Open source electronic medical record software for clinical governance in phacoemulsification and intraocular lens implant

Session Details

Session Title: Moderated Poster Session: Cataract
Session Date/Time: Friday 09/02/2018 | 14:00-15:00
Paper Time: 14:00
Venue: Poster Area


First Author: C.Holmes UK
Co Author(s): N. Patel                 

Abstract Details

Purpose:

To demonstrate the utility of open source Electronic Medical Record (EMR) software in clinical governance and quality assurance for phacoemulsification and Intra-Ocular Lens (Phaco+IOL) implant surgery. Quality assurance has become an important aspect of the cataract service in the United Kingdom, with outcome targets published by the Royal College of Ophthalmologists, and monitored in the ongoing National Ophthalmology Database Audit. EMR software holds the potential to streamline this process by providing a platform for recording information and facilitating access to large volumes of outcome data at the touch of a button. Open source EMR enables customisation of this process.

Setting:

East Kent Hospitals University NHS Foundation Trust

Methods:

All patients who had undergone phaco+IOL between December 2016 and August 2017 had data routinely recorded with “OpenEyes” software. Data on 1132 patients was collated and exported for analysis with Microsoft Excel. Data collected included demographics, surgeon, procedure type, complications, and refractive and visual outcomes. Comparison was made with the cataract national dataset.

Results:

Visual acuity in all patients was 6/12 or better in 1000 (88.7%); and 6/6 or better in 493 (43.7%). Refractive outcomes were within 1 dioptre of predicted in 981 (86.6%) and 0.5 dioptres in 712 (62.8%). There were 29 (2.47%) complications, with posterior capsule rupture and/or vitreous loss occurring in 5 (0.44%) cases. No cases of endophthalmitis were reported, but recording of post-operative complications was potentially limited by partial implementation of the EMR system. This is the second use of “OpenEyes” EMR to audit the department’s cataract outcomes, and its output has been customised to allow comparison to standardised benchmarks.

Conclusions:

Open source EMR is a potentially powerful tool in the information age of cataract surgery. With the prospect of departments and individual surgeons publishing outcomes in the UK to facilitate patient choice of provider, EMR software provides easy access to this data in a usable format. Open source software enables customisation of data at the point of collection and at output, and so can facilitate clinical governance and research as required. Future customisations in our department will include predicted PC rupture rate according to risk factors, thus improving comparison between surgeons.

Financial Disclosure:

None