RESUMEN
BACKGROUND: Due to the increasing digitalization in ophthalmology, increasingly more documentation and diagnostic data are becoming electronically available. In order to improve patient care beyond sectoral boundaries, electronic cooperation portals were introduced in Münster and Homburg, which serve the networking with ophthalmologists in private practice. METHOD: This article reports on the implementation of an electronic cooperation portal at the University Eye Hospitals in Münster and Homburg in 2015 and 2016. RESULTS: The FIDUSweb represents a data protection-compliant cooperation portal that can be easily set up. By implementing it as a web portal all terminal equipment and also electronic patient files can be networked. Particularly important functions are the transmission of medical reports in real time, appointment booking functions, the transmission of imaging data and shared treatment documentation. CONCLUSION: Cross-sectoral care can greatly benefit from the use of the FIDUSweb, especially in digital and multimodal ophthalmology.
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Oftalmopatías , Oftalmología , Telemedicina , Documentación , Hospitales Universitarios , Humanos , Oftalmólogos , UniversidadesRESUMEN
Clinically, the floppy eyelid syndrome is a frequent but underdiagnosed condition. This clinical phenotype is characterized by an extreme laxity of the eyelid, which is enlarged and has a rubber-like structure in combination with a pronounced hyperelastic tarsus. When looking down, minimal vertical tension can trigger spontaneous eversion of the upper eyelid leading to chronic papillary conjunctivitis. This syndrome usually affects older, adipose men who also suffer from sleep apnea and metabolic syndrome. Due to the resistance of chronic papillary conjunctivitis to conservative treatment, surgical treatment is often necessary; however, due to the frequent association between floppy eyelid syndrome, sleep apnea and metabolic syndrome a collaborative interdisciplinary approach is necessary.
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Conjuntivitis , Enfermedades de los Párpados , Párpados , Humanos , Masculino , SíndromeRESUMEN
BACKGROUND: The implementation of electronic medical records (EMR) in the Department of Ophthalmology at the Saarland University Medical Center (UKS) in January 2016 was a timely response to growing documentation requirements and rapidly increasing electronic diagnostic data. The software system was primarily developed for private practices and cannot therefore meet the different requirements of various clinics out of the box. The purpose of this study was to identify features of the EMR beyond purely paper replacement that can assist in the clinical workflow and whether these features can be implemented in a running system. METHODS: The EMR was specifically individualized with respect to the work processes and documentation requirements of the Department of Ophthalmology at the UKS. In addition to a seamless integration into the hospital information system (HIS) the modifications included changes in the structure and visual presentation of the EMR as well as functional extensions. An internet-based platform was set up to enable a direct exchange of appointments and patient data with specialist practices. RESULTS: Due to the introduction of a so-called ghost list the position of patients within the hospital who are allocated to a physician, e.g. for diagnostics, can be reconstructed at any point in time. The logging of the individual treatment times enables tracking of patient flow within the clinic and a reduction of waiting times. Existing paper documents particularly for the graphic recording of findings, such as sketches, are digitalized eliminating the need to scan documents. The UKS.AUGEN.NETZ is an internet-based portal to facilitate direct organization of appointments with specialist practitioners and for the exchange of digital examination data and medical correspondence. CONCLUSION: The permanent close cooperation between employees of the Department of Ophthalmology at the UKS and the manufacturer of the software enables a continuous optimization of the EMR in a fully operational clinical workflow. In addition, the web-based interface improves the cooperation between the hospital and private practices.
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Oftalmología , Universidades , Centros Médicos Académicos , Registros Electrónicos de Salud , Humanos , Programas InformáticosRESUMEN
We report on a 52-year-old male patient presenting with unilateral loss of vision of one week's duration. Pellucid marginal corneal degeneration was known. Slit lamp examination showed pronounced corneal edema as defined by acute corneal hydrops. After inferior preventive YAG iridotomy through clear cornea, intracameral air injection was performed. Deep stromal 10-0 nylon sutures were applied along the Descemet's membrane tear. The next day, the corneal edema had already begun to decrease.
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Edema Corneal , Queratocono , Enfermedad Aguda , Lámina Limitante Posterior , Edema , Humanos , Masculino , Persona de Mediana Edad , SuturasRESUMEN
Postoperative maximum dilated fixed pupil after penetrating keratoplasty, so-called Urrets-Zavalia syndrome, is rare. Primary insufficiency of the graft can necessitate a repeat keratoplasty. Subsequently, a segmental artificial iris reconstruction might be beneficial.
Asunto(s)
Trasplante de Córnea , Midriasis , Trastornos de la Pupila , Humanos , Iris , Queratoplastia Penetrante , Complicaciones Posoperatorias , Trastornos de la Pupila/etiologíaRESUMEN
BACKGROUND: For more than 60 years patient records of the Department of Ophthalmology at the Saarland Medical Center in Homburg were documented on handwritten paper documents and filed in archives. Increasing requirements for medical documentation, exploding volumes of diagnostic data, overcrowded archives and unavailable files when needed, were the essential rationales for the implementation of an electronic patient archive (EPA). METHODS: The EPA has been specifically adapted to the requirements of the Department of Ophthalmology in order to guarantee a standardized unobstructed documentation and patient care across all sections of the department. Seamless integration into the clinic information system (KIS) and network-compatible diagnostic software were essential as well as a timely digitization of existing paper charts. Decisive factors for using FIDUS (Arztservice Wente GmbH, Darmstadt, Germany) as the EPA software were the visual layout of the EPA, user friendliness and reference installations of the software in other ophthalmology departments. RESULTS: After one and a half years of meticulous preparation with specific adaptations to the requirements of our department, the EPA was finally implemented in January 2016 and since then we have been working on improvements. The EPA software retrieves basic patient data from the KIS and diagnostic data from electronic devices via various interfaces. Expenses for printers could be reduced but computer workplaces had to be expanded or newly created. For previous patients paper files are digitized externally and stored in an electronic archive directly accessible from the EPA. DISCUSSION: Successful reorganization and implementation of electronic documentation during clinical routine is feasible with careful preparation and timely involvement of information technology experts, motivated physicians, nurses, research departments and the administration.