User:Mike mair

New Profile Proposal for IHE Eye Care

For consideration in the 2011-2012 Cycle of the IHE Eye Care Domain.

1.Proposed Work item: IHE CATARACT SURGERY PROFILE PROPOSAL • Proposal Editor: Michael Mair • Editor: Michael Mair • Date: 27.11.11 • Version: 1.0 • Domain: Ophthalmology

2. The Problem Problem Statement Surgeons use different data sets, equipment, and information systems and need a ‘common currency’ to express and collate their work. Cataract Surgery is one of the most commonly performed surgical procedures in the world. There is no universally agreed and available technique for sharing cataract surgery data or permitting outcome research beyond the ‘silo’ of each local information system. Many clinics are afraid to implement Electronic Records for fear of getting locked in to the wrong technology. A successful standard available now would address this and facilitate adoption of electronic medicine in this and other domains. 3. Key Use Case Use Case • A surgeon performs a cataract procedure on an individual eye of a patient and records data before the procedure, at the time of the procedure, and after the procedure in an Ophthalmology management application. An auditor at another site is unable to access this data, and a researcher trying to design an efficient cataract surgery process is unable to gain access to this data.

Many stakeholders including the surgeon, the patient community, payers, accreditation agencies, researchers would like to track outcomes from this and other similar procedures and benchmark them against the work of other surgeons working both locally and globally. This would bring benefits including: • accreditation and assessment of individual surgeons. • identification of needy populations, and • evaluation of differences in surgical technique, equipment and consumables by their effect on outcome

4. Standards and Systems Standards Acuity Notations include Snellen (US and UK/Australasian), Logmar, ETDRS etc Optometric notations for dioptric power and corneal curvature Data standards including OpenEHR archetypes and Detailed Clinical Models (DCMs) CDA and the HL7 vs3 and the Clinical Statement Protocol Codes e.g. Snomed, ICD Loinc Systems Paper Records (most surgeons still are paper bound) EHR systems Devices measuring ocular parameters e.g. axial length, keratometry, refraction.

5. Discussion: An IHE profile for Cataract Surgery would complement the General Eye Exam profile. It uses many of the same ‘content modules’. A cataract profile now would be additional ‘proof of concept’ of the IHE General Eye Exam initiative, and along with a Glaucoma profile and a Fundus profile would encapsulate about eighty percent of the work of eye clinics worldwide. A cataract surgery profile would facilitate improvement in global cataract surgery outcomes and enable a global currency for exchange of cataract data and to facilitate outcome research.