Strategic Plan

Strategic Plan

The American Glaucoma Society Board of Directors, Bylaws & Strategic Planning Committee, and Invited guests met prior to the AGS meeting in Austin, TX in 2023 to review and update the society's strategic plan. The strategic plan was approved by the Board of Directors on April 28, 2023. Instead of a road map, this plan is a GPS where we can anticipate change, adjustments, and will approach this plan with a nimble mind set.

Core Ideology

Core ideology describes an organization’s consistent identity that transcends all changes related to its relevant environment.  Core ideology consists of three notions: core purpose, mission, and core values. Core purpose describes the organization’s reason for being.  The mission describes who we are, what we do and how we do it. Our core values are the enduring principles that guide the behavior of the organization.

 

DRAFT CORE PURPOSE:

To improve the quality of life of all individuals with glaucoma and those at risk.

 

DRAFT Mission Statement:

AGS is the preeminent organization dedicated to improving the lives of all people with glaucoma and those at risk by leading the advancement of education, research, health care access, and advocacy.

 

DRAFT Core Values:

·         Integrity - Uphold the highest level of ethical principles.

·         Intellectual curiosity - Recognize and embrace innovation and commit to continuous reexamination of knowledge and ideas.

·         Respect - Conduct work with collegiality

·         Compassion - Recognize the needs and minimize burdens of patients, families, and caregivers.

·         Inclusion - Embrace diversity and inclusion of people and ideas to better reflect the population we serve.

·         Education - Disseminate high quality evidence-based information.

·         Equity - Promote fair and just distribution of healthcare resources

Vivid Description of a Desired Future

 

A Vivid Description conveys a concrete, yet unrealized vision for the organization.  It is a description of how the world could be different for key stakeholders and serves as a focal point for effort.  It describes the intersection of what a group is passionate about, what they do best, and what they can marshal the resources to accomplish.

 

American Glaucoma Society DRAFT Vivid Description

AGS is a thriving member community due to efforts in continuing education, opportunities for collegiality, professional development, and scientific exchange. Members are better able to demonstrate their value to society and other organizations because of big data developed and disseminated by the AGS. Our Society is the leading voice for glaucoma and a trusted advocate across the spectrum of basic and clinical glaucoma research and patient care. AGS catalyzes the integration and access to care in collaborations with numerous stakeholders including patients, providers, community leaders, industry, regulators, and legislators.

 

Glaucoma patients benefit from earlier diagnosis due to AGS successful efforts in improving glaucoma screening, awareness, and education about the disease. Our patients benefit from improved outcomes due to innovative treatments that AGS has facilitated and have improved access to glaucoma care due to workforce diversity, equity, and inclusion programs implemented by the AGS. All people with glaucoma have adequate access to high level care including diagnosis, monitoring and effective treatments and benefit from effective collaboration among glaucoma specialists, comprehensive ophthalmologists, optometrists, and other health care providers.  Seamless data integration and communication among providers and researchers affords the ability to integrate new technologies in an evidence-based, patient-focused manner that has enhanced capabilities while improving the connection between provider and patients.

 

AGS members experience improved quality of work and professional satisfaction because of AGS efforts in providing resources and care for the profession. Our Society is a thriving member community due to efforts in continuing education, opportunities for collegiality, professional development and scientific exchange. AGS members represent a diverse group of physicians, including practice environments, gender, race/ethnicity, geographic region, and surgical expertise. The number of historically underrepresented minority physicians is increasing. Underserved geographic areas across the US receive expert glaucoma care.

 

Glaucoma researchers benefit from increased research funding and opportunities due to AGS efforts in fundraising with the resources they need to advance the science of glaucoma. All eye care providers benefit from the activities of the AGS to provide best practices for efficient and successful glaucoma diagnosis and treatment and have attained better and safer diagnostic and therapeutic modalities due to research supported by the AGSF. Industry benefits from widespread application of technology for glaucoma care.

 

 

 

Environmental Scan

Building Foresight

 

Conditions, Trends and Assumptions

These statements, developed by the group, help to purposefully update the strategic plan on an annual basis. Since the outcome-oriented goals that will form the basis of the long-range strategic plan will be based on the vision of the future that appears in this section, an annual review of this vision will be an appropriate method of determining and ensuring the ongoing relevancy of the goals.

