Dear Prof. Cursiefen,
You are the director of the Center for Ophthalmology at the University Hospital of Cologne. For about 5 years, there have been videos of the Center for Ophthalmology on the university's own YouTube channel. With great success - some of the videos have over 100,000 clicks. What motivated you to create these videos back then?
With the educational videos, we wanted to give our patients the opportunity to get more detailed information both before and after the initial contact in the context of eye surgery. After all, we have a lot of patients at the Center for Ophthalmology (almost 7,000 inpatients and about 50,000 outpatients per year) and we want to improve patient engagement through this better preparation and follow-up of the interview situation.
What are the patients' reactions to the videos? Are the videos also used in everyday clinical practice for education in the clinic?
Measured in terms of click-through rates, the feedback is very positive. There is also sometimes good feedback from individual patients. The extent to which individuals actually watch these videos, which we also refer to in part with business cards, is difficult to evaluate on a day-to-day basis. For technical reasons, these videos are not yet used for education on the ward, but this is also planned for the future.
In the context of content marketing, customers are won by producing advisory and informative content and thus strengthening confidence in the competencies of the company. Is this also reflected in the number of patients at the Center for Ophthalmology with the respective diseases after uploading the YouTube videos? Especially the video on the topic of refractive corneal surgery has over 130,000 clicks, do you also have correspondingly many inquiries in your refractive consultation?
Outpatient and inpatient demand for treatment at the Center for Ophthalmology or in our private medical practice has increased steadily in recent years. To what extent this is due to these educational videos is difficult to say.
Why are videos particularly suitable for educational purposes in ophthalmology?
Ophthalmology is a very visual subject with a very aesthetic organ as a treatment goal, so that many things can also be represented graphically. On the other hand, the patient's appreciation of vision is extremely high; the fear of blindness is about the same as the fear of developing tumors and higher than all other fears of disease. In this respect, the desire for education and the need for education among patients with eye diseases is also very high.
Are there any legal pitfalls with regard to patient education by means of videos? In general, individualized patient information is required.
In fact, the educational video has not yet replaced the individualized patient education interview. However, the future should naturally merge these two formats.
Especially in Corona times, the use of telemedicine applications has increased tremendously. What are your experiences? In your opinion, is the use of such educational videos also conceivable via telemedicine?
In principle, yes, with the above-mentioned legal restrictions.
Up to now, there has been very little telemedicine in the field of ophthalmology. In the USA and Great Britain, however, telemedical procedures are increasingly being used in ophthalmology, for example by the NHS. In addition, there are now a large number of cell phone tools for applying imaging procedures even in regions where traditional ophthalmological care is not available. In your opinion, what are the main limitations in the use of telemedicine in ophthalmology?
The main limitation before Corona was certainly the lack of affinity for technology; this has now improved significantly in the pandemic. Nevertheless, it should not be ignored that a large proportion of the patients affected are in an age group for whom dealing with cell phone apps etc. still takes some getting used to or is completely outside their reality of life.
The second problem goes in the same direction, namely that a larger proportion of patients certainly still want an individual patient consultation. Of course, this does not exclude teleconsultation, which, as mentioned, is certainly an interesting addition to personal care in rural areas.
In the USA, there is now also a first algorithm for the automatic detection of diabetic retinopathy using artificial intelligence. Where do you see the use of artificial intelligence as helpful, where as necessary, where as superfluous?
I think that the use of AI will help us immensely to improve the precision of our ophthalmological diagnoses and to develop therapeutic algorithms and thus also to reduce the ever-increasing workload with an ever-shrinking ophthalmological "workforce". In this respect, I see the use of AI especially in the field of image analysis and especially in the field of ophthalmology as a fundamentally very positive development. However, it is still the responsibility of the ophthalmologist to interpret all the findings in total and then also in accordance with the needs of the individual patient and to draw conclusions from them.
With regard to the topic of artificial intelligence and big data, there are repeated calls for a data solution that is at least Germany-wide, if not Europe-wide, in order to generate sufficient data pools. How do you think something like this should be implemented, and what are the current obstacles?
If we do not want to be completely left behind by foreign competitors, it will be unavoidable to generate larger data pools and to think about realistic solutions for Germany and Europe, which of course still ensure patient protection. American ophthalmology has led the way with the IRIS registry, and the German Ophthalmological Society (DOG) is currently setting up the OREGIS registry in order to generate treatment results on a large scale throughout Germany so that correspondingly valid big data analyses can be performed.
Another question that particularly concerns young scientists and doctors. Generations X, Y and Z in particular are increasingly striving in the direction of established New Work models such as part-time work, home office and decentralized working. In our last interview, we spoke with Prof. Sebastian Kummer, head of the Vienna University of Economics and Business. Mr. Kummer manages his institute decentrally from a catamaran for half of the year. His publication achievements and third-party funding acquisitions are nevertheless impressive. Do you think that such a way of working could also be possible in the future for physicians working in the clinic and in research? What would be necessary for this?
Of course, clinic management from a catamaran sounds very tempting, but I think that this will be difficult to implement in the medium term, especially in disciplines that require direct patient contact and surgical activity, such as ophthalmology. In subjects such as radiology or pathology, something like this is certainly more conceivable thanks to AI (and has already been implemented). But you are absolutely right that we naturally need more flexible solutions for regulating working hours for Generation XYZ. But in research, too, it is of course the case that laboratory research cannot be realized from home. We learned that again recently in the corona pandemic. In this respect, it will take even longer in the field of medicine and thus also in ophthalmology (I think the corona pandemic was a good example of this, when large parts of the working world were shifted to the home office, but we continued to work in principle just as before) until such radical changes can be realized. Besides, we all became doctors not to sit in a home office, but to help patients in direct contact with them.
Last question: You are known worldwide for being a visionary in ophthalmology, especially with regard to imaging techniques. Where do you see ophthalmology in 20 years, how do scientists work in ophthalmology, how do ophthalmologists work? What status will imaging and AI have?
That is a broad field. In relation to my generation, ophthalmology will certainly be more female, more part-time and more flexibly democratic than we have known it. Artificial intelligence and the optimization of image data collection and analysis will certainly have a significant impact on our workflow and thus improve our diagnostic and therapeutic accuracy and therapy monitoring. The work models will certainly become more flexible, but, I think, we will nevertheless continue to maintain the close doctor-patient contact in the direct analog relationship not only in consultation, but of course also in surgical treatment, and therefore we will not face such dramatic upheavals as in other subjects in the field of medicine. As far as research is concerned, ophthalmology is currently in a truly spectacular phase of new developments in many areas, which we should use to reduce the numerous unmet needs that still exist in the treatment of our patients. This is why the German Ophthalmological Society is advocating the establishment of a German Center for Health Research with a focus on ophthalmology, in order to be able to offer our patients, whom we have not been able to help well so far, better diagnosis and treatment options in the future. So it is an ideal time especially for younger colleagues and students to choose ophthalmology.
Thank you very much for the exciting insights and outlooks!
Contakt:
Chief secretariat of the Center for Ophthalmology of the University Hospital Cologne
Telephone +49 221 478-4300
Telefax +49 221 478-5094
Email: marie.seifert@uk-koeln.de