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SPOTLIGHT ON TECHNOLOGY & TECHNIQUE

Goodbye, refractive surprise

Veracity’s aim is to make surgical planning less daunting.

EMRs are typically designed to document information, not assimilate it, but the latter is what a surgeon must do before performing a patient’s cataract operation. Responding to that need, Zeiss offers Veracity Surgical a cloud-based, surgical software package designed for clinical planning, treatment choices and outcomes analyses. It culls information to acquire patient history, clinical exam data and diagnostic tests, and it does so from manu sources: EMRs, biometers, topographers, and eventually, auto refractors, OCTs and more — and presents it one spot.

It’s a common misconception that the computer dictates to the doctor, says Kerry D. Solomon, MD, a creator of Veracity and now Zeiss partner. But with this software, it flows from the surgeon. Based on the clinical examination, diagnostic findings and surgeon’s preferences, the software presents solutions for each patient. The result: software that helps “assimilate and interpret all of this digital data and presents it to a surgeon in an understandable and intuitive way,” Dr. Solomon says.

The Veracity Surgical

WHY VERACITY IS HERE

“Surgical planning is incredibly cumbersome for physicians and their staff, but it is a very necessary part of cataract surgery,” says Dr. Solomon, a partner with Carolina Eyecare Physicians, LLC in Charleston, SC. “We have to figure out the exact solution for patients for the vision they want to achieve.”

Because there are often other conditions to consider during cataract surgery, including astigmatism or spherical aberration, these conditions, and their data, must be considered when choosing an IOL.

Dr. Solomon’s frustration in trying to coalesce the data, then make sense of it, led to the birth of Veracity. “The genesis was really two-fold,” he says. “One, how can we easily get at this information to improve our outcomes, which ultimately benefits patients? And two, how can we speed up the process of surgical planning?”

THE HOW AND WHY

Dr. Solomon, along with co-inventors Warren E. Hill, MD, Kyle Smith, MD, and Jeremiah Elliott, developed Veracity in 2016. While Veracity was created at Dr. Smith’s and Mr. Elliott’s firm Integrity Digital Solutions, the men wanted “a corporate partner to take advantage of synergies with resources ... and sales and marketing savvy to help develop and distribute our products,” Dr. Solomon says.

The Veracity software interfaces with the necessary technology, mining its data relevant for a given procedure. This way the surgeon can avoid printing out any sensitive information contained in an EMR.

Dr. Hill, medical director of East Valley Ophthalmology in Mesa, Ariz., and adjunct professor of Ophthalmology at Case Western Reserve University in Cleveland, Ohio, says the software increases surgical planning accuracy. Also, Veracity picks up key pieces of information from the medical history that are required in surgical planning, such as whether the patient has glaucoma or has undergone prior refractive surgery. “Sometimes, patients just do not tell us this information,” says Dr. Hill, who helped develop Veracity.

If not taken into account, such an oversight could result in a refractive surprise.

“If the software has information that the surgeon undercorrects by half a diopter, it might suggest making a selection of a specific IOL based on that surgeon’s past outcomes,” says Eric Donnenfeld, MD, clinical professor of Ophthalmology at New York University and a partner in Ophthalmic Consultants of Long Island.

Dr. Hill, whose office specializes in IOL power calculations, likens Veracity to having another set of eyes looking at the entire preoperative planning process. The software applies generally accepted validation criteria to the measurement process and identifies common issues that the surgeon should address before a decision is made regarding an IOL power or type, taking IOL power calculations to the next level.

THE INFORMED CONSENT

Dr. Donnenfeld says the software provides access to best practices by using the optimal and most advanced IOL formulas, and can provide informed consent in paperless mode. “The patient is made aware of the risks and benefits, and [the software] documents the informed consent process ... to make sure the patient understands the options available,” says Dr. Donnenfeld, who works with Zeiss as a consultant.

A comprehensive and detailed informed consent process is vital for ophthalmologists, according to the Ophthalmic Mutual Insurance Company (OMIC), the largest insurer of ophthalmologists in the United States. The organization concluded in 2011 that an inadequate informed consent process was “the single most important driver of PIOL (premium intraocular lens) malpractice claims.” Dr. Donnenfeld also likes that the software can track patients’ outcomes after cataract surgery, allowing for outcomes analysis.

With the Zeiss partnership, Dr. Solomon believes viral adoption of Veracity is within reach. “This software will help surgeons and ultimately patients,” he says. “Think of it like the ‘open table’ app.” OM