Electronic Ophthalmic Surgery

Management (EOSM)

Patient History Record Medical Status and History

Review of systems Family and Social History

Interfaces Diagnostic Equipment

Administration Systems

Consent Forms Surgery (Word Document)

Anesthesia (Word Document)

Anesthesia Documentation Anesthesia Questionnaire

Pre-op Anesthesia Order Post-op Anesthesia Order

OP Documentation Pre-op Record

(Intra) Operative Note Post-op Record

Nurse Documentation Pre-op assessment

Intra operative Record Post op Record

OP-Report Surgery Report (Word Document)

Data Export Clinical Trials

Surgery Registries

OP Plan OR Planning

Attachments EyeDraw

Ifa4iPad Interface List (extract)

The OP record can be fully

integrated into the clinical EMR:

Dashboard

1. Medical History

Using ifa's SmartScreen technology, a user can easily enter all the relevant patient OP information.

The user is then able to generate meaningful data (e.g., based on SNOMED terminology) and export

it utilizing the query function for reports, clinical trials, disease registries, and other outcome

databases.

The structured data formats are available for:

- Past medical history - Past ocular history - Family history - Allergies and risks - Medication history - Social history

The user selects terms from "pick lists" associated

with standard codes such as ICD or SNOMED and

their compatible terms with clinical modifiers for

precise documentation.

2. Interfaces

The connectivity guarantee is important for any paperless ophthalmic OR. Interfaces are designed for

data import from ophthalmic equipment and for exchanging data with administration systems

(HIS/Hospital Information Systems and PMS/Practice Management Systems).

Equipment Interfaces

More than 450 instruments and digital systems can be connected with the ifa OP management. The

interfaces are based on exclusive agreements with the leading vendors for ophthalmic technology.

Examples:

- IOL Master (Zeiss Meditec) - PentaCam (Oculus) - Orbscan (Alcon) - HRT (Heidelberg Engineering) - Image Systems (e.g. Topcon, OIS, Kowa, Canon

etc.) - Autorefractor/Keratometer (Topcon, Nidek,

Canon, Humphrey etc.) The up to date list is available on the web:

www.ifa4emr.com.

HL7-Interfaces:

- Demographic data

- Diagnosis codes

- CPTM codes

- Reports CDA

DICOM :

- Images

- Structured Reports

HIS- and PMS Interfaces

The clinical OP management can be connected with the existing administration system (Hospital

Information System/Practice Management System). The bi-directional interfaces are based on the

international HL7 standard (Health Level 7: www.hl7.org).

The ifa system imports all relevant demographic data from the HIS/PMS, stores it within the surgery

record, and then exports all relevant information (e.g. diagnosis, procedure codes etc.) for billing and

documentation purposes.

The ifa surgery management is also designed to

communicate with the integrated image data base or

professional PACS.

DICOM is the standard format for the integration of all

kind of BLOBS (binary large objects) incl. OP videos (e.g.

AVI files).

Signature pads support the

paperless ASC

3. Consent Forms

Consent forms management depends on the relevant legal requirements. All documents are stored

as WORD files which can be modified by merging the patient data from the medical record: name,

DOB, type of procedure etc..

The merged documents can be printed, signed by the patient and the surgeon, and imported as a

scanned object into the EMR.

If the legal requirements allow a digital signature the

patient can sign on an electronically pad (without printing

the consent document).

The system provides samples of various consent forms.

Within the customization service all relevant consent

documents can be stored and mapped to the merging

functionality by the ifa consultants.

The iPad allows mobile

computing in the OR

4. Anesthesia Documentation

The ifa surgery management provides a tool to generate all kind of data fields. The user can choose

check boxes or multiple choice codes. For example anesthesia questionnaires can be created for the

preanesthesia evaluation. Data fields can be structured e.g. for:

- Allergies (medications, food, latex) - Current medications - Problems (heart, blood pressure, kidney, lever,

neurology etc.) - Anesthesia history - Type of anesthesia - Postanesthesia evaluation (level of

consciousness, status cardiopulmonary etc.)

The other alternative is the use of existing paper forms

which are scanned and imported into the surgery record.

Also combinations (structured data and scanned

documents) can be generated within the customization

process.

The integration of the IOL Master is an

example for save and professional

device integration. More than 450

interfaces listed (attachments)

5. OP Documentation

The documentation requirements for surgical procedures in ophthalmology are complex and

changing depending on new equipment, implants and technologies. Therefore the ifa software allows

user defined data structures and vocabularies.

Predefined data structures can be provided for:

- Cataract Surgery - Vitreous Surgery - Retina Surgery - Glaucoma Surgery - Refractive Surgery - Plastic and Orbital Surgery

The structured data concept can be also used to generate

surgery plans for the OR (see OP plan).

6. Nurse Documentation

For the nurse report (NR) the user can choose between two alternatives:

- Digital codes (structured templates with the EMR)

- Scanned paper form

The solution depends on the work flow and the preferred

data use. If users require searchable NR information, ifa

recommends digital code storage. If the NR is stored

because of legal requirements, the scanning process with

paper forms is more convenient. The scanner interface is

also specifically designed for small, fast-scanning devices

(e.g. Fujitsu ScanSnap).

Surgeons can concentrate on

procedures and reduce the paper

work.

7. OP Report

The OP notes are generated automatically by merging pre-defined text reports with the individual

patient and procedure data. The basic text is a WORD document with structured merging features.

