OpenEyes, an internationally awarded electronic patient record and referral system for eye care, developed by an Australian company, has been successfully rolled out across eight major hospitals in Scotland.
The system enables ophthalmologists and optometrists from different hospitals and clinics to enter and access a patient’s medical history, diagnose ocular conditions, and measure and monitor changes over time.
The system initially went live in June 2022, with glaucoma being the first sub-specialty covered. Now OpenEyes caters to the needs of all ophthalmology subspecialties.
Dr Paul Cauchi, an ophthalmologist and the ophthalmology lead for OpenEyes in Scotland, explained that as a proof of concept, OpenEyes was rolled out site-by-site across eight hospitals in the largest Health Board in NHS Scotland, Greater Glasgow and Clyde. Together these hospitals serve a population of 1.4 million people, providing free healthcare to all permanent residents.
“After a successful roll out of the glaucoma subspecialty, we introduced OpenEyes site-by-site for all sub-specialties… The full roll out to all outpatient clinics took about a year,” Dr Cauchi said.
OVERCOMING SHORTFALLS
He said OpenEyes is expected to overcome significant shortfalls in the current healthcare system.
“The ophthalmology department in Glasgow is still using paper notes, which represents a significant financial cost, and is of limited use in terms of data and service planning,” he explained to mivision. “OpenEyes represented an opportunity to get rid of traditional paper notes allowing electronic working with all of its advantages.”
Additionally he said, “There was no detailed audit of the treatments we were using, such as anti-VEGF injections for age-related macular degeneration. So OpenEyes represented a real opportunity to understand better why there are prescribing differences from region to region.
“It is very possible that the structured data from OpenEyes could inform why there are differences and result in a potential reduction in the number of injections required for patients with a significant cost saving,” he added.
OVERCOMING CHALLENGES
Dr Cauchi admitted that “real challenges” arose when integrating OpenEyes with current management systems.
“This integration was critical in pulling details of demographics and live clinic information. As with all big integrations, several IT issues had to be dealt with. Fortunately, the same patient management system is used throughout Scotland,” he said.
However, the most challenging aspect was winning over the “hearts and minds” of team members who were already working to capacity, and persuading colleagues that “we had to move to electronic working and that it would make taking care of patients more reliable, efficient and safer”.
He said they needed to be convinced that “it would also allow us to have detailed data on our patient population with the many opportunities it would or could provide”.
“One of the main concerns was whether having to input data would slow the already very busy clinics down. We initially reduced the number of patients in clinic but were able to see the same number quite quickly as people got used to the system,” Dr Cauchi said.
The digital transformation required the support of three information technology groups. Toukan Labs provided the highest-level support followed by NES technical (National Education for Scotland) and finally, local support came from NHS Greater Glasgow and Clyde IT, which provided essential “hands on” training and trouble shooting.
IMMEDIATE GAINS
With over 120,000 patient records now on the OpenEyes system in Scotland, and being accessed by over 600 users, Dr Cauchi said the benefits are already being experienced.
“OpenEyes has allowed excellent data sharing for asynchronous clinics where patients attend for scans and measurements, and the clinician then checks the data at a different time and location to make decisions on patients. This is being used for virtual glaucoma clinics and ocular oncology clinics. This allows extra patients to be seen without causing congestion in the face-to-face clinics,” he said.
Although the NHS Scotland has not gone live with OpenEyes in the operating theatre environment, plans are in place to do so within the coming months.
“We have rolled out for community optometrists with a glaucoma qualification who take care of stable glaucoma patients discharged into the community. Additionally, three Health Boards have started to use OpenEyes with more to follow.
“Of course, we would like to roll out the system to all Health Boards in Scotland. And with the proof of concept in Glasgow, we know it can be done,” he concluded.
