OpenEyes

Owner

OpenEyes is owned by the OpenEyes Foundation, a not-for-profit charity that organises the OpenEyes community, commissions development, manages its public and commercial licences and protects the relevant intellectual property. Its open source software is managed by the Apperta Foundation.

OpenEyes is licensed under the AGPL-v3 licence, which allows for free use of the software for modification, distribution, patent use, private use and commercial use.

Background

Patient information on eye health (examination results, images, pathology and correspondence) is gathered from a number of sources and needs to be consolidated and checked for duplication. Unfortunately, information on eye care does not fit well into most generic electronic patient records (EPRs), and hospital trusts do not have enough in-house capability to create a solution to the problem. Moorfields Eye Hospital has previously attempted to develop an ophthalmic EPR with a third party, but supplier lock-in and then buyout stalled the project and presented substantial governance challenges.

Situation

In order to ensure that an eye health EPR could be developed without further risk of vendor lock-in, buyout or potential abandonment, the project has been restarted using an open source framework and a sustainable governance approach.

The OpenEyes Foundation is a Charitable Foundation Trust and independent provider, with its own board, that allows the interests of the project to be protected.

Aspiration

• Digitise eye care, especially at secondary and tertiary level
• Work closely with clinicians to meet their needs
• Anticipate existential risk to an ophthalmic electronic patient record
• Implement a sustainable and independent governance framework

Solution and impact

OpenEyes is an eye care specific, web-based EPR that consolidates disparate information into one easily accessible record. The EPR unifies data from systems, imaging machines and clinical input into nationally and internationally agreed data sets. These data sets define the different facets of each ophthalmic specialty, and can then be used for tracking clinical outcomes, clinical audit, and research and development. The software interfaces with a hospital’s patient administration system (PAS) and many of the key pieces of imaging equipment used in eye units, including DICOM compliant devices. Consultant Ophthalmologist Dr David Haider says, “We’re big on click count being low, on things being in the right place, and just fitting with the mental map of the clinician.”

Software design for OpenEyes is planned by a clinician-led design authority, which has resulted in a web-based, graphical, intuitive, and friendly experience for clinical data input. David adds, “One of the benefits of the software is that its clinician designed rather than being death by drop down.”’

OpenEyes is owned by the community, rather than a corporate entity or an individual: staff have the option to submit ideas and designs while funding for new features comes from trusts that want to expand the product. Those features are then available to all users. Some of the primary benefits of OpenEyes are centred around cost sharing, collaboration and allowing the community of clinicians to develop features and pathways according to their own unique requirements and specifications. Because OpenEyes cannot be sold to a third party, users have security that they can successfully influence continued development.

The result is provision of a fast and high quality EPR designed by clinicians but professionally built.

Functionality

OpenEyes is primarily for use in the NHS, and is being deployed for the whole of Scotland and Wales, with increasingly wide deployment in England. OpenEyes:

• Is an EPR for eye care that can be locally or cloud hosted
• Designed primarily for use in a clinical setting
• Facilitates high flow virtual clinics and avoidance of handwritten transcription errors
• Interfaces with key ophthalmic devices
• Web-based, so can be used on all types of computers, tablets and smartphones.
• Presents a slick and configurable user interface

Capabilities

• Connects HL7 compliant PAS systems and DICOM imaging equipment
• Fully compliant with NOD (National Ophthalmic Database) surgical outcomes
• Supports multi-tenanting, so multiple trusts can share a deployment
• Web-based and intuitive interface
• Can be hosted in a firewalled intranet or in the cloud, allowing remote access if desired

Scope

• Remote access has helped ophthalmologists in Scotland to deliver urgent and emergency care while managing infection risk during the COVID-19 pandemic.
• Has increasing usage internationally.
• Avoiding the risk of vendor lock-in and the ability to change providers makes the project more sustainable into the future.

Key learning points

• Clinician leadership and design (with support from a professional interface designer) has been a key factor in the success of the product
• Regular community meetings to listen to the users and set the focus has been another key factor in the success and flexibility of the solution
• Successful deployments are dramatically helped by a clinician with an interest in the deploying organisation, who is permanently tasked with leading local implementation

Digital equalities

A digital Ophthalmic EPR means that patients’ communication preferences can be logged and reliably referred to. Access needs due to sight impairment can be combined with those related to age, digital enablement, language or poverty (among others). Consistent use of preferred contact (by email, letter, video, or telephone), and accessibility requirements, is then an essential part of the service.

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Page last updated: September 2022