Information Technology (IT) and value for money
The preceding sections of this document provide an implicit reminder of the extent to which ophthalmology is already dependent on IT. Much of the equipment used in modern diagnostic and surgical procedures is controlled by sophisticated computer software. Digital archiving has almost completely displaced the use of film and paper for the acquisition, storage and viewing of ophthalmic images. Indeed, many types of image (for instance multifocal electroretinography, optical coherence tomography (OCT)) are only intelligible as a result of complex mathematical processing of data.
Electronic Medical Records (EMR) are rapidly becoming an indispensable part of ophthalmic care as a means of integrating data from many instruments, diagnostic tests and images, particularly where the care of the patient is shared across more than one location or between different eye care professionals. EMR systems also yield a wealth of high quality data for clinical audit and other quality assurance initiatives which it is almost impossible to duplicate with paper-based systems. The College has supported the development of a National Ophthalmology Database which holds pseudonymised data from EMR systems on the outcomes of a range of ophthalmic operations and other treatments. This will allow units or individual ophthalmologists to compare their own outcomes with those of a large group of their peers.
Decisions about the procurement and deployment of IT systems to support clinical care can be very difficult and many expensive mistakes have been made in this area in the history of the NHS. The capital cost and maintenance costs of IT systems can be substantial and the benefits may not be realised for some time. Nevertheless, many ophthalmology units have achieved successful deployments of EMR systems which have improved the quality and efficiency of clinical care. Although no procurement or implementation of an EMR system will be free of risk, system developers are increasingly using the same software technology which underpins the internet, mobile phones and social networking applications in order to allow systems to communicate easily and securely with other healthcare systems and to reduce the risk of systems quickly becoming obsolete.