Thursday, July 28, 2011

Ophthalmologist fetches West Mount Airy 7BD

William V. Anninger and Carol C. Odonoghue bought a seven-bed, 3.5-bath home at 607 W. Upsal St. in West Mount Airy from Robert S. Warren and Stefanie J. Fogel for $690,000 on June 24.

The property was previously acquired for $380,000 in Aug. 2000. The 4,818-square-foot house was built in 1925.

Dr. Anninger is an attending physician at The Children's Hospital of Philadelphia in its Division of Pediatric Ophthalmology. He specializes in ophthalmology. He is also an assistant clinical professor of ophthalmology at both Scheie Eye Institute and the University of Pennsylvania. In addition, he is also affiliated with Children's Hospital Main Campus and Children's Hospital Specialty Care Centers in King of Prussia and Bucks County.

He received a medical degree from Dartmouth Medical School and had an internship at Cambridge City Hospital, Harvard University. He completed his residency at William Havener Eye Institute, Ohio State University and his fellowship at Children's Hospital of Philadelphia.

Dr. Anninger and Ms. Odonoghue also own a home at 6905 Wayne Ave.

According to BlockShopper.com, there have been 119 home sales in West Mount Airy during the past 12 months, with a median sales price of $249,900.

Plans complete for 2012 World Ophthalmology Congress

Phase One plans for the staging of the World Ophthalmology Congress (WOC) 2012 - the world's longest continuous medical meeting taking place in Abu Dhabi next February - are now complete

Abu Dhabi: Phase One plans for the staging of the World Ophthalmology Congress (WOC) 2012 - the world's longest continuous medical meeting taking place in Abu Dhabi next February - are now complete.
The organiser, the Middle East Africa Council of Ophthalmology (MEACO), reports that over 900 speakers have been invited to the event; over 2,700 abstracts have been submitted, more than 80 companies have signed on for the associated exhibition, and more than 40 Abu Dhabi hotels are participating.
"The planning is going well and we are on target in terms of our operational goals. Approximately 3,000 square meters, which represents 70 per cent of the targeted exhibition space, has been contracted. We also have platinum, gold and silver sponsors confirmed and more in the pipeline. Abu Dhabi's stakeholders are responding extremely positive- in supporting the congress which will be the largest ever medical congress to be held in the UAE capital with a target of more than 8,000 people visiting the city to attend it," said Dr Abdul Aziz Al Rajhi, President, WOC 2012.

UT Southwestern ophthalmologist helps develop device for monitoring degenerative eye disease

DALLAS – An ophthalmologist at UT Southwestern Medical Center has helped create a convenient device that lets patients who have a degenerative eye disease better track vision changes.

With the hand-held digital device, called myVisionTrack, patients can now perform an accurate self-test in less than 90 seconds, said Dr. Yu-Guang He, associate professor of ophthalmology at UT Southwestern.

“Many patients do not have timely eye exams and end up suffering preventable vision loss,” he said. “Careful self-monitoring is critical because treatment for age-related macular degeneration and diabetic retinopathy is most effective when given at precise stages in the disease’s progression.”

Supplied as an app on an iPhone or iPod touch, the prototype device displays three circles on a screen, one of which is markedly different from the others. Patients cover one eye, then touch what they perceive to be the odd-shaped circle on the screen. With each click, the differentiation becomes more subtle. The test is then repeated with the other eye. Results are stored in the device so patients do not have to memorize scores. If a significant vision change is detected, patients are instructed to see their doctor.

Degenerative eye diseases affect more than 13 million people in the U.S. Experts estimate that as the population ages up to a fourth of Americans will be affected by 2020.       

Patients diagnosed with a degenerative eye disease previously have used an eye chart developed in the 1940s to track distortion in their vision. Known as an Amsler Grid, the chart looks like graph paper with a black dot in the center. When they focus on the dot, patients begin to see blurred, wavy or missing lines on the grid.

Many patients using the grid, however, failed to notice subtle vision changes. By contrast, myVisionTrack’s “shape discrimination” tests are twice as sensitive as the paper eye chart in detecting small changes in vision, Dr. He said.

The myVisionTrack device was produced by Vital Art and Science Inc., a Richardson, Texas-based biotech firm that recently received approval for up to $1 million from the Texas Emerging Technology Fund to develop the product.

Researchers at UT Southwestern and the Retina Foundation of the Southwest tested the prototype device in an eight-month clinical study funded by the National Institutes of Health’s National Eye Institute. Forty diabetic patients diagnosed with retinopathy used the monitoring device at home each week. Their test results showed a high correlation with an ophthalmologist’s reading of their retinal images, taken at the beginning, midpoint and end of the study.

Dr. He co-founded Vital Art and Science with Dr. Yi-Zhong Wang, clinical assistant professor of ophthalmology at UT Southwestern and senior research scientist at Retina Foundation of the Southwest; Dr. Kang Zhang, professor of computer science at UT Dallas; Mike Bartlett, former executive vice president of Texas Instruments; and Dr. Bill Krenik, chief technology officer of Texas Instruments’ Wireless Business Unit.

Visit www.utsouthwestern.org/eyes to learn more about UT Southwestern’s clinical services in ophthalmology.

Tuesday, July 26, 2011

Kremer Eye Center Selects Nextech as their EMR and Practice Management Software

NexTech Systems, Inc., the leader in fully integrated Electronic Medical Records, Practice Management, and Marketing Software announces today that Kremer Eye Center has selected NexTech's fully integrated Ophthalmology EMR, Practice Management, and Marketing software for their Ophthalmology software needs. Kremer Eye Center chose NexTech Practice 2011 for its robust Ophthalmology EMR templates, reports, marketing, and Ophthalmology specific features.

Kremer Eye Center provides advanced cataract surgery, glaucoma treatment and refractive surgery including bladeless LASIK and the Visian lens implant. With 11 Surgeons and 8 Optometrists, Kremer Eye Center has surgical centers, satellite offices,and over 500 Affiliate Optometrist Offices throughout Pennsilvaynia, New Jersey, and Deleware. Switching to NexTech for their Electronic Medical Records, Practice Management, and Marketing software needs will streamline their practice and offer better patient care.

