EyeRoute at UIC - A Six Month Review

Patient - PhysicianInteraction

RetCamPhotos

Corneal Topography

ICGAngiogram

Ultrasound Imaging

GoldmanVF

FluoresceinAngiogram

Nidek MP-1Microperimeter

HumphreyVF

ClinicalPhotos

OCT

Over the past six months, the University of Illinois, Chicago, Department of Ophthalmology has benefited from the purchase and installation of the EyeRoute Image Management System. The need for such a system became obvious as the apparent inefficiencies of the manual printing of patient photos and diagnostic tests, organizing and filing, and finally retrieving patient data led to physician, staff and patient dissatisfaction. A bold move in technology and infrastructure was necessary to springboard the Department into the new millennium. The purchase of the EyeRoute image storage system through the generous donation of the Karl Cless foun-dation was that springboard which has revolutionized patient care, resident education and clinical research. This document will serve to outline how the EyeRoute system has enhanced our department.

To understand how significant this change has been to our department, one must take a step back and look at the past. Prior to the installation of the EyeRoute image management system, diagnostic testing, whether a fluo-rescein angiogram, Humphrey Visual Field, or Optical Coherence Tomography, required a printed report be generated for physician review. Unfortunately, creating these reports entailed a great deal of effort, resources, and time. After creating such reports, this information had to be transferred to the end-user physicians to deliver patient care. However, our faculty consists of 18 resident physicians, 12 clinical fellows, 35 full-time faculty members and 22 part-time adjunct faculty mem-bers in multiple clinics in three separate facilities. This created a huge logistical nightmare. For many years we

were able to plug along, but with significant reduction in clinic efficiency, as well as staff and patient satisfaction.

During the summer and fall of 2005, the ophthalmol-ogy faculty reviewed and tested several different image management solutions including OIS Webstation, OcuLab and Zeiss VisuPac. We came to the con-clusion that the EyeRoute image management system offered us the best user interface, technological plat-form, and ability to effectively interface with multiple instruments from diverse manufacturers.

Over the last six months the faculty has seen the ben-efits of this system. First, there has been a significant improvement in physician satisfaction. Before EyeRoute, the typical hunt for various test results could be likened to a full blown safari. For example, finding one photo or OCT result could involve searching in at least four different locations between two different buildings. It could easily add fifteen to twenty non-productive minutes to a patient encounter. Today, the physician sits with the patient in the exam lane and with a few keystrokes pulls up the patients test results for review. Second, it has improved support staff efficiency. Prior to EyeRoute, the photo clerks and photographer would dedicate about two hours per day to obtain photo charts for the next days clinic. Today, they can use this time more productively and schedule more patient vis-its. Also, we have eliminated the lost chart syndrome. This critical improvement ensures that all diagnostic test data is efficiently stored in real time. Also, a significant cost of running a diagnostic photo service is disposable. Digital photography eliminated the cost of film and developing. Today, with the EyeRoute image manage-

by Lawrence J. Ulanski II, MD*Assistant Professor of OphthalmologyUniversity of Illinois, Chicago

Ophthalmic Image Management System

Diagnostic Testing for Patient Care

ment system we have eliminated the cost of photo printing and mailing. We estimate this savings alone is $15,000 to $20,000 per year. In addition to these direct monetary savings, we have seen significant indi-rect savings. Recently, I communicated with an adjunct faculty member in California about a difficult patient I was planning to enroll into a clinical study. I was able to have her sign into EyeRoute from her office and we were able to review the fluorescein angiogram together in real time. Likewise, today when we have teaching conferences with the residents, all the case material comes from the EyeRoute system. It is quick, the resi-dents can access the data they need either from home or directly in the auditorium during their presentation, and it increases the efficiency of our teaching mission. It has also significantly impacted our research mission. Today, with a few keystrokes, all of the patients with a given diagnosis can be located within the database in minutes and the data collated. In the past, such a query would have taken days if not weeks. However, in the end, the most important aspect of any institutional or small office upgrade is how it affects the patient-physician interaction. The EyeRoute image management system has dramatically improved our patient-physician interactions. Today, we can pull up a patients diagnostic test results in the exam lane and immediately show the patient their individual pathol-ogy as it compares to normal. Whether it is an ultra-sound, color photograph, or OCT, the data is there to be presented. By having easy and quick access to this data, the patient becomes a more informed participant in the health care delivery process, and can more easily and confidently come to a decision regarding their health-care. Also, just the immediate presentation of the data to the patient helps foster a sense of confidence in the patient in the institution and the physician. Patients today expect high tech!

The addition of any high tech interface is often a process loaded with anxiety and headaches. The tran-sition to the EyeRoute system has been neither. The initial setup, from server installation to finishing and

Benefit:

Improved Physician Efficiency

Increased Photography Unit Efficiency

Reduced Printing/Mailing Cost

Improved Teaching Efficiency

Improved Patient Communication

Estimated Monetary Savings:

Four Additional Patient Visits per Day

Four Additional Patient Visits per Day

$15,000 - $20,000 per year

Priceless!

Priceless!

Benefits Derived From the Installation of the EyeRoute System

verifying all network connections, took three days, and this did not interfere with our clinical operations. After the system went live, there were almost no problems. We have also been able to integrate the software into our Universitys Citrix environment without significant issues. The company itself has been very responsive to any request for assistance. Any problem or system hiccup has been solved in less than 24 hours. EyeRoute engi-neers have made numerous follow-up visits to ensure our needs have been met and to help with system upgrades. Recently, we have been discussing EyeRoute integration into a new EMR. Again, the EyeRoute team is already there with a solution.

UIC Systems Interfaced with EyeRoute:

Topcon 50IA w/ ICG & IMAGEnet 2000 Zeiss FF4 with OIS 5000 WIN Station Zeiss Stratus III OCT Nikon SF3V PhotoSlit Lamp Nikon DX2 SLR External Camera (Manual Import) Goldman Visual Fields (Manual Import) Humphrey 750i Visual Field Units x 2 Quantel CineScan Ultrasound Machine RetCam Nidek MP-1 Microperimeter

Overall, the transition to the EyeRoute system has been nothing but a positive experience for our department. The EyeRoute team has been nothing short of excel-lent, and I think collectively the members of our faculty would be in agreement that the EyeRoute image man-agement system has brought a significant improvement to our clinical operations. I would recommend this system to both large institutional practices and small private offices without hesitation.

* Disclaimer: I have no financial interest in EyeRoute Systems or Topcon Inc. I have not received any compensation for this product endorsement.

2007, Lawrence J. Ulanski II, MD - All rights reserved. All registered trademarks are the exclusive property of their respective owner. ERulart0702