Within the customization process the existing user reports are evaluated and preset for the

electronica work flow. If required the OP reports can be

completed with scanned documents (nurse reports,

anesthesia reports, instrument print outs, graphical

documents and drawing documents).

The OP reports can be directly printed and/or sent by e-mail

with the relevant data protection features.

8. Data Export

The ifa software suite offers comprehensive data export functionality. Quality outcome data bases,

registries and clinical trial projects can import directly data from the surgery EMR. The data

structures are SNOMED compatible and can be used for international projects.

Integrated into the OP management is also the export

interface for the EUREQUO project which is used worldwide.

The registry for cataract and refractive surgery allows the

comparison of the user`s quality data with international

registry. The reports are developed by experts based on

data outcome studies by the ESCRS (European Society for

Cataract and Refractive Surgery, more information:

www.eurequo.org).

All EMR versions are available

for Apple iPad

9. OP Planning Chart

The OP management software generates the complete plan for the OR. Users can customize the

layout for the different procedures or surgeons. The system imports the patient related data from

the EMR and integrates the clinical data (visual acuity,

refraction etc.) into the OP plan.

The flexibility of the tool makes painless and efficient, and

the plan can be printed or displayed on a computer screen

(e.g. in the prep area).

Additionally, a tablet PC (such as the Apple iPad) further

enhances immediate access to the OR plan or any other

procedure-related information.

10. Attachments

10.1. EyeDraw

The EyeDraw tool allows all kind of drawings for ophthalmic surgery management

10.2. ifa 4 iPad

All functions are also designed for pad computers like the Apple iPad and for Touch Screen

Technology.

10.3. Interface List

EcMR for Cataract and Refractive

Surgery

Biometer, Ultrasound, Cornea Topography and Multi Function Devices

• Biometer, Optical

• Tomey AL-100

• Zeiss IOL-Master

• Ultrasound Systems

(biometer/pachymeter)

• Bio-/Pachymeter

• 4Optics OCP

• Alcon OcuScan RxP

• Alcon OcuScan (software)

• B-scan systems with video port

• Haag-Streit AXIS II PR (serial interface)

Heidelberg OCP

• M + C - I 3 system

• Mediconsult I-Scan

• Nidek A-/B-Scan US 2500/20

• Nidek Echoscan US-4000/500

• Oculus Pachycam

• Quantel Pocket Pachy

• Quantel Medical CineScan (video port)

• Quantel Medical Compact II (video port)

• Quantel Medical Aviso (video port)

• Technomed E-Z Scan B5500/ E-Z Scan

AB5500

• Technomed PacScan 300 A/300 P/300 AP

• Teknar/Mentor B-Scan III Plus

• Teknar/Mentor A/B-Scan III Plus

• Teknar/Mentor Image 2000

• Tomey AL-100 Biometer/AL-2000/-3000

• Tomey UD-6000

• Tomey SP-100/3000

• Tomey IS-500 A/B-Scan

• Tomey AI-510 A/B-Scan

ifa offers a broad range of device connectivity

EcMR for Cataract and Refractive

Surgery

Cornea Topography (examples)

• Bausch & Lomb Orbscan

• bon Optic EyeTop,

EyeTop-H, Eye Top-S

Haag-Streit Keratograph

• Nidek OPD Scan II

• Oculus Keratograph

• Oculus Easygraph

• Optikon Keratron/Keratron

Scout

• Rodenstock Keratograph

• Tomey RT-6000/7000

• Zeiss ATLAS Model 9000

• Oculus Pentacam

EcMR for Cataract and Refractive

Surgery

Refraction Devices (examples)

• Autorefractor/Keratometer/

Tonometer:

– Nidek RKT-7700

– Nidek TONOREF II

– Oculus Park-1

– Topcon TRK-1P

• Autorefractor:

– Canon R-10/20/22/30/50/F10

– Canon RK3/RK5

– Hoya AR 550

– Humphrey HAR-420/500/510/

525/540/580/580 S/585/590/595

– Nidek AR-310A/330A/600/660

/700/800/820/1000/1200 M

– Nikon NR-5000/5100/5500/8000

• Autorefractor:

– Nikon Speedy

– Nikon Retinomax

– Plusoptix S04

– Rodenstock PR-60

– Rodenstock RA-303

– Rodenstock RX-202/502/520/900

– Shin-Nippon RC 380

– Shin-Nippon QR-007 N

– Shin Nippon EZRef 8000

– Tomey TR-1000/3000

– Tomey RT-7000

– Topcon RM-A-2000/3300/6000/6300/

7000/ 7300/ 8000/RM-8800

– Welch Allyn SureSight Hand-

– Autorefractor

– Zeiss Humphrey Acuitus

EcMR for Cataract and Refractive

Surgery

Kerato-Refractometer (examples)

• Alcon Handheld Keratometer

• Canon RF-1/10

• Canon RK-1/F1/2/3/5

• Grand Seiko GR-3100K

• Humphrey Acuitus

• Humphrey HAK-420

• Humphrey HARK-595/597-599

• Huvitz MRK-3100 P/HRK-7000

• Nidek AR 530A/510A

• Nidek ARK-

510A/530A/560A/700/700A/

760/900/2000

• Nidek KM-500

• Nikon NRK-8000/10000

• Nikon Retinex K-Plus Hand-Ker.

• Nikon Retinomax2

• Nikon Speedy-K

• Potec PRK-5000

• Rodenstock CX 500/520

• Shin Nippon ACCUREF 8001/K

9001

• Tomey RC-1000/5000

• Topcon KR 7000/7000 S/7000

P/7500/

• 8100/8100 P/8800