ifa systems AG ifa united i-tech Inc. ifa systems Latinoamérica Augustinusstr. 11 1850 SE 17 St., Suite 107 Alfonso Ugarte 235, Ofc. 108 50226 Frechen Fort Lauderdale Barranco – Lima Germany FL 33316, USA Peru info@ifasystems.com info@ifa-united-i-tech.com info@ifasystems.com www.ifasystems.com www.ifa4emr.com www.ifasystemslatinoamerica.com

Electronic Ophthalmic Surgery Management

(EOSM)

Contents

1. Patient History Record (medical status & history, review of systems, family & social history ....... 3

2. Interfaces (diagnostic equipment, administration systems) ........................................................... 4

3. Consent Forms (surgery and anesthesia) ........................................................................................ 6

4. Anesthesia Documentation (questionnaire, pre-op & post-op anesthesia order) ......................... 7

5. Surgery Documentation (pre-op record, intra-operative note, post-op record) ............................ 8

6. Nurse Documentation (pre-op assessment, intra-operative record, post-op record) .................... 9

7. Surgery Report .............................................................................................................................. 10

8. Data Export (clinical trials, surgery registries) ............................................................................... 11

9. OR Planning Chart ......................................................................................................................... 12

10. Attachments .............................................................................................................................. 13

10.1. ifa EyeDraw ........................................................................................................................ 13

10.2. ifa4iPad .............................................................................................................................. 13

10.3. Interface List (extract) ....................................................................................................... 14

The OP record can be fully integrated into the

clinical EMR: Dashboard

1. Patient History Record

Using ifa’s SmartScreen technology, a user can easily enter all relevant patient surgery information.

The user is then able to generate meaningful data (e.g. based on SNOMED terminology) and can

export it utilizing the query function for reports, clinical trials, disease registries, and other outcome

databases.

The structured data formats are available for:

Past medical history

Past ocular history

Family history

Allergies and risks

Medication history

Social history

The user selects terms from "pick lists" associated with

standard codes such as ICD or SNOMED and their

compatible terms with clinical modifiers for precise documentation.

2. Interfaces

The connectivity guarantee is important for any paperless ophthalmic OR. Interfaces are designed for

data import from ophthalmic equipment and for exchanging data with administration systems

(HIS/Hospital Information Systems and PMS/Practice Management Systems).

Equipment Interfaces

More than 450 diagnostic devices and digital systems

can be connected with the ifa surgery management.

The interfaces are based on exclusive agreements

with the leading vendors for ophthalmic technology.

Examples:

IOL Master (Zeiss Meditec)

Pentacam (Oculus)

Orbscan (Alcon)

HRT (Heidelberg Engineering)

Image systems (e.g. Topcon, OIS, Kowa, Canon etc.)

Autorefractor/keratometer (Topcon, Nidek, Canon, Humphrey etc.) The up to date list is available on our website www.ifa4emr.com.

HL7 Interfaces:

Demographic data

Diagnosis codes

CPTM codes

Reports CDA

DICOM :

Images

Structured Reports

HIS and PMS Interfaces

The clinical OP management can be connected with the existing administration system (Hospital

Information System/Practice Management System). The bi-directional interfaces are based on the

international HL7 standard (www.hl7.org).

The ifa system imports all relevant demographic data from the HIS/PMS, stores it within the surgery

record, and then exports all relevant information (e.g. diagnoses, procedure codes etc.) for billing

and documentation purposes.

The ifa surgery management is also designed to communicate

with the integrated image database or professional PACS.

DICOM is the standard format for the integration of all kind of

BLOBS (binary large objects) incl. surgery videos (e.g. AVI files).

Signature pads support the paperless ASC

3. Consent Forms

Consent forms management depends on the relevant legal requirements. All documents are stored

as MS Word files which can be modified by merging the patient data from the medical record: name,

date of birth, treatment plan, type of procedure etc.

The merged documents can be printed, signed by the

patient and the surgeon, and imported as a scanned

object into the EMR.