“I am extremely excited and eager to begin the implementation of the NexTech Software. The service that I had received during my decision making process was extraordinary, and we definitely put their software to the test. But outside of the quality of service we received, what ultimately lead to our decision to purchase NexTech was the marketing and reporting tools, as well as the customizability of the Electronic Medical Records. NexTech did not just say “yes we can build that template” or “yes we can create that report,” they either had it already in existence, or they built the templates for the doctors in advance,” Stephanie Cohen, Assistant Vice President of Kremer Eye Center.

“For Kremer Eye Center to choose NexTech says a great deal about our product and organization as a whole. With so many options given to doctors these days it means a great deal to us that such a prestigious group has chosen us for their practice,” Kamal Majeed, Ph.D., President and CEO of NexTech.

About Kremer Eye Center
Kremer Eye Center provides advanced cataract surgery, glaucoma treatment and refractive surgery including bladeless LASIK and the Visian lens implant. Founded in 1980, Kremer is a leader in cataract treatment, pioneering no-stitch/no-injection surgery, and in the field of refractive surgery. Kremer doctors performed the first LASIK surgery in North America, and are committed to utilizing the most advanced technologies and procedures to accelerate recovery time and improve patients' vision.

Kremer staff includes the most experienced and trusted cataract specialists, glaucoma experts, corneal specialists and an oculoplastics surgeon to provide medical eye care at three surgical centers throughout Pennsylvania, New Jersey and Delaware. Pre- and post-operative care are conveniently provided at satellite offices and at over 500 Affiliate Optometrist Offices throughout the Tri-State Area. http://www.kremereyecenter.com

About NexTech
NexTech Practice 2011 is an ONC-ATCB 2011/2012 Complete EHR. A powerful and complete Ophthalmology and Refractive Surgery software solution, NexTech Practice 2011 is fully integrated EMR, Practice Management, and Marketing software designed specifically for Ophthalmologists and Refractive Surgeons. With a client base of over 3,500 surgeons and physicians and 30,000 in staff worldwide.

Main modules and features include Electronic Medical Records, Scheduling, Financial Accounting, E-Prescribing, E-Billing, Marketing, Inventory (Contacts & Glasses), Optical Shop Management, Surgery Center Management, Contact Management, Patient/Prospect Tracking, Procedure & Surgery Quotes, Patient Education Forms, Microsoft Word Mass Merge, Reporting, Website Integration, Image Archiving, Interfaces with many Ophthalmic Devices and Equipment, and Links to PDAs and Smart Phones.

NexTech was among the first Ophthalmology specific EMR company to certify for meaningful use through CCHIT® for ONC-ATCB 2011/2012 Certification, with its product, NexTech Practice 2011 version 9.7. NexTech Practice 2011 is a Certified, Fully-Customizable, Template-Driven EMR. It is the COMPLETE SOLUTION! For more information visit http://www.nextech.com

Topcon penetrates ophthalmology market with new devices, systems

Collagen cross-linking for treating keratoconus and ectasia, laser photocoagulation of retinal disease and integration of electronic imaging records are among the areas of the ophthalmology market where Topcon Medical Systems is making inroads.
Topcon is funding three ongoing trials to assess the potential use of corneal collagen cross-linking while the U.S. Food and Drug Administration considers the treatment for post-LASIK ectasia and keratoconus. This effort follows on the heels of Topcon’s acquisition of the Pascal system and, more recently, the release of the updated comprehensive software platform EyeRoute Synergy.

Corneal cross-linking

Corneal cross-linking, a process in which the cornea is strengthened through a combination of riboflavin administered to the cornea and application of ultraviolet light, is not yet approved by the FDA. In some cases, the riboflavin product is applied after the epithelium is removed; in other cases, the epithelium is left on and a transepithelial product is used. According to Sooft Italia literature, in the corneal cross-linking procedure under study sponsored by Topcon, after the epithelium is removed, the cornea is saturated with Ricrolin (Sooft Italia) and then exposed to a customized dose of ultraviolet light.

Additionally, Sooft, for which Topcon serves as an exclusive distributor, has released in the European Union Ricrolin TE, a transepithelial formulation of the drug that offers the same clinical benefits as Ricrolin but does not require the removal of the epithelium.
“That means less procedure time and less patient discomfort,” Robert Gibson, Topcon vice president of marketing, told Ocular Surgery News.
“What we’re trying to show is that using [cross-linking] will stop the progression of keratoconus, so that the patient doesn’t have to go to a corneal transplant,” he said.

Pascal system

Topcon’s focus is not just on the surface of the eye.
In August 2010, OptiMedica sold its retina and glaucoma assets to Topcon Medical Laser Systems, a then newly established subsidiary that received ownership of all related intellectual property, manufacturing rights and facilities, as well as sales and distribution rights worldwide.
The Pascal (Pattern Scan Laser) system, initially developed at Stanford University to treat a variety of retinal conditions including diabetic retinopathy, age-related macular degeneration and retinal vascular occlusive disease, was acquired in the exchange. According to a company press release, the Pascal photocoagulation system, due to its ability to deliver gentle photocoagulation with reduced heat diffusion and provide shortened treatment durations through the use of multi-spot, rapid laser pulse technology, had already achieved sales success under OptiMedica. Success has continued under Topcon, which has exceeded sales plans in both units sold and dollar revenue.
“What we’ve been doing is simply utilizing the full Topcon sales channel,” Greg Halstead, Topcon director of sales and marketing, said. “We have direct sales in the U.S., most of Europe, large parts of Asia and Japan. [We’re] putting the emphasis of all of Topcon behind it.”
Regarding Topcon Medical Laser Systems, Mr. Halstead said, “We have been testing and evaluating 577-nm lasers and are releasing those to countries as registration permits. [We] should be ready for the majority of the global market by the [American Academy of Ophthalmology] meeting.” 

Report: Many Ophthalmologists' EHRs Don't Meet Their Needs

A new report by the American Academy of Ophthalmology noted that many electronic health record systems used by ophthalmologists do not meet their needs, according to an AAO news release.

The report by the academy's IT committee specified the areas where these EHRs, designed for primary care physicians, don't mesh with ophthalmologic practices and described how they could be improved.

