Impact Of Digital Cataract Workflow On Productivity

To prospectively evaluate efficiencies in time and resource utilization with integration of digital workflow solution to existing electronic medical record-based workflow (EMR) for cataract surgery with monofocal, multifocal and toric intraocular lenses (IOL).

A time and motion study was designed to measure time savings with the incorporation of a digital cataract workflow solution (Zeiss EQ Workplace with FORUM) to the existing EMR workflow in 3 high volume cataract practices in Germany. The cataract workflow consisted of routine preoperative assessments in biometry, topography, OCT, ECCand IOL calculation, as well as digitally guided toric IOL implantation (in case of toric IOLs). 

In 1 center the full digital workflow was deployed and compared to 2 centers with a regular EMR-only enhanced workflow. Results were compared with use of statistical methods.

Time and motion measurements were done on a total of 227 patients in the EQ workplace cohort and 203 patients in the non-digital cohort. Integration of Zeiss digital workflow to the existing paperless EMR workflow resulted in reduction of total workflow time by 7:33 minutes for monofocal, 10:04 minutes for multifocal and 14:11 minutes for toric IOLs. Significant reductions were achieved for each phase: preoperative testing (7:33 min, p<0,005), surgical planning (2:31 min, p<0,008), and surgery time (4:07 min, p<0,005). Relative savings with the EQ workplace varied between 12 and 44%. We further discovered a significant reduction in the variation of examination times between 10-39% (p<0,005, except for topography which was non-significant).

Integrating a digital workflow solution to existing clinical workflow offers a significant value add with reduction in time and resource utilization and hence a significant productivity up-side opportunity.