 

Healthcare Delivery System:

Ø  Shortage of ophthalmologists with aging of the population and increasing disease prevalence will further decrease patient access to care. Insurance companies dictate what diagnostic, medical and surgical care patients can receive.

Summary of "Current Conditions" discussion

 

Ø  Eye care is becoming an integral part of health insurance and health care delivery. Patient-centric delivery systems, coordinated care, tele-health and AI integrated technologies represent important trends. Healthcare systems are contributing to the increasing scope of practice for non-MDs.

Su                                                                                                                                                                                                   Summary of "Trends" discussion

 

Ø  Large healthcare systems will support less-trained providers taking care of patients with earlier stages of glaucoma. Further decreases in ratio of glaucoma specialists to glaucoma patients will continue with increases in remote diagnostic testing.

Summary of "Assumptions About the Future" discussion

 

Business and Economic Climate:

Ø  Presently, AGS has limited interaction and partnerships with our industry partners and leaders in ophthalmology. Insurance companies are dictating care. Costs are rising and the economy is tanking beyond periodic inflation.

Summary of "Current Conditions" discussion

 

Ø  Increasing influence of 3rd party payors on which and how health care is delivered. Decreased reimbursement for patient care and surgeries. Large healthcare organizations seem to have different priorities than individual physicians and patients.

                                                                             Summary of "Trends" discussion

 

Ø  More cuts to physician/surgeon reimbursement. Reimbursement from commercial payers will continue to align more closely with Medicare payments. Continued consolidation of care.                      

                                                                              Summary of "Assumptions About the Future" discussion

 

Legislation and Regulation:

Ø  Many observers blame physician salaries as the cause of high health care costs in America but impractical regulations are the main factors that drive up cost. Insurance companies continue to have significant control over U.S. health care.

Summary of "Current Conditions" discussion

Ø  There must be a unified voice for glaucoma care in the United States, and the AGS must be the voice, clarifying issues and uniting the cause for glaucoma. There are many societies that are involved in eye care, but we must be the final/strong voice when it comes to what is the best glaucoma care in the United States.

Summary of "Trends" discussion

Ø  As healthcare organizations become larger and larger, physician concerns will be drowned out by the legislative and regulatory needs of the organization rather than the individual physician’s needs. AGS needs a grassroots effort from our patient base in order to create meaningful change.

Summary of "Assumptions About the Future" discussion

  Social Values and Demographics:

Ø  Lack of provider and leadership diversity. Very limited pipeline of minority physicians and leaders. Dysfunctional health care systems exacerbating inequalities in access to care.

Summary of "Current Conditions" discussion

Ø  Hopefully, increasing diversity among health care professionals, better care of our elderly patients, less fragmented medical care and more integrated health care organizations unified by a common electronic health record.

Summary of "Trends" discussion

Ø  More optometrists managing glaucoma patients, which influences the public perception of who is qualified to perform specialty eye care. Healthcare should decrease unnecessary costs. Increased diversity of glaucoma docs over next 20 years.

Summary of "Assumptions About the Future" discussion

Technology and Science:

Ø  Continued investment in innovation by industry. Innovation suffers as industry partners meet challenges in reimbursement of these newer technologies and therapeutics. However, these therapies are often costly and either LCAs or MACs will not approve, create step therapies, or restrict use of such therapies.

Summary of "Current Conditions" discussion

Ø  High quality clinical trials will drive real science vs pseudoscience in clinical practice guidance and introduction of real technology and science. High technology use drives down reimbursement. Integrated technologies to help with glaucoma diagnosis and monitoring.

Summary of "Trends" discussion

Ø  The cost of useful technology will increase as reimbursements decrease or remain the same, so the cost of taking care of patients ultimately increases for the physician. Technician-independent diagnostic testing becomes more prevalent.

