Low Vision Service Activities Review and Use of the Electronic Health Record

Abstract

BackgroundLow vision is defined as any form of visual impairment due to different chronic eye diseases not correctable by eyeglasses or surgery; patients have a visual acuity less than of 20/60 or a visual field inferior of 60° in the better eye. World Health Organization in 2014 estimated that 285 million people worldwide had vision impairment; 39 million people are blind and 246 were low vision [1].Visual disability negatively impacts on daily life activities. Visually impaired became unable to perform many Activities of Daily Living (ADLs) such as reading, recognizing faces, watching television and driving resulting in a poor quality of life. According to some author's findings, visual impairment has an effect on psychological status and quality of life and it can be related to feelings of inadequacy and higher level of depressive symptoms [2][3][4][5]. Based on clinical and psychological features of visually impaired, an holistic and multidisciplinary approach should be recommended. Our National Center of Services and Research for the Prevention of Blindness and Rehabilitation of Visually Impaired, IAPB Italia onlus, has a multidisciplinary team including psychologist, ophthalmologist, orthoptist, orientation and mobility teacher and expert in tiphlology. As our standard procedure, first of all the psychologist approaches the patient focusing on psychological status and personal demands. A complete ophthalmological examination is performed subsequently. Considering patient's residual visual function and needs, a customized rehabilitation program is defined. Therefore, patients can start with the devices training sessions supported by the orthoptist in order to identify and correctly use magnifying aids.In the recent years, our team adopted an Electronic Health Record (EHR), a digital version of patient's paper charts implemented with several tools, in order to achieve specified improvement in patient care delivery, provide more effective methods of communicating and sharing information among multidisciplinary team and better manage patient medical records as reported by other authors [6][7][8][9][10]. The EHR is based on an electronic medical database that resides on a web server (Figure1). Therefore, inside of an integrated health system, the EHR adoption can impact on the improvement of clinical care and research quality. Before EHR adoption our center used paper charts to collected clinical data divided in specific sections considering the different professional roles.The aim of this study was to describe two years activities in our low vision rehabilitation center based on a multidisciplinary approach using an EHR in order to highlight the benefits of the tool and its impact on clinicians care delivering. MethodsThe retrospective review was carried out in 420 patients with low vision who attended the National Centre of Services and Research for the Prevention of Blindness and Rehabilitation of Visually Impaired, IAPB Italia Onlus, in Rome from January 2015 to December 2016. Patients were referred to our ...