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OpenEyes G W Aylward Moorfields Eye Hospital

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Goals • Patient care • Outcomes • Research • Teaching

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0 17,500 35,000 52,500 70,000 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 Notes Diagnoses Procedures

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100% 10 0% 0 Clicks Diagnoses

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@

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Clinical Digital Maturity Paper Partially digital Fully Digital Partial Integration Full Integration

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Clinicians want to be digital

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‘Clinical systems’ • Moorfields 18 (+ 50) • Leeds: 320 • St Thomas’: 760 • Medline:118,552

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The solution 1) Make it easy data into electronic form: 2) Integration:

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OpenEyes • Web application • Open Source • Clinically led • Flexible

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OpenEyes at MEH • In use at all 13 sites • All prescriptions, correspondence, operation bookings, since January 2012 • Clinical modules for cataract, glaucoma, medical retina released, others by end of 2013

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Prescribing

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Correspondence

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Clerking

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Clerking

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Event types • Adding functionality • A large collection • Many more to come • ‘Developer community’

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‘Event’ store OE Developer Do your own! Need a new event type?

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Will this approach work outside Moorfields?

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Will this approach work outside Ophthalmology?

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OpenEHR Archetype OpenEHR Template

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The Core Team Personnel WTE Director 0.4 Developers 4.5 Product/Project Managers 2 Quality Assurance 1 Support 1 (Funded by MEH through to 2017)

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Other resources • > 50 Ophthalmologists (volunteers) • Developers in Cardiff and Maidstone (Funded by local host Hospital)

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Why Open Source?

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Open source • Good fit for clinicians

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Clinical development Clinician has idea Improved results Tries it out Publishes it Others modify it

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Open source • Good fit for clinicians • Speed and flexibility

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Collaboration

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Process • Form Group

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Process • Form Group Cataract Strabismus Core ARMD Glaucoma Adult A&E Medical Retina

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Process • Form Group • Create written specification (What and How)

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Process • Form Group • Create written specification • Turn into web ‘elements’

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Process • Form Group • Create written specification • Turn into web ‘elements’ • Discuss!

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Open source • Good fit for clinicians • Speed and flexibility • Security

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Open source • Good fit for clinicians • Speed and flexibility • Security • Low(er) cost

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Licences • GitHub ($25 per month) • JIRA ($1200 for 25 users $600 per year • Sauce Labs ($150 per month) • Travis (£500 per year)

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Open source • Culture

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Moorfields Cardiff Fife Maidstone Salisbury Glasgow Liverpool

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Open source • Culture • Control

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Users OpenEyes

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Users Foundation IMS Data Colleges OpenEyes OpenEHR Industry

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Open source • Culture • Control • Funding

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The Core Team Personnel WTE Director 0.4 Developers 4.5 Product/Project Managers 2 Quality Assurance 1 Support 1 (Funded £3.5million by MEH through to 2017)

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Conclusions • OpenEyes is an enabler for change • Clinical leadership is vital • Open Source is a good fit for clinical software, but barriers remain