EHRs designed specifically for ophthalmologists tend to be made by small companies that may not have the resources to upgrade software to meet federal Meaningful Use standards.

Read the American Academy of Ophthalmology release on ophthalmologist EHR systems.

World Ophthalmology Congress® 2012 - Plans Take Shape 900 Speakers Invited. 2,750 Abstracts, 80 Exhibitors Confirmed. 40 Abu Dhabi Hotels Participating.

Phase One plans for the staging of the World Ophthalmology Congress® (WOC) 2012 – the world’s longest continuous medical meeting taking place in Abu Dhabi next February – are now complete. The organizer, the Middle East Africa Council of Ophthalmology (MEACO), reports that over 900 speakers have been invited to the event; over 2,700 abstracts have been submitted, more than 80 companies have signed on for the associated exhibition, and more than 40 Abu Dhabi hotels are participating.

“The planning is going well and we are on target in terms of our operational goals,” commented Dr. Abdulaziz Al Rajhi, President, WOC 2012. “Approximately 3,000 square meters, which represents 70% of the targeted exhibition space, has been contracted. We also have platinum, gold and silver sponsors confirmed and more in the pipeline. Abu Dhabi’s stakeholders are responding extremely positive- in supporting the congress which will be the largest ever medical congress to be held in the UAE capital with a target of more than 8,000 people visiting the city to attend it.

“An official hotel programme is now in place with around 40 participating hotels now bookable online through www.woc2012.org.”

The organizer, together with a delegation from Abu Dhabi Tourism Authority (ADTA) which is supporting the congress, are to launch a major WOC 2012 ‘push’ at the 24th Congress of the European Society of Cataract & Refractive Surgeons, which will be held from 17-21 September in Vienna.

“We will be on hand to answer any questions potential delegates have before they make final travel decisions,” explained Mubarak Al Nuaimi, International Promotions Manager of ADTA. “Our hope is to convince them that Abu Dhabi is the right choice for the World Ophthalmology Congress and that they can expect a welcome like no other when they arrive in the UAE capital.”

Monday, July 25, 2011

EyeCare America Encourages Everyone to Get The Facts During August's Cataract Awareness Month

Education is Vital to Preventing, Treating Leading Worldwide Cause of Vision Loss
SAN FRANCISCO, July 25, 2011 /PRNewswire-USNewswire/ -- Though cataracts are the leading cause of vision loss worldwide, myths persist about their cause and treatment. More than 20 million people in the US older than 40 have cataracts, and more than half of them will develop cataracts by age 80, according to the National Eye Institute.
"Cataracts are not preventable, but they are treatable," said Richard P. Mills, M.D., "and the best way to ensure vision stays healthy for a lifetime is to schedule a visit with an ophthalmologist. In fact, more than 90 percent of the people who have cataract surgery regain useful vision."
In honor of Cataract Awareness Month, EyeCare America, a public service program of the Foundation of the American Academy of Ophthalmology, provides eye exams at no out-of-pocket cost to people age 65 and older [The medication assistance isn't relevant to cataracts]. The eye exams are provided by a corps of nearly 7,000 volunteer ophthalmologists across the U.S. and Puerto Rico. Those interested in the program can visit www.eyecareamerica.org to see if they are eligible. The organization's online referral center also enables friends and family members to find out instantly if their loved ones are eligible to be matched with an EyeCare America volunteer ophthalmologist
Separating Cataract Fact from Fiction
Cataracts are a natural result of aging. As the eye's lens, which sits behind the pupil, grows older, its cells die and accumulate, turning the lens yellowed and cloudy. The result is blurred vision and "fuzzy" images. Eye injuries, certain medications and diseases such as diabetes are also known to cause cataracts. In the early stages, stronger lighting and eyeglasses may lessen vision problems caused by cataracts. But at a certain point, cataract surgery—the most frequently performed operation in the United States—may be necessary to improve vision.
Five common Cataract myths to dispel:
  • MYTH 1: Eye drops can prevent or dissolve cataracts.
    • FACT: No. The Food and Drug Administration has not approved any drops that cure or delay cataracts. Some such products claim they can prevent cataracts, but cataract formation is a natural part of the eye's aging process. Other products claim they can "dissolve" cataracts. But since cataracts are not a "substance," there is nothing for the drops to dissolve.
  • MYTH 2: Close-up tasks like reading or sewing make cataracts worse.
    • FACT: No. Cataracts are not caused by how people use their eyes. However, cataracts likely become more noticeable during close work. One sign of a cataract is the need for more light to do the same activities well.
  • MYTH 3: Cataracts are reversible.
    • FACT: No. The lens naturally clouds as it ages. This process is unavoidable. However, its progress can be slowed by quitting smoking, eating a balanced diet and wearing sunglasses with 100% UVA and UVB protection.
  • MYTH 4: Cataract surgery is dangerous, and recovery takes months.
    • FACT: No. Cataract surgery is one of the safest and most highly perfected surgical procedures in medicine, with a 95 percent success rate. Of course, as with any surgery, risks do exist and should be discussed with a doctor before the procedure. Patients will need to avoid bending or lifting anything heavy for up to three weeks after the procedure, as well as refrain from rubbing or pressing the eye. Normal activities may be resumed the day after surgery, when the eye patch is removed. Cataract patients often notice vision improvement immediately following surgery, and others will notice more gradual improvement for a few months afterward.
  • MYTH 5: Cataracts "grow back."
    • FACT: No. Cataracts develop as the lens's cells die and accumulate; they are not a "growth" that sits on top of the eye. Occasionally patients do develop a different, secondary cataract, though. When the membrane that holds the new lens implant becomes cloudy, vision can be compromised. But this can easily be treated with laser surgery, a painless, 15-minute procedure usually done at a doctor's office.

