How Data Integration Advances Clinical Decision Making
By Peter A. Karth, MD, MBA
Today, eyecare providers serve the growing demands of an aging population that has a higher disease burden and requires more education. To better serve these patients, there has been an explosion of high-quality, multimodal imaging and diagnostic data. Multimodal imaging has become standard in my clinic, even for routine patients. For instance, I regularly use OCT angiography (OCTA), ultra-widefield color fundus photos, and OCT analysis of the retinal nerve fiber layer (RNFL) and optic disc, all of which offer almost infinite dimensional views and various analytic algorithms.
I don't have time to log onto each platform and review multiple images, but I refuse to settle for brief snapshots of the data we’ve collected. My patients deserve better than that, both for complex diagnoses and treatment decisions as well as for following disease progression.
How can we manage the increasing demands of our patients and mountains of data, particularly with the added challenge of reimbursement reductions that throttle our chair time? How can we get the most out of the latest technologies to help our patients, but still work efficiently?
SEAMLESS DATA INTEGRATION
The answer is another technology – one that improves data integration, visualization, and analysis. I've come to rely on the Integrated Diagnostic Imaging platform from ZEISS to turn those mountains of data into the images and information I need for efficient clinical decision making.
This is very different from a PACS system viewer. It’s my cockpit for modern patient care. On one screen, I have multimodal image overlay, with point-to-point registration and comparison. Treatment effect overlays provide expanded temporal comparisons. The result, frequently, is one or more new insights into the patient’s status.
Integrated Diagnostic Imaging modules are designed around our needs for specific conditions, including glaucoma and retinal diseases. For patients with glaucoma, multiple metric graphs show RNFL and ganglion cell (GCL) thickness plots, mean deviation, and cup-to-disc ratio on one screen. We can compare up to 15 data points over time, adjust baselines after treatment, and see statistical analysis of changes. For retinal disease, the system provides an instantaneous synched overlay of OCT/OCTA, ultra-widefield, fluorescein angiography, indocyanine green, and other color photos. I can easily view the results of treatment over time, with data from multiple visits correlated on a single screen. A graphical data display tracks macular thickness and other metrics we use to gauge the effects of treatment. The system has similar modules for diabetic retinopathy, AMD, and other diseases and pathologies.
AN INDESPENSABLE DEVICE
Data integration technology has become indispensable for my work. I don't need to choose between using modalities that procure large volumes of data and running an efficient practice; the ZEISS Integrated Diagnostic Imaging platform allows me to do both. And, although I enjoy the capabilities as a clinician, the real beneficiaries of this advanced technology are my patients.
Figure 1. Retina Workplace monitor screen showing two fundus images with OCTA overlays.
Figure 3. Retina Workplace monitor screen showing images from three different visits.
The opinions expressed herein are those of the author and do not necessarily reflect the opinion of Ophthalmology Management and/or PentaVision — nor should they be taken as an endorsement by Ophthalmology Management and/or PentaVision. Dr. Karth is a paid consultant to ZEISS.
Peter A. Karth, MD, MBA, is a writer, a speaker and a vitreoretinal surgeon practicing in Oregon, USA. Contact him directly at www.PeterKarthMD.org.