The National Academies of Sciences, Engineering and Medicine (NASEM) Report
By now many of you have seen the NASEM report released in the last quarter of 2016 titled, Making Eye Health a Population Health Imperative: Vision for Tomorrow. It includes recommendations and a call to action “to examine the core principles and population health strategies to reduce vision impairment and promote eye health in the United States.”1-3 For those who have not seen it, you’re probably asking, “What is NASEM and why is their report important to us?”
First a little history – the establishment of the National Academy of Sciences dates back to the Civil War era. The Act of Incorporation establishing the group was signed by President Abraham Lincoln in 1853. Over the years the National Academy of Sciences has expanded to provide various services to the government. In 1916 the government established the National Research Council as part of the National Academy of Sciences at the request of President Woodrow Wilson.1 The National Academy of Sciences have since formed the National Academies of Engineering (1964) and Medicine (1970), now known collectively as NASEM.1,2 NASEM are private, non-profit institutions that provide independent, objective analysis and advice to solve complex problems and inform public policy decision.2 The Health and Medicine division of NASEM was previously known as the Institute of Medicine.
In 2013 the Centers for Disease Control and Prevention (CDC) began its Vision Health Initiative which proposed the concept of a NASEM consensus study on vision and public health. The CDC prioritized the scope of work to include:
limitations and opportunities to improve vision and eye health surveillance
reduce vision and eye health disparities
promote evidence-based strategies to improve knowledge, access, and utilization to eye care
identify comorbid conditions and characterize their impact in the US. and
promote health for people with vision impairment. NASEM was also asked to examine the potential for public and private collaborations at the community level and to elevate eye health as a public health issue.2
Initially, the CDC’s Vision Health Initiative provided funding to conduct the NASEM study.2 Subsequently other sponsors, including the American Academy of Optometry, Prevent Blindness, the National Eye Institute, Research to Prevent Blindness, the American Optometric Association, the American Academy of Ophthalmology, the Association for Research in Vision and Ophthalmology, the National Alliance for Eye and Vision Research, and the National Center for Children’s Vision and Eye Health, contributed to the project.2 Our financial support of the project enabled the Academy to have input into the study and its dissemination.
The report includes core recommendations to facilitate public awareness through timely access to accurate and locally relevant information, generate evidence to guide policy decisions and evidence-based actions, expand access to appropriate clinical care, enhance public health capabilities to support vision-related activities, and promote community actions that encourage eye and vision healthy environments.3 Hopefully much of this can be achieved with the concerted effort of federal agencies like the CDC, Department of Health and Human Services, and other key stakeholder groups.
Importantly, the NASEM study found an absence of federal directives and programs to advance eye and vision related health.3 This included marked discrepancies in guidelines for care of individuals with eye and vision related problems. Therefore, the professional organizations representing eye care providers have been encouraged to develop a single set of evidence-based guidelines and measures to be used by eye care professionals, other health care providers and public health groups. The guidelines will strive to prevent, monitor and screen, as well as detect and treat, eye disorders. In addition, the directive asks for guidelines that drive payment policies including coverage determinations for corrective lenses and visual assistive devices following a diagnosis.2,3 This is where the Academy and the other key stakeholder groups will likely play their most active roles.
The Academy has had preliminary discussions with several of the stakeholders that are essential in achieving the recommendations set forth. I’d like to thank our optometry representatives and Academy Fellows who served on the NASEM committee, Drs. Sandra Block, Lori Grover and Edwin Marshall, for their tireless efforts and for admirably representing optometry. A special thank you to Drs. Kevin Jackson and Debbie Hettler from the Academy’s PHEV Section, along with our Executive Director, Lois Schoenbrun, for their valuable input to the Academy Board of Directors and for attending meetings held by NASEM following their report release last year.
We look forward to working toward purposeful joint guidelines by collaborating with other key stakeholders including the American Optometric Association and the American Academy of Ophthalmology, among others. We anticipate a collaborative effort using many of the resources within the Academy, including input from several of our committees, Sections and SIGs. The Academy will keep you informed along the way. In the meantime, look for the editorials and a comprehensive review of the NASEM Report outlined in the April 2017 issue of our Academy journal, Optometry and Vision Science.
Joseph P. Shovlin, OD, FAAO
President, American Academy of Optometry