Sometimes in life you need to take a leap of faith. Go against the herd. Predict the future. Jason Holland reflects on the opportunity his team embraced and how technology – in the form of Topcon’s Harmony – helped to propel the practice forward.
It was 2020, and I was part of a team looking for opportunity at The Eye Health Centre in Brisbane.
Most businesses were focussing on the logistics of temporary closures and staff redistribution, but not us. We decided it would be a good time to expand our business, ready for the other side of the COVID-19 pandemic. And so we did. From 2020 and well into 2022,
The Eye Health Centre underwent significant expansion. From a single site with Dr Andrew Apel as the sole practitioner, we expanded to four sites in metropolitan Brisbane, and a new regional site in Rockhampton. First came Dr John Hogden. Then we welcomed an additional two doctors to the team. Our newly combined expertise covered anterior and posterior segments.
EVOLUTION
As we broadened the scope of the practice, we also invested in equipment and clinical staff to support our bold vision. The volume of data we collected daily began to increase significantly and it soon became clear that a review of the systems and processes that underpinned our clinical workflow was also necessary.
Right away we could see the main challenges were:
- Optometrists were entering patient details up to six times, due to software platforms running different devices – this meant workups were taking up to 25 minutes per patient,
- Doctors needed to open up to six different software windows to view scanned information in addition to their clinical notes,
- Longitudinal comparative data involved reviewing multiple print-outs or scans across different software platforms,
- Visibility of the data while off-site in theatre was logistically challenging,
- Data security involved back-ups to hard disk drives on a regular basis, and
- We were unable to accommodate customised data requirements for anterior vs. posterior ophthalmologists.
These challenges were not unique to The Eye Health Centre. To this day, they create bottlenecks that cost clinical businesses like ours money and productivity. They also limit the capacity of doctors to provide care to a greater number of patients.
THE LEAP OF FAITH
Conversations about clinical data management are not new. Sometimes referred to as PACS systems, data management platforms are fast cementing their value in the clinical workflow. Good data management platforms offer clinical businesses tools that streamline data flow and the review process.
As we began investigating data management solutions, we quickly found that there were plenty of options and that not all were created equal.
For us, an important consideration was the ability to integrate multiple devices onto the same platform over time. Diagnostic equipment is constantly evolving. We wanted freedom to choose the best devices for our business, from any manufacturer, both now and into the future, without impacting our chosen data management solution. Fortunately, the use of DICOM, raw data, native reports, etc is now making it possible for many data management platforms to do this.
After much analysis, we chose Harmony from Topcon Healthcare for various reasons. This platform allows our doctors to review all patient data in a single screen. The functionality that we use in our practice, for example, scrolling through optical coherence tomography (OCT) b-scans along with the colour fundus image, and comparing longitudinal data, all happens via the Harmony interface. It is useful for diagnosis, for surgical decision making, and for patient education.
THE FUTURE
There is no doubt that integrating a data management platform into our clinical workflow has enhanced the efficiency of our business. The patient DICOM worklist has been a game changer for our clinical optometry team, saving time by eliminating data entry, and cleaning up data by reducing transcription errors.
Our doctors are also very happy. The customisable hanging protocols mean they can review their scans in their preferred layout, and easily switch when needed. All diagnostic data is presented in a single screen, with easy access to longitudinal data via the intuitive timeline. Our data is no longer locked to a physical location, which is important, not only for a multi-site businesses, but because all operating doctors need to easily access patient data in theatre from a tablet.
We are a team that believes more data leads to better outcomes for patients. The Harmony cloud-based data management platform is helping us to realise this vision.
Jason Holland BAppSc(Optom)(Hons) GradCertOcThera CASA CO graduated from Queensland University of Technology in 1994. He worked as a locum for The Optical Superstore until 2002, when he became the National Director of Optometry. Mr Holland also commenced work with ophthalmologist and anterior eye specialist, Dr Andrew Apel in 2001, and has since been providing pre and postoperative assistance at his Brisbane rooms. He obtained his ocular therapeutic prescribing rights in 2012 and founded a dry eye, glaucoma, and advanced contact lens clinic.
This article was commissioned by Topcon Healthcare.
Not all products, services or offers are approved or offered in every market, and products vary from one country to another. Contact your local distributor for country-specific information and availability.
As we began investigating data management solutions, we quickly found that there were plenty of options and that not all were created equal
Case Report: Data Management in Action
Figure 1a
Figure 1b
Figure 1a and b. With DICOM compatibility, Harmony makes it possible to review all scans in one screen, regardless of device type or brand. This functionality enables raw data to be used in the same way as it is with instrument-specific review software, while offering efficiencies because all relevant data is presented in the single screen. Here, an image taken on a Heidelberg Spectralis OCT is being reviewed in Harmony. The dynamic/scrollable macula OCT is being used to assist with monitoring diabetic cystoid macular oedema.
Figure 2 Harmony
Figure 2. Harmony’s Timeline feature enables easy identification of when each scan was taken, and in just once click provides the ability to review longitudinal data. Here Harmony is used to review topography scans from an Oculus Pentacam, comparing the patient’s initial cataract work-up to his final follow-up.
Figure 3
Figure 3. The cataract hanging protocol with OPD/Pentacam/IOL Master 700 and OCT enables our doctors to efficiently compare keratometry measurements taken from the different devices, to screen for any signs of ocular health problems like age-related macular degeneration or glaucoma, and assists in their choice of intraocular lens implant. Having all the scans in one snapshot also enables Dr Hogden to explain what is being seen in the scans to the patient.
Figure 4. With all patient data stored in the cloud, doctors can easily and seamlessly review scans from anywhere, at any time. Here, Dr John Hodgen is using Topcon Harmony in theatre to efficiently review patient scans before surgery.