EyeCare America is designed for people who:
  • Are U.S. citizens or legal residents
  • Are age 65 and older
  • Have not seen an ophthalmologist in three or more years
  • Do not belong to an HMO or receive eye care benefits through the VA

To see immediately if you, a loved one or a friend, 65 or older, is eligible to receive a referral for an eye exam and care, visit www.eyecareamerica.org.
EyeCare America is co-sponsored by the Knights Templar Eye Foundation, Inc., with additional support provided by Alcon. The program is endorsed by state and subspecialty ophthalmological societies.
About EyeCare America
Established in 1985, EyeCare America, the public service program of the Foundation of the American Academy of Ophthalmology, is committed to the preservation of sight, accomplishing its mission through public service and education. EyeCare America provides eye care services to medically underserved seniors and those at increased risk for eye disease through its corps of nearly 7,000 volunteer ophthalmologists dedicated to serving their communities. More than 90 percent of the care made available is provided at no out-of-pocket cost to the patients. Since its inception, EyeCare America has helped more than 1.5 million people. EyeCare America is a non-profit program whose success is made possible through charitable contributions from individuals, foundations and corporations. More information can be found at: www.eyecareamerica.org

Saturday, July 23, 2011

Docs debate eye surgery bill

Doctors on Thursday debated the amount of training needed for optometrists to perform some minor eye surgeries allowed under legislation approved in February by the Kentucky General Assembly.
Senate Bill 110 raised eyebrows for the short time it took both chambers to pass the bill - 10 days - and the Kentucky Optometric Association's political action committee giving more than $400,000 in campaign contributions to lawmakers and the gubernatorial campaigns of Gov. Steve Beshear and Senate President David Williams in the past two years.

The bill will allow optometrists to do some procedures previously reserved only for ophthalmologists. Kentucky becomes the second state to allow optometrists to perform these types of surgeries, behind Oklahoma.

The Kentucky Board of Optometric Examiners held a public forum Thursday in Lexington on regulations that would set the standards of certification for optometrists to perform these procedures, which include the use of lasers for some conditions involved with cataract surgery and the injection with a needle of certain medications. It would not allow optometrists to perform LASIK surgery.
The current proposed regulations would require optometrists to complete courses approved by the Board of Optometric Examiners.
Optometrists said the need is there so they can provide services to rural areas in the state where there aren't ophthalmologists.
James Sawyer, an optometrist from Wayne County in southeastern Kentucky, testified Thursday that many residents in that county don't have the option to go to an ophthalmologist.
"It is medically underserved," Sawyer said. "Wayne County has a high number of Medicaid recipients and many elderly residents. Getting our folks to travel to another county to get health care is a challenge. Many cannot afford gas and cannot drive."
Ophthalmologists Thursday urged for the revamping of the requirements, which they said puts patients at risk. They criticized a flyer advertising a 16-hour weekend course in September to grant surgical privileges to optometrists.

The regulations don't specify the teacher credentials or length of training and are vague in many areas, said Woodford Van Meter, chief of ophthalmology at Central Baptist Hospital in Lexington and president of the Kentucky Academy of Eye Physicians and Surgeons. He said Senate Bill 110 is an "abysmal failure" to protect patients.
"One cannot become an eye surgeon in 16 hours," Van Meter said.
It stands in contrast to the extensive training and education ophthalmologists go through to become medical doctors, said William Richardson, an ophthalmologist from Georgetown.
"It is at this point, eight years, 17,000 hours, 1,200 hours in operating room, 626 hours of lab instruction, a minimum of 3,000 patients and board certification when we are considered qualified to safely perform surgery on our own," Richardson said.
Ophthalmologists are medical doctors who specialize in eye care.
Optometrists are licensed to provide primary eye care services such as conducting exams, diagnosing diseases, prescribing glasses and performing minor procedures of the eye. This requires an undergraduate degree and four years of education in a college of optometry.
Senate Bill 110 is similar to when optometrists in Kentucky faced opposition but successfully lobbied the General Assembly for the right to dilate eyes with eye drops, said Darlene Eakin, executive director of the Kentucky Optometric Association.

"History shows that optometrists exercise this privilege frequently to the benefit of thousands of Kentuckians," Eakin said.
This law allows optometrists to do in office procedures without general anesthesia and doesn't allow major procedures, she said. The more labor-intensive procedures allowed under the bill we require more than a weekend course, she said.
"That course has some areas covered, but that's not everything they would have to have," Eakin said.
Florence optometrist and councilwoman Julie Metzger Aubuchon testified in support of Senate Bill 110 and said optometrists will be just as qualified for these procedures as ophthalmologists.
"Many references have been made to a weekend course," Aubuchon said. "I submit to you that many ophthalmologists that testified here today did not learn the current procedures in medical school. They had to go back. They had to learn those things in a course."
The way the bill passed through the General Assembly concerned local ophthalmologist James Sanitato, who practices in ophthalmology in Cincinnati and Crestview Hills.
"It is not in the purview of the legislature to redefine surgery in bills that were rushed through," Sanitato said.

The Kentucky Board of Examiners before Aug. 15 will send proposed regulations to the General Assembly. If approved by a sub-committee, they could go into effect by November. The public can send written comments until Aug. 1 to the Kentucky Board of Optometric Examiners, 163 W. Short St., Suite 550, Lexington, KY 40507.

Ophthalmologist stymied by lack of OR time

Dwight Silvera went to school for 13 years to be an ophthalmologist, specializing in corneal transplants.

He wants to use his skills at home. But the only place he can operate right now is abroad, on humanitarian missions to places like Colombia, Jamaica and Bolivia.

Silvera, 35, was born and raised in Oshawa. He studied at McMaster University’s medical school, was awarded one of two coveted spots in ophthalmology at Queen’s University, then, his top pick, a one-year corneal fellowship at the University of Iowa.

For four years, the father of two has been trying to get regular operating room time at a hospital in the GTA, with no success. He’s talked with nine hospitals in Toronto, Mississauga, Brampton, Oakville and Hamilton.

“They look at me and say ‘Given our budget, we’re not expanding, we’re not taking on new ophthalmologists right now,’” Silvera said Friday, adding that the process of allocating OR time at the hospital level doesn’t always seem equal. Some surgeons have a lot of time, some have none.

Silvera has even reluctantly played down his specialty in corneal transplants, in an attempt to convince hospitals taking him on wouldn’t cost as much money.

He wants to stay in Canada. “I do love our country,” he said. “The world is here in terms of ethnicity and culture and I think that’s very enriching in terms of raising our kids.”

But if he can’t get some time to do surgery this year, the largely Canadian-trained physician said he will be forced to uproot his family and take one of many job offers coming from the United States.

