Radio frequency identification is commonly used to deter shoplifting, but those at University of Michigan Kellogg Eye Center are employing RFID to achieve real-time localization of patients and health-care providers. The practice says that the technology is streamlining operations by using data visualization to decrease patient wait time and therefore im-prove the quality of the visit.
“We know that people’s time is valuable and people are always more satisfied with their care if they don’t have to wait as long,” says Paula Anne Newman-Casey, MD, an assistant professor of ophthalmology at Michigan Medicine, who conducted the study. By analyzing raw data, she aimed to accomplish two things. “I was looking to deploy a system to calculate how much time patients spend waiting to be seen in order to see if we could implement policy changes to work on reducing that time. Also, I was looking to see where we could add standardized education to patient visits.” She explained that by analyzing RFID data, the clinic would be able to test new policies and quantitate any impacts on wait times and overall length of clinic visits.
Doctors, ophthalmic technicians, medical assistants and more than 2,000 patients agreed to don ID tags embedded with a small chip that transmits a signal to a remote scanner. With the information generated, the facility can attempt to increase the number of patients seen and improve clinic efficiencies, notes Dr. Newman-Casey. She says that there is interest in using the data to improve scheduling and optimize templates. The end result, the center says, is a “smart clinic,” where more patients can be seen without compromising wait times.
Dr. Newman-Casey is also designing a web application that delivers personalized glaucoma coaching. The goal is to train medical assistants to provide support to patients through the application, which, she says, “generates specific education and counseling sessions for the patient based on their actual test results, diagnosis, doctor’s recommendations and barriers to optimal self-care. Instead of having a generic discussion about the disease, the information that the counselor provides is highly personalized.” Dr. Newman-Casey believes personalized education can encourage people to take medications as prescribed, and offering additional self-management support will help people take better care of themselves.
Visual Field Loss and Disability
Researchers from the Duke University Department of Ophthalmolgy in Durham, North Carolina, and the Department of Ophthalmology at the State University of Campinas in Brazil say that even a small amount of visual field loss can result in disability.
In their study, published in the January issue of the American Journal of Ophthalmology, the researchers analyzed 263 glaucoma patients using visual function questionnaires and used a method called latent class analysis to quantify the amount of visual field damage associated with disability. They divided patients into mutually exclusive classes based on their responses on the questionnaires, and investigated any differences in standard automated perimetry mean deviation and integrated binocular mean sensitivity values between the classes.
The researchers say that a model with two classes, disabled and non-disabled, turned out to fit the data best. The disabled group had 48 patients (18 percent) and the nondisabled group had 215 (82 percent). The average mean deviation in the better eye in the disabled group was -5.98 dB, versus -2.51 dB in the nondisabled group (p<0.001). For the worse eye, the values were -13.36 dB in the disabled group and -6.05 dB in the nondisabled group. They found that patients with severe glaucoma in the better eye had five times higher odds of being classified as disabled.
“We identified that, on average, a loss of approximately 6 dB in the better eye was associated with disability in glaucoma,” the researchers noted. “For the worse eye, the average loss in the disabled group was approximately 13 dB. This is an important finding, as it shows that even relatively early defects can be associated with disability if they occur in the better eye.” REVIEW