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HomemiequipmentOculo: A Tool for Collaboration and Co-management

Oculo: A Tool for Collaboration and Co-management

With over 3,600 optometrists and ophthalmologists now using Oculo to manage patients and refer them on to support groups, this unique platform, which was developed in Australia, is helping Glaucoma Australia achieve its mission to eliminate glaucoma blindness by early detection and treatment.

Oculo is a unique platform that grew out of the Centre for Eye Research Australia, to enable optometrists, ophthalmologists and other health care providers to share clinical imaging, referrals and other clinical correspondence securely and instantly.

Oculo facilitates the development of a stronger patient-focused community of care among clinicians by changing the way information is shared. It centralises patient medical histories, ocular examination results and clinical imagery, and gives doctors instant access to this history with the delivery of every referral.

It is very easy to attach images, especially OCT scans to ophthalmologists, which aids the triaging process between eye care professionals

According to Dr Kate Taylor, CEO of Oculo, this innovative platform is moving healthcare decision making from one snapshot in time to longitudinal, cloud-based, collaborative and integrated patient care.

“Oculo has always been looking for ways to challenge and improve the way eye care professionals communicate,” Dr Taylor said. “From humble beginnings, with an aim to develop a tool that is ‘better than a letter’, we have consistently innovated and evolved the way players in eye care communicate and share information.

“Between medical providers, the Oculo platform connects otherwise disconnected data silos by moving clinical communications out of the dark ages of faxing and snail mail and in to the cloud, opening up important patient medical data and imaging, thereby promoting better decision making and better ongoing care.”

INSTANT COMMUNICATION

Greg O’Donnell, Director at Specsavers Salamander Bay, believes that Oculo’s ability to improve communication between health providers is one of its best features.

“The ability to copy OCT images to a referral for example, and flag it for the ophthalmologist to assess the required urgency is a great enhancement to the referral process. For us, Oculo has become the chief mode of communication with ophthalmologists, to the betterment of all,” he said.

Instant, secure communication between optometrists and ophthalmologists has been a key feature since the platform first launched. The immediate value this feature provides to patient care has always been evident. What has become more evident, with the benefit of time, is the value this instant feedback loop adds to the quality and accuracy of primary care – Oculo allows ophthalmologists to seamlessly report on the outcome of their assessment and send relevant post-consultation data directly back to the optometrist. That means optometrists receive real-time visibility to the accuracy of disease detection and their associated referrals. The instant peer-to-peer feedback facilitated by Oculo promotes continual improvement in the standards of clinical care.

Dheeran Makadia, Director at Spectacle Warehouse Australia, said this instant peer-to-peer feedback has made his professional life simpler and more efficient.

“The platform enables me to follow the progress and treatment of my patient in a smooth efficient way. From my initial referral to the ophthalmologist, I am able to track when the referral has been accepted and the patient has been booked in for their initial visit. Once seen, I love to read the findings and plan of action created for their needs. In most cases this will be a single appointment over a six or 12 month

period, however for others there may be multiple visits in a relatively short period of time, which involves the patient to be seen by the optometrist in between. This way, all notes flow in a chronological order, so any healthcare professional can follow the treatment plan, ultimately providing the best care for the patient,” said Mr Makadia.

Louise Winkler, Director of Specsavers Nowra agrees. “Oculo offers a safe efficient interprofessional communication between myself and other health providers. This ensures the information trail between providers is kept in order for each patient. I am able to monitor my detection, diagnosis and referral rates to improve my clinical standards. I am also notified if a report or referral fails to send or my patient fails to attend an appointment with the ophthalmologist, which leads to better care for my patient,” she said.

Dr Benjamin Wong, Managing Optometrist at OPSM Bourke Street commented on the time saving features of Oculo.

“The ability for the referral template to change based on the eye condition – whether its glaucoma, medical retina and or/cataracts – helps with getting referrals done on time. It is very easy to attach images, especially OCT scans to ophthalmologists, which aids the triaging process between eye care professionals,” he said.

CONNECTING PATIENTS WITH SUPPORT

Dr Wong also highlighted Oculo’s ability to refer patients to groups that can offer ongoing support, both for the patient and their relatives.

Indeed, Oculo has established tangible referral pathways from providers to a growing number of community-based support services, such as Keep Sight Australia, Macular Disease Foundation Australia, and Glaucoma Australia (GA). In one-click, any clinician can connect patients with organisations, education and interventions for better informed and more effective self-management.

Glaucoma Australia has actively encouraged health professionals to use this feature and, as a consequence, Oculo is now the leading source of referrals to GA due to the ease of the process. Referral numbers have steadily grown since its launch in April 2018 and as of the end of 2019, GA was receiving, on average, over 250 patient referrals per month. A significant increase in the uptake of the referral function was seen following educational talks by GA’s CEO Annie Gibbins at clinical conferences, where the ease and benefits of referring patients for support were promoted to optometrists.

STAGING IMPROVING OUTCOMES

In September 2018, GA began ‘staging’ glaucoma patients referred by Oculo on their referral pathway. As part of their referral, patients are classified into the following groups: first ophthalmological assessment, existing ophthalmological glaucoma suspect for review, and ophthalmologically diagnosed glaucoma for review. This additional information aids GA in providing tailored education and support. The data collected and provided by GA on the referral pathway has shown measurable improvements and impact of the services provided. For example, through GA patient support services, there has been an increase in patient awareness of the familial link in glaucoma. Referral data collected shows that in the initial stages of the referral pathway, only 55% of referred glaucoma suspects are aware of the familial link in glaucoma, and in the final stages of confirmed glaucoma patients, 79% are aware of the link. The referral data also shows patients are reaching GA 20 years earlier, with the previous average age of referred patients starting at 80–89 years old, having now dropped to 60–69.

Annie Gibbins, CEO Glaucoma Australia, says the opportunity for health providers to refer glaucoma suspects and patients on to GA immediately, has had enormous benefits.

“Glaucoma Australia is delighted to be providing free education and support to an exponential number of patients at an earlier stage of their diagnosis. This provides our orthoptist educators a golden opportunity to drive best practice appointment and treatment adherence while new regimens are being established. Being referred patients at the point of care is a huge value add for both the practitioner and patient. The earlier we receive a patient referral, the more value they receive from our patient support journey resources. The collaborative approach to improve glaucoma patient quality of life outcomes by striving to save sight brings everyone joy,” she added.

CLOSING THE LOOP IN PATIENT CARE

Since the launch of Oculo in 2014, there are now over 3,600 optometrists and ophthalmologists using the platform. The community continues to grow organically as invitations to join Oculo can be sent to unregistered peers as part of the referral process. The constant innovation and evolution of the platform has already seen a great improvement in the confidence of the practitioners on board, and the outcomes of referred patients. To enhance the collaborative care process, GA and Oculo are currently working on closing the loop on patient interactions by providing regular feedback to referring optometrists on service delivery to their patients. And as Ms Gibbins says, “each step brings us closer to GA’s mission to eliminate glaucoma blindness by detecting and treating early”.

Theresa Bui is an optometrist at Specsavers and a member of the Glaucoma Australia optometry committee. She was a member of Young Optometrists NSW/ACT. Ms Bui graduated from University of NSW with a Bachelor of Optometry/Bachelor of Science Honours Class 1 in 2012.