TSG Innovations

A typical clinical environment of an ophthalmological set up comprises of:

• An EMR
• A Practice Management system
• A Billing System
• Examination Instruments
• Examination workstations (connected to instruments)
• Review Workstations
• An Image Management System

An Image Management system captures images from instruments, archives and stores the images and provides viewing functionalities. A large number of ophthalmologists are using image management as a central system for clinical examination and diagnosis.

The Challenges of Interoperability in an eye care set up

Data and images on instruments are stored in proprietary format and hence have limited connectivity to EHRs and PACS. This creates barriers in acceptance and use of EHRs and PACS and results in issues for ophthalmologists such as:

• Redundant patient & clinical data entry into devices
• Issues of data transfer from devices to EHRs and PACS
• Workflow challenges to automatically capture and index the images and data from devices.
• Difficulty in connecting devices from different vendors

Adoption of DICOM standards for images and measurement data on devices resolve these basic issues of connectivity.

Majority of existing systems DO NOT provide TOTAL interoperability.

Many systems do not follow DICOM standards and hence are constrained in connecting and integrating devices and systems.

Majority of the systems are not able to integrate all instruments. Large number of legacy devices does not have DICOM capability. Some of these devices cannot be connected on the network. These systems do not integrate in these devices and are also not able to fulfill the need of connectivity among devices, EHRs and PACs.

Some systems provided by device manufacturers connect with instruments of their own make but fail to integrate other vendors. Image management systems from such instrument manufacturers are built on proprietary platforms and are based on proprietary data of instruments of their own make. These systems do not have vendor neutral environment. Such systems impose severe restrictions in clinical ophthalmological set up.

Some systems do not provide real-time images from all instruments. They provide various work-around such as scan solutions and fail to provide real time images from critical instruments for diagnosis.

Not all systems are able to connect with EMR, Practice Management systems and Billing software.

Any constraint on TOTAL interoperability has a severe impact on the workflow, resulting in drastic reduction of interoperability benefits.