EyeRoute at UIC A Six Month Review

Ophthalmic Image Management System

by Lawrence J. Ulanski II, MD*

Assistant Professor of Ophthalmology
University of Illinois, Chicago
Over the past six months, the University of Illinois,
Chicago, Department of Ophthalmology has benefited
from the purchase and installation of the EyeRoute
Image Management System. The need for such a system
became obvious as the apparent inefficiencies of the
manual printing of patient photos and diagnostic tests,
organizing and filing, and finally retrieving patient data
led to physician, staff and patient dissatisfaction. A bold
move in technology and infrastructure was necessary to
springboard the Department into the new millennium.
The purchase of the EyeRoute image storage system
through the generous donation of the Karl Cless foundation was that springboard which has revolutionized
patient care, resident education and clinical research.
This document will serve to outline how the EyeRoute
system has enhanced our department.
To understand how significant this change has been to
our department, one must take a step back and look at
the past. Prior to the installation of the EyeRoute image
management system, diagnostic testing, whether a fluorescein angiogram, Humphrey Visual Field, or Optical
Coherence Tomography, required a printed report be
generated for physician review. Unfortunately, creating
these reports entailed a great deal of effort, resources,
and time. After creating such reports, this information
had to be transferred to the end-user physicians to
deliver patient care. However, our faculty consists of
18 resident physicians, 12 clinical fellows, 35 full-time
faculty members and 22 part-time adjunct faculty members in multiple clinics in three separate facilities. This
created a huge logistical nightmare. For many years we

Humphrey
VF

OCT

Nidek MP-1
Microperimeter

RetCam
Photos

ICG
Angiogram

Patient - Physician
Interaction

Fluorescein
Angiogram

Goldman
VF

Ultrasound
Imaging

Clinical
Photos

Corneal
Topography

Diagnostic Testing for Patient Care

were able to plug along, but with significant reduction

in clinic efficiency, as well as staff and patient satisfaction.
During the summer and fall of 2005, the ophthalmology faculty reviewed and tested several different image
management solutions including OIS Webstation,
OcuLab and Zeiss VisuPac. We came to the conclusion that the EyeRoute image management system
offered us the best user interface, technological platform, and ability to effectively interface with multiple
instruments from diverse manufacturers.
Over the last six months the faculty has seen the benefits of this system. First, there has been a significant
improvement in physician satisfaction. Before EyeRoute,
the typical hunt for various test results could be likened
to a full blown safari. For example, finding one photo
or OCT result could involve searching in at least four
different locations between two different buildings.
It could easily add fifteen to twenty non-productive
minutes to a patient encounter. Today, the physician
sits with the patient in the exam lane and with a few
keystrokes pulls up the patients test results for review.
Second, it has improved support staff efficiency. Prior
to EyeRoute, the photo clerks and photographer would
dedicate about two hours per day to obtain photo
charts for the next days clinic. Today, they can use this
time more productively and schedule more patient visits. Also, we have eliminated the lost chart syndrome.
This critical improvement ensures that all diagnostic test
data is efficiently stored in real time. Also, a significant
cost of running a diagnostic photo service is disposable.
Digital photography eliminated the cost of film and
developing. Today, with the EyeRoute image manage-

ment system we have eliminated the cost of photo

printing and mailing. We estimate this savings alone
is $15,000 to $20,000 per year. In addition to these
direct monetary savings, we have seen significant indirect savings. Recently, I communicated with an adjunct
faculty member in California about a difficult patient I
was planning to enroll into a clinical study. I was able
to have her sign into EyeRoute from her office and we
were able to review the fluorescein angiogram together
in real time. Likewise, today when we have teaching
conferences with the residents, all the case material
comes from the EyeRoute system. It is quick, the residents can access the data they need either from home
or directly in the auditorium during their presentation,
and it increases the efficiency of our teaching mission.
It has also significantly impacted our research mission.
Today, with a few keystrokes, all of the patients with a
given diagnosis can be located within the database in
minutes and the data collated. In the past, such a query
would have taken days if not weeks.

verifying all network connections, took three days, and

this did not interfere with our clinical operations. After
the system went live, there were almost no problems.
We have also been able to integrate the software into
our Universitys Citrix environment without significant
issues. The company itself has been very responsive to
any request for assistance. Any problem or system hiccup
has been solved in less than 24 hours. EyeRoute engineers have made numerous follow-up visits to ensure
our needs have been met and to help with system
upgrades. Recently, we have been discussing EyeRoute
integration into a new EMR. Again, the EyeRoute team
is already there with a solution.
UIC Systems Interfaced with EyeRoute:

Topcon 50IA w/ ICG & IMAGEnet 2000

Zeiss FF4 with OIS 5000 WIN Station
Zeiss Stratus III OCT
Nikon SF3V PhotoSlit Lamp
Nikon DX2 SLR External Camera
(Manual Import)
Goldman Visual Fields
(Manual Import)
Humphrey 750i Visual Field Units x 2
Quantel CineScan Ultrasound Machine
RetCam
Nidek MP-1 Microperimeter

However, in the end, the most important aspect of

any institutional or small office upgrade is how it affects
the patient-physician interaction. The EyeRoute image
management system has dramatically improved our
patient-physician interactions. Today, we can pull up
a patients diagnostic test results in the exam lane and
immediately show the patient their individual pathology as it compares to normal. Whether it is an ultrasound, color photograph, or OCT, the data is there to be
presented. By having easy and quick access to this data,
the patient becomes a more informed participant in the
health care delivery process, and can more easily and
confidently come to a decision regarding their healthcare. Also, just the immediate presentation of the data
to the patient helps foster a sense of confidence in the
patient in the institution and the physician. Patients
today expect high tech!

Overall, the transition to the EyeRoute system has been

nothing but a positive experience for our department.
The EyeRoute team has been nothing short of excellent, and I think collectively the members of our faculty
would be in agreement that the EyeRoute image management system has brought a significant improvement
to our clinical operations. I would recommend this
system to both large institutional practices and small
private offices without hesitation.

The addition of any high tech interface is often a

process loaded with anxiety and headaches. The transition to the EyeRoute system has been neither. The
initial setup, from server installation to finishing and

* Disclaimer: I have no financial interest in EyeRoute Systems or

Topcon Inc. I have not received any compensation for this product
endorsement.

Benefit:

Estimated Monetary Savings:

Improved Physician Efficiency

Four Additional Patient Visits per Day

Increased Photography Unit Efficiency

Four Additional Patient Visits per Day

Reduced Printing/Mailing Cost

$15,000 - $20,000 per year

Improved Teaching Efficiency

Priceless!

Improved Patient Communication

Priceless!

Benefits Derived From the Installation of the EyeRoute System

2007, Lawrence J. Ulanski II, MD - All rights reserved. All registered trademarks are the exclusive property of their respective owner.

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