This week, the Star ran a series of articles on the provinces flawed corneal transplant system. Ontarians are literally going blind as they languish on wait lists for transplants while some corneas are shipped to developing countries, like Kenya, because of a lack of operating room time here.

On Friday, the Kensington Eye Institute, a government funded eye clinic in Toronto, offered to help with the cornea surgery backlog. The clinic is currently operating at 60 per cent capacity and has three working ORs.

Silvera — who works out of Lasik MD in the GTA doing laser eye surgery, as well as in two clinics, one in Mississauga, the other in Brampton doing minor procedures and dealing with medical conditions like glaucoma — has more than 150 patients in need of a cornea transplant on his wait list.

He has to forward those who need the elective procedure to doctors with OR time downtown. But “it’s not a fast track to anything,” he adds, because those surgeons have wait-lists between 18 months and three years.

Silvera adds that in the Halton and Peel region, no one is doing cornea transplants even though hundreds of people need the surgery locally.

In 2008, about 30 of his patients wrote letters to the Ministry of Health, expressing their frustration with cornea transplant wait times. They received a form letter back, he said, adding he’s been largely ignored by the province as well.

What appears to be happening is a “game of tennis” between the government and the hospitals, he said, with the government saying hospitals are given a chunk of money to do with what they see fit and hospitals saying they have finite and competing resources.

A spokeswoman from the ministry, Neala Barton, said hospital funding has risen 50 per cent in the last eight years and that the government doesn’t get directly involved in specific relationships between doctors and hospitals.

Silvera, who just returned from a volunteer mission to Mexico where he performed cataract surgeries, said he doesn’t want to be antagonistic.

He just wants to do surgery.

AAO offers special EHR checklist for ophthalmology

The field of ophthalmology has a number of unique features compared with other medical and surgical specialties regarding clinical workflow and data management, according to an article published by the American Academy of Ophthalmology (AAO) in Ophthalmology online and forthcoming in the Aug. 1 issue.

The article, authored by the San Francisco-based AAO's Medical IT Committee (MITC), presented a list of the special requirements needed to make EHR systems intuitive and efficient for ophthalmology practices.

“Ophthalmologists often lament the absence of these specialty-specific features in EHRs, particularly in systems that were developed originally for primary care physicians or other medical specialists,” wrote MITC Chair Michael F. Chiang, MD, from the departments of ophthalmology and of medical informatics and clinical epidemiology at the Oregon Health & Science University in Portland, and colleagues.

The paper includes the list of 17 "essential" and six "desirable" features in the areas of clinical documentation, ophthalmic vital signs and laboratory studies, medical and surgical management, and ophthalmic measurement and imaging devices.

Among the 17 essentials were enabling entry and storage of all ophthalmology-specific data required to support AAO Preferred Practice Patterns; organizing ophthalmology-specific elements (such as past ocular history and ocular medications) separately; and conforming or mapping to vendor-neutral standard terminologies such as SNOMED CT or ICD to represent problem lists. Some desirable features were allergies and clinical findings, exchange of a full set of ophthalmic clinical data with EHRs from other vendors and allowing physicians to easily review patient information before an encounter.

The guidelines are intended to be used by ophthalmologists and their staffs to help identify important features when searching for EHR systems, according to the authors.

The recommendations addressed how an EHR system should accommodate certain areas of ophthalmic practice, including:

    * Supporting documentation in and transitions between the ophthalmologist's office and the operating room;
    * Capturing, tracking and displaying "vital signs of the eye," such as visual acuity; and
    * Incorporating hand-drawn sketches or annotations into records.


“The American Academy of Ophthalmology believes that these functions are elements of good system design that will improve access to relevant information at the point of care between the ophthalmologist and the patient, will enhance timely communications between primary care providers and ophthalmologists, will mitigate risk and ultimately will improve the ability of physicians to deliver the highest-quality medical care,” the authors concluded.

Friday, July 22, 2011

EHRs too cumbersome for eye docs

An information technology committee organized by the American Academy of Ophthalmology this week released a list of special requirements to help electronic health record (EHR) systems be used more "intuitively and efficiently" by ophthalmology practices.
In a report now available online in the journal Ophthalmology and forthcoming in the Aug. 1 issue, AAO committee members note that many EHRs currently used by ophthalmologists are "large, comprehensive systems that originally were designed for other medical specialties or large enterprises," such as hospitals or health plans. As such, the systems pay little attention to the needs of ophthalmologists.

The paper includes a list of 17 "essential" and six "desirable" features in the areas of clinical documentation, ophthalmic vital signs and laboratory studies, medical and surgical management, and ophthalmic measurement and imaging devices. The guidelines are intended to be used by ophthalmologists and staffs to help identify important features when searching for EHR systems.
"Our recommendations define what will make a system work efficiently within the unique workflow and data management needs of an ophthalmology practice," said Michael Chiang, the study's lead author and IT committee head for the departments of Ophthalmology & Medical Informatics and Clinical Epidemiology at Oregon Health & Science University.
The recommendations on how an EHR system can accommodate certain areas of ophthalmic practice, include:
  • Supporting documentation in, and transitions between, the office and operating room.
  • Capturing, tracking and displaying "vital signs of the eye," such as visual acuity.
  • Incorporating hand-drawn sketches or annotations into records.
EHR vendors will be asked to respond as to how their systems match up against the list of essential and desirable features. Information detailing these vendors' responses will be provided to AAO members in the future.

AAO committee sets bar for EHR use in ophthalmology

The American Academy of Ophthalmology’s Medical Information Technology Committee is spearheading efforts to make electronic health records more useful and effective for ophthalmology practices, according to a news release from the AAO.

“Our recommendations define what will make a system work efficiently within the unique workflow and data management needs of an ophthalmology practice,” Michael F. Chiang, MD, chairman of the committee, said in the release. “The Academy is also urging the adoption of common data standards in order to optimize the delivery of time-critical patient information and enable physicians to provide the very best in patient care.”

Dr. Chiang and fellow committee members recommended key functions in a report scheduled for publication in the August issue of Ophthalmology. The report lists essential and desirable features in clinical documentation, ophthalmic vital signs and laboratory studies, medical and surgical management, and ophthalmic measurement and imaging devices.