Summary of "Assumptions About the Future" discussion

Draft Goals, Objectives & Strategies

 

Goals represent outcome-oriented statements intended to guide and measure the organization’s future success. The achievement of each goal will move the organization towards the realization of its “Envisioned Future.” Supporting objectives further clarify direction and describe what the organization wants to have happen with an issue.  In other words, a descriptive statement of what constitutes success in measurable terms. Strategies describe how the association will commit its’ resources to accomplishing the goal. They bring focus to operational allocation of resources and serve as a link from long-term planning to annual planning.  Finally, strategies set strategic priorities for committees, staff, and all other work groups.

 

Priority Key

Critical (C) = Work on this strategy must be completed in the coming year.

Immediate (I) = Work must begin on this strategy in coming year

Intermediate (IN) = Work on this strategy may begin in the coming year  if resources permit

Later (L) = Work on this strategy should wait until a subsequent year  

 

 

Draft Goal A - AGS the Organization

AGS will be the leading voice for glaucoma increasing awareness and collaborating with partners and stakeholders to provide the highest level of patient care, research, and continuing education.

 

Draft Objectives:

1.      Increase representation of AGS on relevant AAO committees and as AAO decision-makers.

2.      Increase effective communication between AGS and AGSF. Make more members aware of the AGSF.

3.      Increase traffic to the website; increase prominence of AGS website via search engines.

4.      Increase avenues for philanthropy to AGSF (internal and external), increase number of philanthropic targets and contributions. Develop easy method for doctors to direct their patients to donate to AGSF.

5.      Increase resources devoted to staffing the AGS and AGSF.

6.      Increase the number of glaucoma providers who are members of and actively engaged in the Society, experiencing satisfying professional rewards from their membership and leadership, reflecting the diversity of our patients.

 

 

 

 

Draft Strategies:

Critical

1.      Develop philanthropic plan, potentially including CPO identification of 3 potential donors for each philanthropic program each year, increasing member engagement, establishing new philanthropic programs and targets.

2.      Re-establish the communication loop between the AGS representative to the AAO Healthcare Policy Committee and the appropriate AGS committees (e.g. Patient Care) and the AGS board; consider having committee member(s) attend select AGS board meeting as invited (nonvoting) member

Immediate

3.      Create educational hub on website for members- include links to AAO ONE network, one-minute videos, EyeWiki; use XCD platform to upload recorded talks from members, slide sets with AGS branding and solicitation for donations to AGSF.

4.      Review select AAO committee rosters to determine appropriate inclusion of AGS members. Increase communication to bring AGS agenda to the AAO committee with coordination by the AAO councilor and/or AGS representative on the committee.

Intermediate

5.      Explore the potential of an industry symposium for start-ups and members on the day before the annual AGS meeting. This may strengthen ties with industry and could be organized by the AGSF advisory board, somewhat similar to Eyecelerator@AAO program (non-CME)

6.      Hire a communications specialist and develop a marketing and communication strategy, including social media campaign to raise public awareness, major website revision (user-friendly educational hub for patients, links to other supportive organizations, e.g. Prevent Blindness)

Later

None

 

 

 

 

 

Draft Goal B - Researchers

Researchers will have the means to advance big data research, informatics, translational sciences, and clinical trials, supporting a diverse group of young- and mid-career clinician-scientists.

.

 

Draft Objectives:

1.      Achieve consensus on definition of glaucoma diagnosis and progression.

2.      Achieve interoperability and access to patient-level structural and functional data to establish large and diverse datasets.

3.      Establish network of participants for future clinical trials.

4.      Increase funding for glaucoma research.

Draft Strategies:

Critical

1.      Develop consensus on definition of glaucoma diagnosis and progression.

2.      Identify potential partners for funding, including government, industry, foundations, members, and patients.

Immediate

3.      Advocate for improving interoperability and access to patient-level structural and functional data to establish large and diverse datasets.

