Dr. Flora Lum on Ophthalmology EHRs: Interoperability is Key

When the American Academy of Ophthalmology took on electronic health record standards in July, its Medical Information Technology Committee wanted to answer one main question: How can EHRs be designed to best help ophthalmologists, their staffs and the ophthalmology practice as a whole?

Flora Lum, MD, executive director of the H. Dunbar Hoskins Jr. Center for Quality Eye Care, and several other ophthalmologists within AAO accomplished this in its report, "Special Requirements for Electronic Health Records for Ophthalmology," published in Ophthalmology.

Dr. Lum says the meaningful use standards have spurred many healthcare entities to look at EHRs and how they can best improve patient care. However, a lot of the EHR systems have been originally developed for primary care physicians or other medical specialists and have not included some physicians like ophthalmologists, and in order for health IT to truly reach its peak, she says all systems must be able to work collaboratively. "What we're trying to promote is interoperability between devices in the office and EHR systems and across multiple EHR systems," she says. "You need meaningful use systems for basic functions, but ophthalmology has a lot of needs and requirements that hadn't been addressed."

Specifically, Dr. Lum and other physicians made four recommendations for future EHRs to accommodate certain areas of ophthalmic practice: that EHRs support standards for data from ophthalmic devices (Digital Imaging and Communications in Medicine), that EHRs support documentation in and transitions between the office and operating room; that they capture, track and display "vital signs of the eye"; and that they incorporate hand-drawn sketches or annotations into records. "A picture conveys a lot more than writing," Dr. Lum says. "We're able to notate where something is located on the eye, use colored pencils and pens to designate pathology. That's an important element."

Dr. Lum adds that after reaching interoperability and achieving specialized data standards, the next challenge will simply be the use of EHRs at all times — and making it work within one's practice. "We've been promoting these standards for a long time," she says. "The biggest barrier for ophthalmology has been how we work with an EHR efficiently in our workflow but also have a relationship with the patient as well."