The group’s recommendations address how EHRs should support documentation and transitions between office and operating room; capture, track and display ocular vital signs such as visual acuity; and incorporate hand-drawn sketches or handwritten notes into electronic records, the release said.

The committee is also developing standards for EHRs to comply with meaningful use criteria set by the Centers for Medicare and Medicaid Services.

Thursday, July 21, 2011

Farewell to pioneering eye expert

AN EYE specialist who helped bring a vital treatment back to Cumbria has retired.

Ophthalmology consultant Soonu Verghese officially took retirement from West Cumberland Hospital in Whitehaven last October but continued part-time until earlier this month.
Mr Verghese played a vital role in bringing back the age-related macular degeneration service to North Cumbria University Hospitals a year ago, allowing patients to be treated locally instead of having to travel to Newcastle.
He also set up a successful link between the Whitehaven hospital and a partner hospital in Tanzania in 2007, which is still going strong.
Mr Verghese trained in India, qualifying in 1973 before moving to the UK in 1976 and going on to obtain his fellowship exams in ophthalmology in 1983.
He started work at the West Cumberland Hospital 10 years later. Since then he and his consultant colleagues have overseen a considerable improvement in local services for west Cumbria. This includes the introduction of laser treatment, small incision cataract surgery and specialised clinics.
Mr Verghese initiated the trust’s twinning programme with Mbeya Hospital in Tanzania in 2007.
In 2010, when the revamp started at the West Cumberland Hospital, he arranged for a container full of recycled equipment to be transported to the hospital. He secured financial support from Cockermouth Rotary, in which he plays an active part.
He hopes to return to Tanzania later this year to help maintain this link.
After several years as a committee member and secretary of the North of England Ophthalmic Society (NEOS), it was a special honour in his final year of work for Mr Verghese to be appointed president of the NEOS – the largest regional ophthalmic society the UK with over 490 members.
Fellow ophthalmology consultant Will Sellar said: “Mr Verghese will be very much missed by many elderly patients whose sight was maintained by his care, as well as by his medical colleagues and the nursing team in the eye unit.”

Levin joins Clay Eye

Dr. Lawrence Levine, a pediatric ophthalmologist, recently Clay Eye Physicians & Surgeons from the faculty at the University of Florida. He will provide complete pediatric eye care, including treating eye muscle disorders for both children and adults. Levine has been caring for patients in the Southeast for over a decade and is nationally known, having lectured and published extensively over his career. He is also active in national education with the American Academy of Ophthalmology.
"Dr. Levine brings a strong and unique background to Clay Eye, and we are fortunate to have him within our own community," said Donald Downer, M.D., Ophthalmologist with Clay Eye Physicians & Surgeons.
Clay Eye Physicians & Surgeons was established in 1977 and is an eight physician group. They currently have offices in Orange Park, Fleming Island and Mandarin. Go online to www.clayeye.com for more information.
Two take course at Camarda
FLEMING ISLAND -- Camarda Financial Advisors says its President and Portfolio Management Board member, Kimberly Camarda, and Jonathan Camarda, an executive vice presidents and Portfolio Management Board member, have both begun the course of study for the Chartered Market Technician professional designation program.
Article includes Clay company
GREEN COVE SPRINGS -- A Green Cove Springs business that specializes in durable duffle bag-like luggage for canine-related items has been named one of the Top 50 in the world of dogs by FIDO Friendly magazine.
Doggy Baggage is mentioned in an article done by the magazine specifically for dog owners. The business is at 3312 Byron Road; call (904) 282-2839 or go online to www.doggybaggage.com for more details.

American Academy of Ophthalmology Establishes Electronic Health Record Standards

The American Academy of Ophthalmology (Academy) has taken a proactive role to ensure that electronic health records (EHR) will support quality patient care, enhance physician to physician communication, and meet the “meaningful use” standards required by healthcare reform policies. The Academy’s Medical Information Technology Committee (MITC) has developed a list of the special requirements needed to make EHR systems as intuitive and efficient as possible for ophthalmology practices.
These key functions are summarized in Special Requirements for Electronic Health Records for Ophthalmology, a report available in the journal Ophthalmology online and forthcoming in the Aug. 1 issue. The lead author is Dr. Michael F. Chiang from the Departments of Ophthalmology & Medical Informatics and Clinical Epidemiology at Oregon Health & Science University and the chairman of the Academy’s Medical Information Technology Committee.
The paper includes the list of 17 “essential” and six “desirable” features in the areas of Clinical Documentation, Ophthalmic Vital Signs and Laboratory Studies, Medical and Surgical Management, and Ophthalmic Measurement and Imaging Devices. The guidelines are intended to be used by ophthalmologists and their staffs to help identify important features when searching for EHR systems.
“Our recommendations define what will make a system work efficiently within the unique workflow and data management needs of an ophthalmology practice,” Dr. Chiang said. “The Academy is also urging the adoption of common data standards to in order to optimize the delivery of time-critical patient information and enable physicians to provide the very best in patient care.”
On July 6, the MITC hosted a webinar for representatives of 15 EHR companies to urge them to build in key functions identified in the journal article. Flora Lum, MD, deputy director of the H. Dunbar Hoskins Jr., M.D. Center for Quality Eye Care, led the webinar.
The recommendations address how an EHR system should accommodate certain areas of ophthalmic practice, including:
Supporting documentation in and transitions between the office and operating room, capturing, tracking and displaying “vital signs of the eye,” such as visual acuity and incorporating hand-drawn sketches or annotations into records.
EHR companies will be asked to respond as to how their systems match up against the list of essential and desirable features. Information detailing the vendors responses will be provided to Academy members in the future and the Academy will continue to work with the vendors to help them understand and evaluate the recommendations.

Wednesday, July 20, 2011

Surgical Errors Drop in VA Medical Centers

The rate of incorrect surgical procedures in Department of Veterans Affairs (VA) hospitals has decreased significantly in recent years, a retrospective study showed.

Reported event rates fell from 3.21 per month in 2006 to 2.4 per month in 2009 (P=0.02), according to Julia Neily, RN, of the Veterans Health Administration in White River Junction, Vt., and colleagues.