Intermediate

4.      Establish interface with big techs for getting access to data from personal devices

5.      Develop a consortium of investigators to support large collaborative clinical trials.

6.      Develop mechanisms to improve involvement of AGS on Editorial Board Member structure of Ophthalmology Glaucoma.

Later

7.      Identify large funding opportunities (i.e. NEI/NIH) to support multicenter clinical research.

 

 

 

 

Draft Goal C - Members, Doctors, Eye Care Providers

Those providing care to glaucoma patients will benefit from a community of competent and professionally satisfied care providers that includes individuals from all practice styles, age, demographics, and backgrounds

 

Draft Objectives:

1.      Increase fair physician reimbursement and reduce administrative/regulatory burdens

2.      Increase education on the appropriate use of diagnostic and therapeutic technologies.

3.      Increase collaboration and mentorship between early and later career physicians.

4.      Increase diversity in providers caring for glaucoma patients

5.      Increase communication and reduce divisions among providers caring for glaucoma patients

 

Draft Strategies:

Critical

1.      Initiate a conversation between AAO and AGS regarding our position on optometric care of glaucoma patients.

2.      Create opportunities and training for members to serve as mentors for new AGS members

Immediate

3.      Collect population data on severe disease to better identify the unmet needs in glaucoma and guide our strategy around workforce

4.      Continue AGS HPLDC program to identify and educate interested members on reimbursement/health policy

5.      Communication and mentorship between early- and mid-level leadership

Intermediate

6.      Improve the AGS website to expand offerings and resources.

7.      Continued participation in the AAO Minority Ophthalmologists Mentoring program.

8.      Expand programs like INSPIRE with possible multimedia resources about the field

9.      Educate members on how to navigate common reimbursement and regulatory challenges

Later

10.  Publish position statements and technology updates.

 

11.   

 

Draft Goal D - Patients

Patients will have knowledge of as well as appropriate and equitable access to glaucoma diagnostics and treatments that enhances their lives

 

Draft Objectives:

1.      Provide high quality educational resources to help patients better understand glaucoma

2.      Increase number and quality of metrics for treatment goals (i.e. --treatment targets other than IOP)

3.      Decrease the cost of care and cost of drugs to patients.

4.      Increase the number of glaucoma specialists practicing in the US.

5.      Acquire data on how to individualize MIGS and other surgeries to improve outcomes.

 

Draft Strategies:

Critical

1.      Website and Patient Engagement Subcommittees redesign patient portal of website to increase patient resources and accuracy of information provided

Immediate

2.      Develop a program for first-degree relatives of current patients of AGS Members to provide referrals to other AGS members for screening.

3.      Identify effective programs from other patient care organizations.

4.      Create additional patient-centered educational content for our website (interactive, video, handouts) with proposals for measurement of the impact/effectiveness of this content.

5.      Refine webinars about choosing glaucoma as a subspecialty and applying to fellowship.

6.      Publish data on insurance abuses of pharmacy benefit management organizations.

7.      Publish more data on the relationships between drug costs, patient adherence, and disease outcomes.

8.      Implement program to engage more AGS Cares members in screening family members of established AGS member patients

9.      Develop additional YOGS programs to publicize glaucoma as an attractive career to their near peers.

10.  Establish YOGS assistance in generating social media campaigns with use of Instagram and other platforms to improve patient education/awareness and attracting med students and residents to the specialty of glaucoma.

Intermediate

11.  Elevate the AGS website ranking/position website searches (Search engine optimization) of glaucoma terminology (e.g. glaucoma treatment, glaucoma surgery, etc.)

12.  Develop in-person regional meetings with educational content and peer support for patients, possibly associated with the AGS annual meeting.

13.  Create a mini-glaucoma fellowship track in the new integrated internship/residency programs to use extra time wisely

14.  Partner with other organizations to increase outreach of patient education.

15.  Develop strategies for collaboration with comprehensive ophthalmology and optometry to work more efficiently, not harder

Later

16.  Create supplements to glaucoma fellowship salaries.

 

 

 

 

 

Draft Goal E - Society and Underserved Geographic Areas

Society will benefit from new, innovative AGS models of glaucoma care to better screen and treat persons with inclusion of all demographic populations.

