‘Practice In Your Pocket’ – How An Integrated Mobile Information Technology (It) Practice Management Solution Helped A Patient With Complications Following Cataract Surgery

To report the case of a patient who suffered complications of cataract surgery and whose management was greatly facilitated by the use of an integrated, mobile, cloud-based, practice management system. It is to show that providing timely access to a patient’s record by multiple people (including the patient), from multiple locations, on multiple devices, at multiple points in time (including out-of-hours) can improve patient care. It also demonstrates the additional benefits of remote access to a booking diary and live inventory updates.

This case study is of a patient attending a private ophthalmology practice in the United Kingdom which is a consortium of consultant surgeons providing consultation and surgical services. The IT solution was implemented by the practice after a wide search of systems available both in the UK and worldwide. It was eventually selected to allow comprehensive practice management including seamless shared care of patients by multiple clinicians across multiple sites.

Mr E attended an optometrist on a Sunday with sudden loss of vision. By using his mobile phone patient portal, Mr E was able to share his history of cataract surgery 3 days earlier including intraoperative zonular dehiscence and the insertion of a capsular tension ring. Examination found a subluxed intraocular lens (IOL) with vitreous haemorrhage. The optometrist contacted Consultant A (practice on-call doctor) who accessed Mr E’s patient record on a tablet at home. This indicated Mr E had also suffered blunt injury to his eye from a tennis ball many years ago. Consultant A entered a note of the optometrist findings and made an appointment with Consultant B the next day at a location nearest to the patient using the practice diary. Consultant B confirmed lens subluxation but with associated macular on retinal detachment. He then contacted Consultant C (vitreoretinal surgeon) who spoke to the patient over the phone, consented him virtually and booked the patient for vitrectomy, cryotherapy, gas, removal of dislocated IOL and insertion of an anterior chamber IOL (ACIOL). Later that evening, Consultant C remotely accessed Mr E’s biometry, selected an appropriate ACIOL, and checked the availability of the implant via the integrated stock inventory module. The check revealed the ACIOL was not in stock at the practice but given the time available, a suitable ACIOL was successfully sourced from a nearby hospital.

The IT solution enabled:

• the patient to accurately share his surgical record with his optometrist
• allowed Consultant A after-hours access to the patient’s record, add the new findings and book the patient a convenient urgent consultation
• allowed Consultant B to have all findings available at the time of the urgent consultation
• allowed Consultant C to book surgery, perform consent online, and have the correct lens available for surgery

Despite the existence of multiple practice management, electronic patient record and stock inventory systems, it was the a) integration, and b) mobile access to these systems which were pivotal in providing successful multidisciplinary and multi-site management of this patient.