If the legal requirements allow a digital signature the

patient can sign on an electronic pad (without printing

the consent document).

The system provides samples of various consent forms.

Within the customization service all relevant consent

documents can be stored and mapped to the merging functionality by the ifa consultants.

The iPad allows mobile computing in the OR

4. Anesthesia Documentation

The ifa surgery management provides a tool to generate all types of data fields. The user can choose

checkboxes or multiple choice codes. E.g. anesthesia questionnaires can be created for the pre-

anesthesia evaluation. Data fields can be structured for e.g.:

Allergies (medications, food, latex)

Current medications

Problems (heart, blood pressure, kidney, liver, neurology etc.)

Anesthesia history

Type of anesthesia

Postanesthesia evaluation (level of consciousness, status cardiopulmonary etc.)

The other alternative is the use of existing paper

forms which are scanned and imported into the surgery record. Furthermore combinations

(structured data and scanned documents) can be generated within the customization process.

The integration of the IOL Master is an example for safe and professional device

integration.

5. Surgery Documentation

The documentation requirements for surgical procedures in ophthalmology are complex and

changing depending on new equipment, innovative implants and emerging technologies. Therefore,

the ifa software allows for users to define data structures and vocabularies when required.

Predefined data structures can be provided for:

Cataract Surgery

Vitreous Surgery

Retina Surgery

Glaucoma Surgery

Refractive Surgery

Plastic and Orbital Surgery

The structured data concept can be also used to

generate surgery plans for the OR (see OP plan).

6. Nurse Documentation

For the nurse report (NR) the user can choose between two alternatives:

Digital codes (structured templates with the EMR)

Scanned paper form

The solution depends on the workflow and the preferred data

use. If users require searchable NR information, ifa recommends

digital code storage. If the NR is stored because of legal

requirements, the scanning process with paper forms is more

convenient. The scanner interface is also specifically designed

for small, fast-scanning devices (e.g. Fujitsu ScanSnap).

Surgeons can concentrate on procedures and reduce paperwork.

7. Surgery Report

The surgery notes are generated automatically by merging pre-defined text reports with the

individual patient and procedure data. The basic text is a MS Word document with structured

merging features.

Within the customization process the existing user

reports are evaluated and preset for the electronic

workflow. If required, the surgery reports can be

completed with scanned documents (nurse reports,

anesthesia reports, device printouts, graphical

documents and drawing documents).

The surgery reports can be directly printed and/or sent

by email with the relevant data protection features.

8. Data Export

The ifa software suite offers comprehensive data export functionality. Quality outcome databases,

registries and clinical trial projects can directly import data from the surgery EMR. The data structure

is SNOMED compatible making it extremely useful for international projects.

The interface for the EUREQUO project which is used on

an international level has also been integrated into the

surgery management. This registry for cataract and

refractive surgery allows for a comparison of the user’s

data with surgeons from other countries. The reports

have been developed by experts based on data outcome

studies by the ESCRS (European Society for Cataract and

Refractive Surgery). More information:

www.eurequo.org.

All EMR versions are available for the iPad

9. OR Planning Chart

The surgery management software generates the complete plan for the OR. Users can customize the

layout for the different procedures or surgeons. The system imports the patient related data from

the EMR and integrates the clinical data (VA, refraction etc.) into the OR plan.

The flexibility of the tool makes it simple and efficient,

and the plan can be printed or displayed on a computer

screen (e.g. in the preparation area).

Additionally, a tablet PC (such as the Apple iPad) further

enhances immediate access to the OR plan or any other

procedure-related information.

10. Attachments

10.1. ifa EyeDraw

The EyeDraw tool allows all types of drawings for ophthalmic surgery management.

10.2. ifa4iPad

All functions are also designed for pad computers like the Apple iPad and for touchscreen

technology.