And analysis of events most likely to cause the greatest harm found that these events decreased by an annual rate of 14% (rate ratio 0.86, 95% CI 0.75 to 0.97, P=0.02), the research team reported online in the Archives of Surgery.

"Wrong-site surgery is the reviewable sentinel event most frequently reported to the Joint Commission and has been estimated to occur at a rate of 0.09 to 4.5 per 10,000 cases," the researchers stated.
In recent years the VA has made patient safety a priority, implementing a medical team training program that emphasizes preoperative checklists and postoperative briefings.
To assess the efficacy of these efforts, Neily and colleagues analyzed reports filed with the VA National Center for Patient Safety for events given the highest rating for potential harm.

They identified 237 cases, 101 of which involved actual harm and 136 close calls, where significant harm could have occurred but was averted.
Types of events included wrong patient, procedure, site, side, and implant.
The type of event associated with the highest rating for harm was wrong procedure (P=0.02), the researchers found.
A total of 150 events took place in the operating room, 58 occurred at other sites such as procedure rooms and radiology departments, and in 29 cases the site was not specified.
Although actual events leading to harm decreased over the study period, close calls increased from 1.97 to 3.24 each month (P<0.001).
The highest rate of events in the operating room was in neurosurgery, at 1.56 per 10,000 cases, followed by ophthalmology, with 1.06 per 10,000.
The neurosurgery events most often were the wrong site during spinal surgery, which the VA has addressed through measures such as mandating the confirmation of the position of the spine marker by the surgeon and requiring marking of the site before the anesthetic is administered in regional nerve blocks.
In ophthalmology, problems most commonly involved the placement of incorrect lenses, occurring in 13 of 22 cases.
When the researchers looked at the root causes for these events, they found the most common to be a lack of standardization of critical clinical processes and procedures, as well as human factors such as difficulties with machinery and operator fatigue.
The VA is continuing its efforts toward limiting patient harm.
"Current plans and actions include continuing to share detailed lessons learned from root cause analyses, rapid notification of adverse events, policy changes as needed based on root cause analysis review, and additional focused [medical team training] for sites as needed," wrote Neily and colleagues.
Limitations of the study included the self-report of adverse events, inadequate information in some reports, and a lack of demographic data.

Older Children Less Responsive to Treatment for Amblyopia

Children aged 7 to less than 13 years of age are significantly less responsive to treatment for moderate and severe amblyopia than younger children, according to a meta-analysis published online July 11 in the Archives of Ophthalmology.
TUESDAY, July 12 (HealthDay News) -- Children aged 7 to less than 13 years of age are significantly less responsive to treatment for moderate and severe amblyopia than younger children, according to a meta-analysis published online July 11 in the Archives of Ophthalmology.
Jonathan M. Holmes, B.M., B.Ch., from the Mayo Clinic in Rochester, Minn., and colleagues assessed whether age at initiation of treatment for amblyopia affects the response among children with unilateral amblyopia who have 20/40 to 20/400 amblyopic eye visual acuity. Data from four randomized amblyopia treatment trials were analyzed and adjusted for baseline amblyopic eye visual acuity, spherical equivalent refractive error in the amblyopic eye, type of amblyopia, previous amblyopia treatment, study treatment, and protocol. Children, aged 3 to less than 13 years, were categorized based on age.
The investigators found that children between aged 7 to less than 13 years were significantly less responsive to treatment for moderate and severe amblyopia than younger children. Treatment response for moderate amblyopia did not differ between children aged 3 to less than 5 years and aged 5 to less than 7 years, but for severe amblyopia, there was a trend toward greater responsiveness in children aged 3 to less than 5 years compared with children aged 5 to less than 7 years.
"Amblyopia is more responsive to treatment among children younger than 7 years of age. Although the average treatment response is smaller in children 7 to less than 13 years of age, some children show a marked response to treatment," the authors write.

Steven P. Shearing, MD, dies

Las Vegas—Cataract surgery pioneer Steven P. Shearing, MD, died July 10 at the age of 76.
Dr. Shearing practiced ophthalmology in Las Vegas, where he founded the Shearing Eye Institute. In the 1970s, he developed an eponymously named and patented compressible posterior chamber IOL. The implant included flexible suspension loops to help keep it in place behind the iris, a design that transformed cataract surgery. He retired in 2000.
Over the course of his career, Dr. Shearing received many honors, being named Innovator of the Year in 1986 by the American Society of Cataract and Refractive Surgery and Inventor of the Year in 1989 by the Nevada Assembly. In 1993, the University of California, San Francisco, established the Steven P. Shearing Chair of Ophthalmology. Dr. Shearing had completed his residency training there.
His wife of 50 years, Miriam Shearing, was the first woman elected as a justice to the Nevada Supreme Court. In addition to Miriam, he is survived by a son and two daughters.

Study: CME Improves Ophthalmologists' Assessment Ability

Continuing medical education improved ophthalmologists' ability to assess optic nerve head photographs, according to a report by BMC Ophthalmology.

In the study, practicing and resident ophthalmologists at an international glaucoma meeting were asked to assess the photos before and after attending a CME lecture on glaucoma diagnosis by ONH assessment.

The overall number of correct classifications increased somewhat, from 69 percent up to 72 percent on average. However, diagnostic sensitivity increased significantly from 70 percent up to 80 percent and the number of photographs classified as uncertain decreased significantly from 22 percent to 13 percent.

