1. A Novel approach for Enhancing management of chronic eye conditions -lessons from piloting cloud based registries in primary eye care centres in south India Ganesh Babu BS, Mohammed Gowth, Sriharinath MG, Thulasiraj RD LAICO - Aravind Eye Care System. Madurai, INDIA

2. Background: - Aravind Comprehensive Eye Survey – 2003
Utilization of Eye Care services among patients identified with Glaucoma
- Aravind Comprehensive Eye Survey – 2003
Follow-up rate of new patients diagnosed
with PACG and PDR in 2010
at Aravind Eye Hospital, Madurai
Last exam within 2 yrs Before 2 years
Had received any treatment No treatment

3. Aravind Primary Eye Care Centres
Tertiary care centre 5
Secondary surgical centres 6
Outpatient centres
Primary Eye care Centres 61
Madurai centres (15)Outpatients-2015
173,224
Patients referred to Base hospital
20,745
% Referral (Treatment/Specialty)
12%

4. Background: Develop registry of patients with chronic eye diseases
Provide a tool for easy access to the registry to generate details of patients due for follow-up or treatment
Ultimately, enhance the compliance of chronic patients and save their vision

5. Methods
Unique Identification Number (UIN) was introduced and assigned to all the patients getting registered across the system
To link patients data with various MR Numbers assigned when they got registered at various satellite hospitals of our hospital
A web platform was developed to retrieve the patients due for clinical interventions and sending text reminders to mobile phone
Challenging to make sure every patient gets identified uniquely within our system, we came up with this….

6. Registry Development Process (daily)
INSERT UIN, DEMOGRAPHIC, DIAGNOSIS, ADVISE, TREATMENT PROCEDURES
Base hospital
-MR No, UIN
New Patient
Com.Centre
-MR No,UIN
Registry
-UIN
Vision centre
-MR No,UIN
Review Patient
Using UIN
Whenever registration happens, in the background, a rqeuest goes to server which generates a UIN and sends back even before the patient registration is completed
With registry, we are able to generate data in all aspects…. Speciality, vision centre wise…
UPDATE VISIT DIAGNOSIS, ADVISE, TREATMENT PROCEDURES

7. Methods List of patients for follow-up from the registry is generated
Visit to each village and reminding patient for eye care
Verified if patient is under Medications
Status is noted and then updated into registry

8. Results: Glaucoma patients follow-up rate

9. Results (secondary outcome)
Case finding per million population / year
Diagnosis
Before the Intervention
After the Intervention
Change
Diabetic
1,431
1,937
35%
DR Cases
184
377
105%
Glaucoma
431
732
70%
Has also resulted in rapid increase in case detection.

10. Conclusion Registry enabled to get real-time data
Enabled field workers to plan their activities more precisely
Increased compliance and chronic case detection rate
Still, It is too early to conclude the impact of registry
Should work on this further and implement appropriate process to improve the compliance rate
We should explore how best registry could be leveraged
In the past, we will get this kind data usually on a project mode with a lot of effort. Now we can get this in real time whenever we want it..
Enable field workers
We need to understand mechanism behind this to leverage this
Increased compliance rate

11. Thank you