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Ophthalmic drug delivery faces major limitations due to poor absorption across the corneal membrane. This process is primarily driven by diffusion and is influenced by two main factors: the physicochemical properties of the drug and tear drainage. Most ophthalmic drugs, such as pilocarpine, epinephrine, atropine, and local anesthetics, are weak bases. They are typically formulated at an acidic pH to enhance chemical stability. However, this leads to high ionization, reducing their ability to...

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Development and Implementation of an Ambulatory Orders-Based Ophthalmology Imaging Workflow.

Michael K Oswald1, Cieara Presley2,3, Laurie A Perry2

  • 1Department of Radiology, University of Cincinnati, Cincinnati, OH, USA.

Journal of Imaging Informatics in Medicine
|September 8, 2025
PubMed
Summary

Implementing an orders-based ocular imaging workflow improved efficiency and standardization in ambulatory ophthalmology. This system integrates with electronic health records, streamlining data entry and enhancing image archiving and billing processes.

Keywords:
DICOMEnterprise imagingEye careOphthalmology

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Area of Science:

  • Ophthalmology
  • Medical Informatics
  • Health Systems Engineering

Background:

  • Standardized ocular imaging workflows are underdeveloped in eye care.
  • Ocular imaging is crucial for diagnosing and managing eye diseases.
  • This study introduces an orders-based imaging workflow for ambulatory ophthalmology.

Purpose of the Study:

  • To design and implement an orders-based imaging workflow for ambulatory ophthalmology.
  • To integrate the workflow with electronic health records and enterprise imaging systems.
  • To evaluate the efficiency and impact of the new workflow.

Main Methods:

  • Developed a DICOM-compliant workflow supporting HL7 integration and modality worklists.
  • Automated workflow steps including order placement, metadata application, and documentation.
  • Evaluated pre- and post-implementation efficiency (mouse clicks, keystrokes, time) and collected study volumes and billing data.

Main Results:

  • Integrated 13 imaging devices across 6 modalities and 5 locations.
  • Reduced manual data entry and enabled structured documentation.
  • Completed 16,267 imaging studies, generating $11.4 million; reduced keystrokes/clicks by 40-86%.

Conclusions:

  • An orders-based workflow enhances efficiency, standardization, and interoperability in ophthalmology imaging.
  • Facilitates proper image archiving and billing.
  • Supports broader adoption of standardized imaging practices despite vendor variability challenges.