An internationally awarded electronic patient record and referral system for eye care – developed by an Australian company and already gaining accolades in the United Kingdom – is being rolled out by the Centre for Eye Research Australia.

The OpenEyes software has proven its potential to significantly improve waiting lists and patient outcomes in the UK, and the developers said it could do the same here, starting with eye disease patients.

OpenEyes uses multiple artificial intelligence (AI) platforms for disease diagnosis. It was developed for Moorfields Eye Hospital and is now being further developed by the Australian digital health company ToukanLabs.

The platform enables ophthalmologists and optometrists to enter and access a patient’s medical history, diagnose ocular conditions, measure and monitor changes in visual acuity, intraocular pressure, and central retinal thickness over time.

With this information, presented on a single screen in pop up panels, eye care professionals can more efficiently and collaboratively care for patients, automating correspondence and triaging patients to ensure they are referred on to further specialist or hospital care only when needed.

With AI beta trials underway from platforms including Optain (formerly Eyetelligence) and TokuEyes, ToukanLabs has partnered with several Australian small-to-medium enterprises (SMEs) to create advanced features to surpass those found in the high-end mega suites.

SUCCESSFULLY PILOTED IN WALES

Implemented across the UK deploying national rollouts in Scotland and gaining a strong foothold in England, the OpenEyes software gained global recognition when it was adopted by Wales to improve eye care backlogs.

National Architect for Eye Care Digitisation of the National Health Service (NHS) Wales Gareth Bulpin collaborated with the Cardiff and Vale University Health Board’s Primary Care Optometry and Secondary Care Glaucoma teams, and ToukanLabs to customise the OpenEyes platform, and then implemented the system in 2020.

He also mobilised trained optometrists with the prescribing rights needed to use OpenEyes and prescribe medications. This enabled them to manage patients in high street practices across Wales, upload imaging and patient data to the system, and then either commence treatments or refer patients to hospital for ophthalmology review.

The results were impressive to say the least. By treating patients outside the system and only referring them to specialist ophthalmologists when necessary, the number of patients being seen on time at Cardiff and Vale University Health Board increased from 40% in April 2020 to 69% in March 2022. This achievement was recognised with 13 innovation and staff development awards.

Today, every hospital in Wales is “safely and securely” digitally connected to an optometry practice via Microsoft Enterprise, Mobility and Security Services, enabling access to OpenEyes and OpenERS (an electronic referrals system).

MOTIVATED BY PERSONAL EXPERIENCE

Mr Bulpin said he was motivated to make a difference to the Welsh hospital system by personal experience.

He had been managing information technology at the University Hospital of Wales for 30 years when a life-threatening stroke, which resulted in the loss of sight to one eye, suddenly turned him into a patient.

As a patient, he was struck by hospital overcrowding and very quickly identified “the perfect storm”.

“It’s a problem that isn’t confined to Wales. It’s global… and it’s only going to get worse with an ageing population. In the United Kingdom one in six patients are 65+. In 20 years there will be one in four. There will be more disease to treat. It got me thinking, how can we make the system more sustainable?”

Eventually returning to work, Mr Bulpin convinced the University Hospital and the Welsh Government of the need for change and, following a competitive tender, engaged ToukanLabs to deliver.

ToukanLabs was tasked to develop a system that would better manage patient care right across the hospital network, with input from ophthalmologists, optometrists, and hospital administrators.

“The model totally works… It’s much more than just a hospital system; consultants are able to ensure continued care. Without it, we can’t have a sustainable model,” Mr Bulpin said.

COMING TO AUSTRALIA

Having proven its potential in the UK, OpenEyes is now being piloted by organisations here in Australia, including CERA with support from the Commonwealth Scientific and Industrial Research Organisation(CSIRO), and Surgical Order (SOx); and in Vanuatu via The Fred Hollows Foundation.

Clayton Blake, CEO of ToukanLabs said interest in the platform has been growing organically, “all by word of mouth… there’s been this groundswell of support from ophthalmologists around Australia”.

“Ophthalmologists spend a massive part of their day working with an EMR (emergency medical record)… so they want a platform they can both use and enjoy – and one that works quickly and effectively,” Mr Blake said.

“OpenEyes gives them complete and timely access to a patient’s medical history, anatomical diagrams, examination findings and diagnosis, all with a single click, providing summary reviews, detailed information, and automating correspondence to other medical professionals.

“As well as accessing individual patient files, ophthalmologists can access broader diagnosis profile reports showing the number of patients with common and less common ophthalmic disorders.”

Mr Blake said the rate of change in OpenEyes since its launch “has been phenomenal” with the company now trialling a cloud-based express version to bring OpenEyes to private practice.

“It’s a really exciting time for eye care and the potential benefits to patients are massive,” Mr Blake said.