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

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.