American Academy of Ophthalmology Takes the Lead in Establishing Standards for Electronic Health Records

First-of-Its-Kind EHR Checklist for Ophthalmology Supports Meaningful Use Standards While Enabling Critical Physician to Physician Communication and Enhancing Overall Patient Care

The American Academy of Ophthalmology (Academy) has taken a proactive role to ensure that electronic health records (EHR) will support quality patient care, enhance physician to physician communication, and meet the "meaningful use" standards required by healthcare reform policies. The Academy's Medical Information Technology Committee (MITC) has developed a list of the special requirements needed to make EHR systems as intuitive and efficient as possible for ophthalmology practices. These key functions are summarized in Special Requirements for Electronic Health Records for Ophthalmology, a report now available in the journal Ophthalmology online and forthcoming in the Aug. 1 issue. The lead author is Michael F. Chiang, MD, from the Departments of Ophthalmology & Medical Informatics and Clinical Epidemiology at Oregon Health & Science University and the chairman of the Academy's Medical Information Technology Committee. The paper includes the list of 17 "essential" and six "desirable" features in the areas of Clinical Documentation, Ophthalmic Vital Signs and Laboratory Studies, Medical and Surgical Management, and Ophthalmic Measurement and Imaging Devices. The guidelines are intended to be used by ophthalmologists and their staffs to help identify important features when searching for EHR systems.
"Our recommendations define what will make a system work efficiently within the unique workflow and data management needs of an ophthalmology practice," Dr. Chiang said. "The Academy is also urging the adoption of common data standards to in order to optimize the delivery of time-critical patient information and enable physicians to provide the very best in patient care."
On July 6, the MITC hosted a webinar for representatives of 15 EHR companies to urge them to build in key functions identified in the journal article. Flora Lum, MD, deputy director of the H. Dunbar Hoskins Jr., M.D. Center for Quality Eye Care, led the webinar.
The recommendations address how an EHR system should accommodate certain areas of ophthalmic practice, including:
  • Supporting documentation in and transitions between the office and operating room
  • Capturing, tracking and displaying "vital signs of the eye," such as visual acuity
  • Incorporating hand-drawn sketches or annotations into records
EHR companies will be asked to respond as to how their systems match up against the list of essential and desirable features. Information detailing the vendors' responses will be provided to Academy members in the future and the Academy will continue to work with the vendors to help them understand and evaluate the recommendations.
Eds: Full text of the study is available from the Academy's media relations department.
About the American Academy of Ophthalmology
The American Academy of Ophthalmology is the world's largest association of eye physicians and surgeons -- Eye M.D.s -- with more than 30,000 members worldwide. Eye health care is provided by the three "O's" -- opticians, optometrists and ophthalmologists. It is the ophthalmologist, or Eye M.D., who can treat it all: eye diseases and injuries, and perform eye surgery. To find an Eye M.D. in your area, visit the Academy's Web site at www.aao.org.
About the Hoskins Center for Quality Eye Care
The H. Dunbar Hoskins Jr., M.D. Center for Quality Eye Care is an evidence-based nonprofit quality-of-care and health policy research center located in San Francisco. The Hoskins Center conducts and supports clinical studies, develops patient care guidelines, establishes national data registries, and collects and analyzes data from clinical practices to improve decision making and public health policies, evaluate the value of eye care services and provide physician education to enhance access and appropriateness of eye care for the public. More information can be found at www.hoskinscenter.org

Kenyan doctor heading home after training to treat glaucoma

Dr. Sheila Marco heads home on Wednesday to Kenya, a country with one specialist to treat the 1.5 million adults who have advanced glaucoma, an eye condition that can lead to blindness.

The country’s 80 or so other ophthalmologists — in comparison, Canada has 1,200 and a smaller population — help out with basic techniques, but only one before Marco had in-depth training from an Edmonton eye surgeon into how to better treat patients with the condition.

Glaucoma, which creates a buildup of fluid that puts pressure on the optic nerve, occurs in about four per cent of Kenyans over 30 and about one in 1,500 children in East Africa. In Canada, the condition is far more rare, effecting one in 15,000 children and is most often diagnosed in people in their 60s or 70s. If diagnosed early, the condition can be controlled with eye drops, but once the optic nerve is damaged, sight can’t be restored.

Marco spent the last four months practising patient care, leadership skills and various surgical options with a team of glaucoma experts in Edmonton, including Dr. Karim Damji, a ophthalmological professor in the University of Alberta’s medical department. Marco is now heading home to the University of Nairobi to pass along her new skills to ophthalmology residents, ensuring the country can grow local talent and build awareness of glaucoma. Many of Kenya’s 38 million people live in rural villages haven’t even heard of the disease, and tend to seek help only after they have gone blind in one or both eyes.

“The advantage of coming here to Edmonton is that you get to have an experience from an ideal setup where everything runs like clockwork,” said Marco, noting that Kenya has fewer human resources and operating rooms, and not as many instruments. That forces the doctors to improvise. Instead of scrub nurses, for instance, the resident often serves as the main assistant during operations.

Until now, Kenyan ophthalmologists have only performed one type of surgery for glaucoma patients. Marco has learned several more techniques with lower infection rates. She’ll do the first clinical trial in Africa comparing results among the different surgeries.

“I’m very happy because I’m taking back a service to my country where it’s really, really needed,” said Marco, who brought her three-year-old son with her to Edmonton. “Of course, at times I feel overwhelmed because of the numbers and the cases and the situations we have to deal with. But I guess I’ll have to find a way of handling it. … It’s very sad and pretty devastating, especially when the patient is very young.”

Marco first recognized the urgent need for more specialists when she worked as a resident in 2006 in rural communities. There, she met blind people who couldn’t afford medication or surgery. While some babies born with genetic glaucoma were diagnosed immediately, many of their families couldn’t afford trips to the big cities for followup appointments. Some free surgeries are now performed by the first Kenyan ophthalmologist Damji trained when he was working in Ottawa. Now, Marco will double that number.

“I had that compelling desire to work more with glaucoma patients,” she said. “I’m going to use whatever I’ve gathered here and pass it on to the next generation.”

Damji, who performed surgery on about 15 children born with glaucoma in Kenya and Ethiopia in December 2010, said the partnership between Edmonton and Africa also benefits local patients.

“It keeps me on top of surgical techniques,” Damji said. “The very advanced cases that are much more challenging (and more common in Kenya), I get an opportunity to share techniques and again keep learning with (Marco) and her patients, so that I can be ready when we face a very advanced case here.”

Damji said the local team considers it a privilege to teach people from other countries.

He said he was drawn to Edmonton because of the strength of the Royal Alexandra Hospital Foundation, which is funding Marco’s training fellowship along with the International Council of Ophthalmology, the Eastern Africa College of Ophthalmologists and an international charitable organization focused on preventing and treating blindness worldwide.

“My hope is (Marco) can act as a catalyst so that there’s a multiplier effect over time,” Damji said. “That would make me happy when I can see individuals get better patient care there and prevent blindness.”