While the digital transformation in ophthalmology is now making ever more progress, the first digital ophthalmology practices are now appearing.
There are very different approaches to how something like this can work, depending on where and with what purpose a digital eye care practice is to be set up.
On the one hand, digital ophthalmic practices are being built to provide general and basic care in underserved areas. On the other hand, digital practices can also improve care for patients in well-served, urban areas who, for example, have to work long hours due to their occupation and therefore cannot see an ophthalmologist at usual times.
The journey of the individual patient in the digital practice is not significantly different from that of the patient in the traditional ophthalmology practice. Anamnesis - preliminary examination - medical examination - diagnosis, patient education and therapy discussion - prescription/ further appointments for surgery etc. are assigned.
In a digital practice, however, individual steps of the patients journey can also be outsourced (Fig. 1). As a result, the patient's stay on site is significantly shortened, waiting times are reduced and the focus can be completely on the actual examination. In addition, more examination appointments can be assigned and an optimal utilization of expensive medical equipment can be achieved.
Before the on-site examination
For example, the patient's medical history can be filled out online in advance. Older doctor's notes and medical data (such as imaging data) can be transferred in advance. The scheduling of appointments and the planning of the on-site visit can then take place in advance on the basis of the data already transmitted and the anamnesis already taken, if necessary also after detailed inquiries to the patient.
During the on-site examination
Initially, of course, the patient should be identified and his insurance status and personal data (address, telephone number, etc.) verified. Pre-examination and examination are carried out uniformly or individually for each patient on the basis of the medical history - ideally in the form of predefined stations to which the patient is automatically guided (e.g., by buzzer, identification via NFC, barcode, insurance card, fingerprint, etc.). The examinations to be performed can be customized depending on the medical history or modified if an experienced medical assistant is on site or an ophthalmologist can be consulted online.
Figure 1: The different steps of the patient journey in a digital ophthalmology practice. By outsourcing certain individual steps and focusing exclusively on the examination during the on-site visit, it would presumably be possible to achieve optimal equipment utilization, shorten waiting times for patients, generally offer more examination appointments at employee-friendly times, and overall provide standardized yet individualized treatment.
After the on-site examination
The data thus obtained can be analyzed and evaluated partly automatically - partly by an ophthalmologist. The diagnosis can then be explained to the patient via smartphone/tablet using his digital and interactive patient file, at a time convenient to him, and a therapy can be discussed. Ideally, there would also be additional information videos, e.g. on the application of drops, side effects, etc.
Prescriptions, certificates, etc. are sent digitally to the patient's terminal device and further appointments are made directly.
A detailed, digital patient report should also follow the face-to-face consultation with the ophthalmologist to avoid unnecessary examinations already performed during consultations with other physicians and to allow the patient to obtain a second opinion.
Furthermore, if necessary, a surgical intervention can also be discussed and planned, if necessary with an explanatory discussion and obtaining a digital signature. Further scheduling can also be done online after the on-site appointment.
In general, the digital ophthalmology practice can be supported by, for example, an online chat function in real time or by a good ChatBot (compare our interview with ChatGPT), so that acute questions of the patients can be clarified and answered directly. This could also improve care and reduce waiting times on site. In addition, it is believed that by better informing and educating patients, a higher level of insight into the disease and adherence to therapy can be achieved, unnecessary on-site appointments can be avoided and more free appointments will be available to other patients.
Digital health apps, for example in the form of drop reminders, could also improve adherence to therapy.
In part 2 of our article, you will learn how this can be implemented with devices and software.
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