Digital transformation in ophthalmology: The collaboration between Retina Operation Center and Qualogy

Discover the unique collaboration between Retina Surgery Center and Qualogy, bringing together medical knowledge and technological expertise to create an adaptive data system to match advances in medicine. Vitreoretinal surgeon Eric Lindstedt played a central role in this journey and shares insights on the origins and ambitions of this partnership.

The evolution of ophthalmology
Eric Lindstedt is a vitreoretinal surgeon and has worked at the Retina Surgery Center in Amstelveen since 2018. During his training and career as a vitreoretinal surgeon, Eric witnessed up close the transformation in ophthalmology. From lengthy retinal surgery under anesthesia to more efficient, nearly painless procedures under local anesthesia. 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 critical to 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 purpose of a good system is to accurately record and analyze treatment outcomes. This allows professionals to gain insight into specific numbers, such as the number of reoperations and patients’ initial versus final vision. With this data, they can offer concrete forecasts to patients. Eric points out, “For example, with a relapse rate of around 3-4%, we are trying to outperform the national average of 5-6%. Capturing these outcomes not only helps monitor quality, but also provides valuable insights for patient care.”

“The dependence on IT systems in medicine is so integrated that we are at a stalemate when the system fails.”

The original MS-DOS-based system used by Retina, though once groundbreaking, was showing its age in the digital age. Designed as an all-in-one solution on a USB, it began to show instability with increasing data input. The limitations in data storage and analysis highlighted the need for an updated, integrated Electronic Patient Record (EHR).

Working together for digital progress: Mendix, data security and system optimization
It was decided to connect a professional party, and in working with Qualogy, Mendix was chosen as the platform to build the new system. In addition to being durable and reliable, Mendix’s platform is extremely user-friendly, which makes programming easier. Another important advantage is the guarantee of data security. Moreover, the platform offers the necessary flexibility; adjustments can be made quickly, which is crucial for effective interaction with customers.

“Data not only helps monitor quality, but also provides valuable insights for patient care.”

Eric says, “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 several modules that were integrated into the old system, such as a letter module and prescription functionality. This choice allowed us to focus on entering data only in a reliable environment while ensuring the integration of older data.

Qualogy made a valuable contribution by actively participating in optimizing our system. Among other things, they improved the user experience by adding additional charts and restyling the interface for more intuitive navigation. The contrast between the old and new system is evident, especially in terms of visual presentation and logical placement of elements. The new setup also simplifies processes, which means we need fewer operations for data processing. Although advanced statistical analysis is not yet integrated, the new system does offer the potential to add it in the future.”

“Qualogy made a valuable contribution by actively thinking along in optimizing our system.”

Partnership in practice: the synergy between Retina and Qualogy
The cooperation between Retina and Qualogy went to the full satisfaction of both parties. In particular, the direct lines of communication made cooperation efficient. The fact that Eric, a surgeon with practical experience, served as a direct point of contact greatly facilitated the process. Although Eric faced some resistance from his critical colleagues when introducing changes, he found that after some getting used to it, efficiency increased. People who have worked with the same system for years may be reluctant to change, but with a surgeon at the helm, it was easier to get everyone on board.

Weekly meetings provided continuity and a consistent feedback mechanism. Key users were part of the Retina project team and thus were able to provide direct input, allowing for quick adjustments. This efficiency was enhanced by being able to call or message directly outside of scheduled meetings. The short lines ensured quick and focused communication, making the project run smoothly.

“The right project environment is important for driving productivity and innovation.”

Innovation through freedom
The pleasant cooperation is also cherished from Qualogy. Valuable in a project is the ability to start from the ground up – it gives teams the unique opportunity to be truly creative and innovative. This project was a perfect example of that. Despite the client’s clear guidelines, the Mendixers were given remarkable latitude to contribute their own insights. This provided an opportunity for the team to fully utilize their knowledge and creativity. This freedom led to intense and fruitful cooperation, not only with the client but also between the juniors and seniors within the team. This composition within the team allowed them to benefit from both fresh perspectives and years of experience.

Rawi Bodha, team lead, emphasizes the freedom the team experienced from Retina: “It was refreshing to see that when we were able to substantiate our proposals well, they were almost always received positively and incorporated into the project. The informal atmosphere and the trust the client placed in us motivated the team to go above and beyond themselves. As a result, they regularly went beyond regular working hours, driven purely by their passion and commitment to the project. It shows how important the right project environment is for driving productivity and innovation.

“The ultimate goal remains to increase usability and ensure the best possible patient care.”

The benefits of technological advances in the medical field
In medicine, data plays a crucial role. As Eric points out, “The dependence on IT systems is so integrated that we are in a stalemate when the system fails. Nevertheless, there are areas where further improvement is desirable, as in the case of the EMMA system. Although the system performs 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 program, given the visual nature of many medical procedures. Drawings, now done externally, often provide an immediate overview of a patient situation without the need for lengthy text descriptions. Unfortunately, these images are sometimes lost, although they can be invaluable to a patient’s record.”

Despite the challenges, the ongoing drive for improvement – such as the recent implementation of the EMMA imager – demonstrates the benefits of technological advances in the medical field. “The ultimate goal remains to increase usability and ensure the best possible patient care.” concludes Eric.