Digital transformation in ophthalmology: the collaboration between Retina Operatie Centrum and Qualogy

The evolution of ophthalmology

Eric Lindstedt is a vitreoretinal surgeon and has been working at the Retina Operatie Centrum in Amstelveen since 2018. During his training and career as a vitreoretinal surgeon, Eric has closely witnessed the transformation in ophthalmology. From lengthy retinal operations under general anaesthesia to more efficient, almost painless procedures under local anaesthesia. The innovations, such as mini-tubes and thin instruments like the 25-gauge, have transformed surgical procedures and resulted in faster recovery times. A positive trend is also the growing availability of data that is crucial for ophthalmology. However, this growth in technological data also underscores the need for a flexible data system that adapts to the evolving needs of ophthalmology.

The importance of accurate data and integrated systems

The primary goal of a good system is to accurately record and analyse treatment outcomes. This enables professionals to gain insight into specific figures, such as the number of reoperations and the initial versus final visual acuity of patients. With this data they can provide concrete prognoses to patients. Eric states: "For example, with a recurrence rate of around 3-4%, we try to perform better than the national average of 5-6%. Recording these outcomes not only helps in monitoring quality, but also provides valuable insights for patient care."

"The dependence on IT systems in medicine is so integrated that we find ourselves at a standstill when the system fails."

The original MS-DOS-based system used by Retina, although once groundbreaking, showed its age in the digital era. Designed as an all-in-one solution on a USB, it began showing instability with increasing data entry. The limitations in data storage and analysis made it clear that there was a need for an updated, integrated Electronic Patient Record (EPD).

Collaborating for digital progress: Mendix, data security and system optimisation

It was decided to bring in a professional party and in the collaboration with Qualogy, Mendix was chosen as the platform to build the new system. In addition to the fact that Mendix is sustainable and reliable, the platform is particularly user-friendly, which facilitates programming. Another important advantage is the guarantee of data security. Furthermore, the platform offers the necessary flexibility; adjustments can be implemented quickly, which is crucial for effective interaction with clients.

"Data helps not only in monitoring quality, but also provides valuable insights for patient care."

Eric explains: "The primary source of input was initially unclear during the design phase of our new system. After careful consideration, we decided to use EMMA as our main input, our original database. This was mainly determined by the presence of various modules that were integrated into the old system, such as a letter module and prescription functionality. This choice allowed us to focus exclusively on entering data in a reliable environment while ensuring the integration of older data."

Qualogy made a valuable contribution by actively thinking along in optimising our system. They improved the user experience by adding extra graphs and restyling the interface for more intuitive navigation. The contrast between the old and new system is clearly visible, especially in terms of visual presentation and logical placement of elements. The new setup also simplifies processes, requiring fewer actions for data processing. Although advanced statistical analyses have not yet been integrated, the new system does offer the potential to add these in the future.

"Qualogy has made a valuable contribution by actively thinking along in optimising our system."

Partnership in practice: the synergy between Retina and Qualogy

The collaboration between Retina and Qualogy proceeded to the full satisfaction of both parties. In particular, the direct lines of communication made the collaboration efficient. The fact that Eric, a surgeon with practical experience, served as a direct point of contact, considerably facilitated the process. Although Eric encountered some resistance from his critical colleagues when introducing changes, he noticed that after some adjustment, efficiency increased. People who have worked with the same system for years can be hesitant about changes, but with a surgeon at the helm, it was easier to get everyone on board.

The weekly meetings ensured continuity and a consistent feedback mechanism. The key users were part of the Retina project team and could therefore provide direct input, enabling quick adjustments. This efficiency was enhanced by the ability to call or message directly outside the scheduled meetings. The short lines ensured fast and targeted communication, which kept the project running smoothly.

"The right project environment is important for stimulating productivity and innovation."

Innovation through freedom

From Qualogy's side too, the pleasant collaboration is cherished. Valuable in a project is the opportunity to start from scratch - it gives teams the unique chance to be truly creative and innovative. This project was a perfect example of that. Despite the clear guidelines from the client, the Mendixers were given remarkably much room to bring their own insights. This offered the team the chance to fully utilize their knowledge and creativity. This freedom led to an intensive and fruitful collaboration, not only with the client but also between the juniors and seniors within the team. Through this composition within the team, one could benefit from both fresh perspectives and years of experience.

Rawi Bodha, team lead, emphasises the freedom that the team experienced from Retina: "It was refreshing to see that when we could substantiate our proposals well, they were almost always received positively and incorporated into the project. The informal atmosphere and the trust that the client placed in us motivated the team to excel. As a result, it was common to work beyond regular working hours, purely driven by their passion and commitment to the project. It shows how important the right project environment is for stimulating productivity and innovation."

"The ultimate goal remains to increase user-friendliness and ensure the best possible patient care."

The benefits of technological progress in the medical sector

In medicine, data plays a crucial role. As Eric states: "The dependence on IT systems is so integrated that we find ourselves at a standstill when the system fails. Nevertheless, there are areas where further improvement is desirable, such as in the case of the EMMA system. Although the system fulfils essential functions, it would be ideal if it could be more intuitive in transferring data from one field to another without repetitive input. The evolution to an EMMA 2.0 could address these inefficiencies."

Another welcome addition would be the integration of a drawing programme, given the visual nature of many medical procedures. Drawings, which are currently made externally, often provide an immediate overview of a patient's situation without the need for long text descriptions. Unfortunately, these images are sometimes lost, although they can be of invaluable value to a patient's file.

Despite the challenges, the continuous pursuit of improvement — such as the recent implementation of the EMMA imager — demonstrates the benefits of technological progress in the medical sector. "The ultimate goal remains to increase user-friendliness and ensure the best possible patient care," Eric concludes.