early 2000s. At that time, when fewer people had smartphones and fewer HIPAA-compliant options for verification existed, robocalls may have seemed like an acceptable option. But today, they are an outdated and inefficient practice.

As the FTC has acknowledged, over the past few years there has been an “emergence of business models that rely exclusively, or almost exclusively, on passive verification as a means to substitute their own brand of daily contact lenses.”. This practice is utilized by large industry players like Hubble Contacts and 1-800 Contacts and newer player like Eiyan Lens, despite the availability of secure, patient-centered alternatives. We now have mobile technology, encrypted communication channels, and a wide variety of HIPAA-compliant methods to verify prescriptions—so there is simply no reason to continue operating with outdated technologies.

This antiquated technology has also helped to fuel the rise of a dangerous practice known as “company-driven substitution,” where online retailers replace a prescribed contact lens with a different, often inferior lens. By relying on passive verification methods, robocalls allow these bad actors to bypass the final safeguard: consultation with the prescribing doctor. This leads to patients receiving lenses that may not be suitable for their eyes, sometimes resulting in catastrophic consequences. Without the doctor’s final check, patients are left without the last line of defense against potentially substandard products.

While contact lenses are designed to correct vision, the wrong lens can cause irreparable harm. Substituting an inferior lens—without the patients or doctor’s knowledge—could lead to serious complications up to and including permanent blindness. Yet passive verification through robocalls removes the critical step where a doctor ensures that the lens prescribed is safe for the patient’s eyes.

As a health care professional deeply concerned with the safety of patients, particularly in my field of optometry, I urge the FTC and the Food and Drug Administration (FDA) to reevaluate the use of robocalls in the verification process and take immediate action to protect patients. We have entered an age where technology can—and should—be used to improve patient safety, not undermine it. The current system, which allows companies to bypass doctors through robocalls, compromises this safety.

The safety of a patient’s vision should never be left to an outdated and antiquated system. We need the strongest safeguards in place to ensure that every contact lens user receives the correct prescription and the safest possible product. The continued use of robocalls for prescription verification must end—before it causes any more harm.

Dr. David Cockrell
Chairman, Health Care Alliance for Patient Safety