10.3. Interface List

EcMR for Cataract and Refractive

Surgery

Biometer, Ultrasound, Cornea Topography and Multi Function Devices

• Biometer, Optical

• Tomey AL-100

• Zeiss IOL-Master

• Ultrasound Systems

(biometer/pachymeter)

• Bio-/Pachymeter

• 4Optics OCP

• Alcon OcuScan RxP

• Alcon OcuScan (software)

• B-scan systems with video port

• Haag-Streit AXIS II PR (serial interface)

Heidelberg OCP

• M + C - I 3 system

• Mediconsult I-Scan

• Nidek A-/B-Scan US 2500/20

• Nidek Echoscan US-4000/500

• Oculus Pachycam

• Quantel Pocket Pachy

• Quantel Medical CineScan (video port)

• Quantel Medical Compact II (video port)

• Quantel Medical Aviso (video port)

• Technomed E-Z Scan B5500/ E-Z Scan

AB5500

• Technomed PacScan 300 A/300 P/300 AP

• Teknar/Mentor B-Scan III Plus

• Teknar/Mentor A/B-Scan III Plus

• Teknar/Mentor Image 2000

• Tomey AL-100 Biometer/AL-2000/-3000

• Tomey UD-6000

• Tomey SP-100/3000

• Tomey IS-500 A/B-Scan

• Tomey AI-510 A/B-Scan

ifa offers a broad range of device connectivity

EcMR for Cataract and Refractive

Surgery

Cornea Topography (examples)

• Bausch & Lomb Orbscan

• bon Optic EyeTop,

EyeTop-H, Eye Top-S

Haag-Streit Keratograph

• Nidek OPD Scan II

• Oculus Keratograph

• Oculus Easygraph

• Optikon Keratron/Keratron

Scout

• Rodenstock Keratograph

• Tomey RT-6000/7000

• Zeiss ATLAS Model 9000

• Oculus Pentacam

EcMR for Cataract and Refractive

Surgery

Refraction Devices (examples)

• Autorefractor/Keratometer/

Tonometer:

– Nidek RKT-7700

– Nidek TONOREF II

– Oculus Park-1

– Topcon TRK-1P

• Autorefractor:

– Canon R-10/20/22/30/50/F10

– Canon RK3/RK5

– Hoya AR 550

– Humphrey HAR-420/500/510/

525/540/580/580 S/585/590/595

– Nidek AR-310A/330A/600/660

/700/800/820/1000/1200 M

– Nikon NR-5000/5100/5500/8000

• Autorefractor:

– Nikon Speedy

– Nikon Retinomax

– Plusoptix S04

– Rodenstock PR-60

– Rodenstock RA-303

– Rodenstock RX-202/502/520/900

– Shin-Nippon RC 380

– Shin-Nippon QR-007 N

– Shin Nippon EZRef 8000

– Tomey TR-1000/3000

– Tomey RT-7000

– Topcon RM-A-2000/3300/6000/6300/

7000/ 7300/ 8000/RM-8800

– Welch Allyn SureSight Hand-

– Autorefractor

– Zeiss Humphrey Acuitus

EcMR for Cataract and Refractive

Surgery

Kerato-Refractometer (examples)

• Alcon Handheld Keratometer

• Canon RF-1/10

• Canon RK-1/F1/2/3/5

• Grand Seiko GR-3100K

• Humphrey Acuitus

• Humphrey HAK-420

• Humphrey HARK-595/597-599

• Huvitz MRK-3100 P/HRK-7000

• Nidek AR 530A/510A

• Nidek ARK-

510A/530A/560A/700/700A/

760/900/2000

• Nidek KM-500

• Nikon NRK-8000/10000

• Nikon Retinex K-Plus Hand-Ker.

• Nikon Retinomax2

• Nikon Speedy-K

• Potec PRK-5000

• Rodenstock CX 500/520

• Shin Nippon ACCUREF 8001/K

9001

• Tomey RC-1000/5000

• Topcon KR 7000/7000 S/7000

P/7500/

• 8100/8100 P/8800