 

Draft Objectives

1.      Increase under-represented in medicine glaucoma subspecialists.

2.      Increase universal access to both screening and appropriate follow-up.

3.      Increase community-oriented health literacy.

 

Draft Strategies

Critical

1.      Engage the AAO Healthcare Policy Committee Glaucoma Representative at AGS board meetings by requiring that this individual holds a board position

2.      Better utilize AGS Members-at-Large (ask them to select a task/subcommittee/committee of interest)

Immediate

3.      Raising awareness of health literacy within the community

4.      Develop QR-code driven (and hard copy) educational materials for members to share with patients.

5.      Create a MIPS requirement based on the Medicare Glaucoma Detection Benefit Screening Rules

Intermediate

6.      Recruitment efforts at all levels of training (high school, college, medical school)

7.      Patient Care Committee to educate a variety of stakeholders (e.g., pediatric and medical societies; Bright Focus; RPB)

Later

8.      None

 

 

 

Appendix A

Mega-Issue Questions

Strategic "mega" issues are overriding issues of strategic importance that cut across multiple goal or outcome areas. They address key questions that AGS leaders must ask and answer, illuminating choices of strategy the organization must make and the challenges which will need to be overcome in moving toward future goals. They articulate the questions that will need to be asked and answered by AGS in the next 5-10 years.

 

Question 1 Discussion - How do we optimize the ability of the AGS Foundation to contribute to our purpose?

•••

Many avenues exist which need to be defined and require different approaches: discussions included tapping into members’ practices, nationwide solicitation, engaging senior members, exploring other foundations and industry support

•••

Packaging the AGSF vision and projects (e.g. Research, Patient Access, Education) so that membership and the public have a better understanding of the AGSF

Targeting membership for donations and making connections

Need a clearer plan from the Board before truly engaging the membership

Highlight benefits from the AGSF during the annual meeting.

•••

Give CPO the needed tools to put the Foundation on a path that will optimize its ability to contribute to the good work of the organization. The Foundation would benefit from having its own strategic plan and a formal fundraising plan.

•••

We need to define a practical philanthropic plan with the CPO to know the level of staffing needed. We should consider a task force to work with the CPO, EVP, and president to further define this plan. Perhaps this task force should include working more closely with emeritus members.

 

•••

We need a variety of sub-programs under AGS Cares (besides surgical support) for fundraising efforts.

•••

The Foundation needs a mission and specific projects that appeal to patients and directly impact patient care.

•••

Edit AGSF mission statement and exciting program names to entice to donors.

•••

Educate the AGS membership about AGSF and how to capture their patients who want to help and involve key members on AGSF advisory board

•••

We need a clear development plan with specific timelines and milestones.

 

•••

Currently, we ask for donors to give to "research" then use the funds for specific projects that we later identify. Perhaps we need to ask donors to give specific research ideas (something that they can get excited about) then solicit applications for those projects.

 

Question 2 Discussion - How can we best balance institutional memory, expertise, and fresh thinking?

•••

Limit of 2 years with the possibility of one 2-year extension to increase the participation of our members on the board.

•••

Limit the board term to 3 years with the possibility of one 3-year extension.

•••

Suggest forming a task force to do a deep dive into the nominations process to consider balance board methods, multiple candidates, term limits and succession planning, increasing equity, diversity, and inclusion.

•••

Create a succession plan of secretary-VP-President as one-year terms each, with past Presidents serving 2-year board term.

•••

Better delineate the job and necessary attributes required for each board position.

•••

Should further consider the open board position.

•••

Formalize the criteria used by the nominating committee to select candidates.

•••

Keep term limits the same as there is institutional memory.

•••

A one-year term for the president, in conjunction with a year as president elect/VP, and then 2 years as past president allows 4 total years of service on the Board. All Committee chairs also have a succession plan with designation of a vice chair 1-2 years prior to completion of the chair's leadership. This provides an appropriate balance of institutional memory; inclusion of new voices and ex officio members can always be contacted for consultation.

•••

Having the most recently elected President/Vice-President begin immediately as a non-voting observer of the Board and can stay on 3 years after their term for a total of 6 years for continuity.

 

If it doesn't already exist, establish YOGS Council (similar to the Past President Council) meet with the Jr. Member at Large, Member at Large, and President on an annual basis with the purpose of providing the YOGS perspective to the Board.

•••

Increase communication among related committees and subcommittees.

•••

In my view, this question is tied to terms of service, succession planning, and memory that our organization was susceptible to "dynasty" succession.

•••

Consider a Patient forum associated with the meeting to educate patients on glaucoma and introduce the society and its goals/programs. Could solicit from local members practices and advertisement.