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Bolton trust targets broader open source eye care record uptake

Neil Merrett Published 09 May 2017

Having this year gone live with OpenEyes software devised by another trust, hospital body now looking to expand functionality and user base among other trusts

 

Bolton NHS Foundation Trust is committed to integrating a growing number of paper-based processes for optical care onto the OpenEyes open source patient record software that was initially developed by Moorfields Eye Hospital in London.

David Haider, Chief Clinical Information Officer and consultant ophthalmologist with the trust, said that the web-based records application went live on January 31 to be used in the context of cataract cases as part of the first phase of a wider implementation plan.

Haider said that over the coming years, the trust planned to move more functions onto OpenEyes.

“This will take some time as each clinical area needs detailed planning to move it to such an electronic system,” he said. “Also, we will need to develop some aspects of OpenEyes to suit our needs. This type of development was also needed for cataract surgery.”

Bolton NHS Foundation Trust is talking to a number of other local trusts to ensure wider community support and adoption, with wider uptake of the technology expected to better future-proof the open source eye care record for NHS use.

Haider said adoption of the open source solution was backed through a £490,000 NHS tech fund award.  This was used largely to support the implementation of computers and network points for the trust’s eye unit, as well as allowing for the replacement of a number of existing devices that could not be safely connected to the hospital network.

Additional funding was also provided to the trust’s software supplier Across Health that had performed development work on software needed to support integration of the system.

“For example, before we took OpenEyes it did not have an industry standard Health Level-7 (HL7) messaging layer (to link it to hospital PAS systems). Some of our funding paid for that layer to be built, a layer which has now been built into the core product, for all trusts to use,” he said.  “The remainder of the money paid for training, project management and other staffing costs at Bolton.”

In opting to implement OpenEyes, Haider argued that the trust had sought a clinician designed, web-based solution that would be scalable enough to be rolled-out in multiple environments.

The open source nature of the technology was also seen as beneficial in order to reduce vendor lock-in, potentially preventing the technology being bought by another organisation and developed in a direction that may not be suitable for NHS use. 

Haider also welcomed the ongoing contributions of clinicians to further develop the software.

“Although this is not unique to open source software, the community nature of this method of software development certainly facilitates it. I am proud of the fact that, as a consultant ophthalmologist and CCIO, I have been able to contribute to many of the recent enhancements to OpenEyes,” he said.

The adoption was not seen as being without challenge for the trust, with Haider noting that a number of amendments were required.  These included incorporating the HL7 messaging layer to ensure the software met required standards to integrate with the hospital body’s systems.

Another key consideration was that OpenEyes runs on Linux, which is less commonly used in NHS IT environments, therefore requiring on-site support to set up the servers required.

“The eye unit also needed to automate some cataract outcome data collection from the Bolton community optometrists that we work with - GM Primary Eyecare,” he said. “We are grateful that the GM Primary Eyecare group contracted Cegedim to enhance their OptoManager software, linking it to OpenEyes. This allows their software to automatically send our surgical results directly back into our OpenEyes software.”

However, Haider noted that the trust had managed to make the required changes and adopt the system without the need for any specific help from Moorfields Eye Hospital, which had originally developed the technology.

Building on the significant development work by the hospital in devising OpenEyes, the software is no longer managed by Moorfields.  Instead it is now overseen by a non-profit foundation to set out the direction of future development for the technology and connect suppliers with trusts, Haider said.

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