Literature DB >> 35326029

Commentary: EyeSmart electronic medical record-based uveitis pattern - A big data analysis.

Dipankar Das1.   

Abstract

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Year:  2022        PMID: 35326029      PMCID: PMC9240548          DOI: 10.4103/ijo.IJO_3108_21

Source DB:  PubMed          Journal:  Indian J Ophthalmol        ISSN: 0301-4738            Impact factor:   2.969


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Big data ophthalmic electronic medical record (EMR) has revolutionized patient care in institutional practice in India and abroad.[123] Disease-specific EMR consists of different facets of patients’ data, encompassing the appointment module, registration module, patient examination system, and administration (including billing records), surgical scheduling, pharmacy management, and application security, all these being the primary objectives of functioning in a system of EMR.[123] It is detailed hardware and software processing that enables the integrated system to run efficiently.[123] Ophthalmic EMR helps the clinician to access a variety of patient data in real time for decision making and timely patient management.[123] Most of the information technology systems developed in India and elsewhere using Microsoft tools and technologies are serving various institutions and their allied hospitals in a better way as compared to the earlier manual recording of patient data.[1234] High-performance activities, particularly paperless systems, have changed the scenario of health care service in institutional practice. Studies are being conducted to evaluate the demographics and epidemiology of various ophthalmic diseases, particularly uveitis presenting to a multi-tier ophthalmology hospital network in southern India.[123] The current study in this journal is a cross-sectional hospital-based study of 19,352 patients with uveitis presenting between 2012 and 2018.[1] LV Prasad Eye Institute (LVPEI) with its network hospitals had adopted the EMR more than 10 years ago, in the form of a smart EMR called EyeSmart.[13] LVPEI group’s EMR for patient care, administration, and research has been published in past issues of Indian Journal of Ophthalmology.[123] Sankara Nethralaya and its allied hospitals in collaboration with Tata Consultancy Services (TCS) have also designed an all-inclusive EMR system for patient care.[123] Big data analysis of 17,34,272 new patients was studied across the secondary and tertiary centers of the ophthalmology hospital network of LVPEI in the current study, which showed that different types of uveitis constituted approximately 1.11% of all cases presenting to their clinics.[1] The most common age group in which uveitis was diagnosed ranged from 21 to 50 years, and the diagnosis was predominantly unilateral. Anterior uveitis (AU) was the most common subtype of uveitis, seen in approximately 38% of cases.[1] In almost all patterns of uveitis from India and the rest of the world, it was observed that AU was the most frequently diagnosed subtype.[56] Traumatic uveitis was noted in all varieties of anatomical descriptions of uveitis in the present study. Uveitis in the pediatric age group among the rural population was observed to be significant. Tuberculosis was the most common cause of infectious uveitis, which was also seen in other recent uveitis pattern studies from India.[56] Vogt–Koyanagi–Harada was the most common disease entity leading to panuveitis, like other studies from India.[56] Panuveitis was the cause of most severe visual loss in this study, with a mean logMAR visual acuity of 1.08 (Snellen equivalent: 20/250). Authors have rightly pointed out the shortcoming of the study being its retrospective nature. This is a very important issue, and my personal take on this matter is to encourage future prospective studies on the patterns of uveitis or changing patterns of uveitis in their respective areas or region.[56] In this original article, the authors have defined “metropolitan region,” which was a very important descriptive indicator in epidemiology.[1] Complicated cataract in their study was seen in 4.88% of cases, and it would have been more interesting to know the number of cataract surgeries performed for the same and their final outcome. In future pattern-of-uveitis studies, complications of various uveitis need to be addressed, which is missing in most of the pattern-of-uveitis studies. The involvement of uveitis specialists with EMR would be very important in the future, particularly paying attention to the clinical findings and digital recording. We know from history that first medical records were documented during the times of Hippocrates.[7] The first EMR was developed in the US in 1972.[8] In our country, EMR was introduced in ophthalmic practice a decade ago, initiated first in southern Indian states.[234] Uveitis is a disease where pattern recognition is given utmost importance; thus, the accuracy of clinical information in digital documentation will support clinical decision-making and will ultimately improve the dissemination of digital data in the community.[156] Uveitic disease coding as per Standardization of Uveitis Nomenclature classification can be incorporated with recent International Classification of Diseases (ICD)-World Health Organization coding system for better digital and international standard recording. Ideally, EMR should be organized as a nationwide proposal for better operational and universality. The government of India has appointed a professional committee in that vein[9] and ophthalmic institutions in entire India can be benefited from this step.[9] EMR needs to be simpler, user-friendly, and accessible to all for the “digital health” of India.[9] At the same time, ophthalmologists and physicians must remember that they are treating a patient and are not treating a digital monitor, thus keeping in mind the best practice pattern.[2] The future of EMR lies in exploring the field of artificial intelligence for all digital recordings and documentation purposes in ophthalmic patient care research in general and uveitis in particular.
  7 in total

Review 1.  From papyrus to the electronic tablet: a brief history of the clinical medical record with lessons for the digital age.

Authors:  Richard F Gillum
Journal:  Am J Med       Date:  2013-10       Impact factor: 4.965

2.  Commentary: Electronic medical record system - should complement but not replace traditional health care.

Authors:  Atul Kumar; Dheepak Sundar; Divya Agarwal
Journal:  Indian J Ophthalmol       Date:  2020-03       Impact factor: 1.848

3.  Big data and the eyeSmart electronic medical record system - An 8-year experience from a three-tier eye care network in India.

Authors:  Anthony Vipin Das; Priyanka Kammari; Ranganath Vadapalli; Sayan Basu
Journal:  Indian J Ophthalmol       Date:  2020-03       Impact factor: 1.848

4.  Electronic medical records - The good, the bad and the ugly.

Authors:  Santosh G Honavar
Journal:  Indian J Ophthalmol       Date:  2020-03       Impact factor: 1.848

5.  The changing patterns of uveitis in a tertiary institute of Northeast India.

Authors:  Dipankar Das; Harsha Bhattacharjee; Kalyan Das; Prerana S Tahiliani; Pankaj Bhattacharyya; Gayatri Bharali; Manik Das; Apurba Deka; Rajashree Paul
Journal:  Indian J Ophthalmol       Date:  2015-09       Impact factor: 1.848

6.  LV Prasad Eye Institute EyeSmart electronic medical record-based analytics of big data: LEAD-Uveitis Report 1: Demographics and clinical features of uveitis in a multi-tier hospital based network in Southern India.

Authors:  Mudit Tyagi; Anthony Vipin Das; Hrishikesh Kaza; Soumyava Basu; Rajeev R Pappuru; Avinash Pathengay; Somasheila Murthy; Hitesh Agrawal
Journal:  Indian J Ophthalmol       Date:  2022-04       Impact factor: 2.969

  7 in total

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