CLs & EMRs: A better way

 I’ve spent the last decade writing contact lens calculators, cataloguing contact lenses, and writing code to search and display contact lens information. After all the nights and weekends hunched in front of my computer, and despite the fact that I’m proud of what I’ve created, you might be surprised to hear what I say next: I wish there was less need for EyeDock. Yup, you heard me. I feel that a site like EyeDock should be a little superfluous.


I’ve felt this way since our clinic switched to an EMR 5 years ago. Mind you, I’m not using one of the cool optometry-specific EMRs that a lot of you are using. My EMR is Epic, which does cardiology, oncology, pretty much everything else, and eye care. I actually think it’s good for what it is, but it’s not tailor-made for ODs.

 



However, I feel all EMRs for optometrists have yet  to meet their potential. And, since I spend a lot of time writing programs that deal with contact lens data and calculations, I spend a lot of time thinking about how the software I use could be more helpful. I’m pretty sure I’m not alone on this issue: We like the idea of electronic medical records but are a little disappointed in the current implementation.

Of course, EMRs are complicated. The front facing interface. The back end coding. The database. HIPPAA and other legal issues. Plus, unlike other specialties, optometry is a unique crossroads of medical testing, optical measurements, and dispensing tangible products. So, I’m going to take the easy route here and I’m going to focus on one tiny part of the EMR experience that I’d like to see improve: The contact lens user interface.

As a bare minimum, these are some of the contact lens related things I would like to see my EMR do.

1. Easily search, or, even better, autocomplete lens names. I want to start typing in “Air Op…” and be given options like “Air Optix Multifocal”, “Air Optix Aqua”, “Air Optix Night & Day”, etc. As extra credit, it should accept abbreviations (eg “AOM” for the Air Optix Multifocal) and some degree of misspelling.

2. Transpose refractions. This probably isn’t a big deal for most of us, but it is for me. I refract in plus cyl and mentally transpose to minus cyl when figuring out my contact lens powers. I’m pretty good at it, but it can be a source of errors. The #1 error? Being 90 off on the axis. That’s embarrassing when you’ve waited 3 weeks for a custom toric lens.

3. Vertexing refractions. I don’t think this needs much explanation. Sure, my calculators on EyeDock can do it, but why should we have to leave the EMR?

All that would be extremely helpful, but I’d like to take it a couple steps further:

4. Limiting parameter choices to what’s available for a given lens. If Biofinities are only available in 8.6 / 14.0 just give me those options - don’t make me have to look it up. Furthermore, if they don’t come in -14.00 don’t let me enter that number. Or at least give me some sort of warning that it may not be available.

5. Parameter lookups. In an effort to further cannibalize all my work on EyeDock, I’d love to be able to look up lens parameters from within my EMR.

OK, now I’m going to get a little crazy...

6. Power suggestions. No only do I want my EMR to vertex and transpose my refractions, I want it to tell me the closest available parameters that a given lens is available in. For example, if my refraction vertexes to -7.00 -2.00 x 97, help me choose the -7.00 -1.75 x 100 lens if that’s my best choice.

These things are tricky, but not impossible. As a proof of concept, I’ve written some hooks into EyeDock and created this simple mockup of how this could work. Granted, this is a little rough around the edges and some things are missing (glasses prism, fields for more than one Rx, GP lenses). I’m hoping that it gives my fellow ODs a glimpse of how things could be. I believe it's very possible for a web-based EMR to do something similar and eventually, if we’re vocal enough, maybe the developers will start making features like this.

Here’s the mockup. See the video above for some instruction on how to use it. Or, just start playing around.

------- A Fake EMR --------

Refraction
 SphereCylinderAxisAdd 
OD
OS

 

Contact lenses
  BrandBCDiamSphereCylinderAxisAddColor  
OD !
OS !

 Note: Non-subscribers will only be able to search for lenses that begin with the letter "A"

 

Unfortunately I don't have the ability to accept comments on this blog, but I'd love to hear a discussion on this topic. Feel free to start the conversation on somewhere where ODs talk: Optcomlist, Facebook, Google Plus, etc. Would this make your life easier? What other features would you find helpful? Will our EMRs work like this in the future?

 

 

 

 

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