Provision of an Ophthalmology Electronic Medical Record (EMR) Solution

The Trust procured and implemented the current Ophthalmology EMR solution twenty years ago and has used it ever since. This creates a hybrid approach to clinical record keeping including extensive use of paper notes. The existing solution will cease to be a fully supported solution in 2024 therefore the purpose of this project is to identify and procure a suitable replacement Ophthalmology EMR solution that will provide the full range of Ophthalmology functionality.<br/><br/>Background<br/><br/>The existing Ophthalmology EMR will cease to be a supported solution in 2024 and as a result The Ophthalmology team is already seeing a degradation in the level of support provided for the legacy solution. This is also resulting in the team’s inability to make necessary improvements or find remedies for known bugs and is affecting their ability to deliver the service effectively.<br/><br/>The existing solution also has significant gaps and shortcomings and does not provide a comprehensive digital record across all sub-specialties. As a consequence, Ophthalmology records are split between a combination of paper and digital records, which is both inefficient and carries clinical risk.<br/><br/>As a result, there are two key strategic drivers for this project:<br/>

• Continuity of service; and<br/>
• Improving clinical quality and safety<br/><br/>In further support of the need for a new solution, the overarching Ophthalmology Clinical Strategy (2020-2025) specifically identifies the use of digital technology to transform patient pathways, in particular, including:<br/>
• Greater integration with Cerner Millennium<br/>
• Communication between community-based activities (e.g. optometrists) and the OUH team<br/>
• Accessibility from all locations from where services are provided<br/><br/><br/>Scope<br/>Ophthalmology has many sub-specialties within the service such as medical retina, vitreoretinal, uveitis, glaucoma, anterior segment including cornea / cataract, oculoplastics, strabismus, neuro-ophthalmology, paediatric ophthalmology, ocular oncology, general and eye casualty. Each of these subspecialties require different combinations of IT systems providing recording of all ophthalmic imaging and diagnostics, which relate to disease state, and recording of progression of these disease to ensure timely treatment and prevention of loss of vision. The same ability to image and monitor patients has driven the development of protocol-based delivery of healthcare by non-medical personnel at cost-saving to the NHS. Capture of imaging and data for asynchronous virtual telemedicine is a vital part of this (eg for managing patients with chronic eye disease (glaucoma/medical retina)). <br/>The ability to deliver care remotely eg in partnership with optometrists and in OUH-owned imaging hubs will be enabled using these technologies in parallel with a networked Ophthalmology-specific IT infrastructure which reflects the imaging requirements, subspecialty patient -record needs and the high volume work which characterises today’s Ophthalmology practice. <br/>The Oxford Eye Hospital serves approximately 112,000 outpatient (OPD) based encounters per year, with 16, 500 Eye A/E, who are are seen between multiple consultants, fellows/ junior doctors, allied health professionals (AHPs), and nurses who need to take /access/review new eye scans and measurements, compare them to previous eyes scans, have a knowledge of the patient’s medical history, and write new notes whilst keeping the patient at the centre of the consultation. Thus, there is a need to be able to rapidly access and input complex information quickly and ensure it is kept in one place. Many ophthalmology patients have multiple appointments throughout the lifetime of their eye condition and at each appointment more paperwork is added to their notes