ORBIS - How to use E-Learning & E-Consultations within the medical community on a global level - to...

8/14/2019 ORBIS - How to use E-Learning & E-Consultations within the medical community on a global level - to benefit those who need it the most

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How To Make a Global HouseCall

How ORBIS International created an original and

innovative Internet E-Learning & E-Consultation

program to help bring sight back to millions


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How to Make a Globa

A True Visionary

Table o f Contents

A True Visionar y 3

Taking A Closer Look 4

Seeing the Potential 6

Out of Sight 8

A New Perspective 9

Conclusion 11

This Page:

Photo by Claude Ho

Cover Photos:

Surgeon in OR by Paul Lowe

Cornea box going to plane by Patrick Saine

Mother and daughter by ORBIS International

Next Page:

Photo by ORBIS International

Over the course of the last two decades, the measurable positive

benefits that are achieved by using online learning and consultation

programs and services have been carefully studied and clearlydocumented. Initially, typical applications of using eresources,

elearning and econsultation services and tools were primarily

capitalized upon by the educational and corporate industries.

Fortunately, in recent years the medical industr y has recognized the

invaluable advantages that the online community can offer patients

on a global level. One of these remarkable visionaries can be found

in Dr. Eugene M. Helveston, M.D., OphthalmologistinChief of

ORBIS International (ORBIS). ORBIS is a nonprofit humanitarian

organization dedicated to blindness prevention and treatment in

developing countries.

In November of 2 002, Dr. Helveston found a corporate community

partner with Clarity.ca Inc (Clarity) and together they launched a

new Telemedicine ELearning and EConsultation service of the

ORBIS CyberSight program in June of 2003. The CyberSightprogram is an initiative of ORBIS, targeted at establishing an

extended presence of the ORBIS Volunteer Faculty with partners

worldwide. This innovative EConsultation program is a clinical

application designed by Clarity to allow a partner ophthalmologist

located anywhere in the world to be connected with an ORBIS

Telemedicine mentor ( Telementor) for professional assistance.

Dr.EugeneHelvest

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How to Make a Global HouseCall4 How to Make a Globa

Anne Frank once said How wonderful it

is that nobody need wait a single moment

before starting to improve the world.

Nothing could be truer in todays digitally

and electronically connected world. This

fact was made evident once again with Dr.

Helvestons vision to further enhance the

capacity of ORBISs Volunteer Faculty to

provide ongoing assistance to the global

ophthalmologist community by creating

an easily accessible Telemedicine website,

providing topnotch patient diagnosis

and treatment to anyone in the world

who needs it. Having the vision is the first

step, but turning a vision into a practicalapplication calls for good oldfashioned

analysis and technical knowhow. Luckily,

thats Claritys specialty.

The true purpose of the project analysis

process is to turn a concept into a working

reality. Excellence in frontend analysis of

any project is not only found in the ability

to accurately identify and create a program

that meets the user needs of today, but

to design a program that incorporates

a flexible infrastructure that anticipates

the way the program may need to evolve.

Working closely with the Volunteer Faculty

of ORBIS, Clarity ensured that the multi

faceted needs of the partner doctors andpatient recipients, now and in the future,

were taken into full consideration.

As our world continues to grow, so do the

demands upon the medical community to

find new ways to provide medical services

User Capabilities

Developing a program or website that

is dependent upon accurate and timely

information exchange becomes completely

ineffective if the endusers technical

capabilities can not match the programs

technical requirements. For example, when

dealing with diagnostic images (pictures

or Xrays), it is important to assume

that the user will be working with a low

bandwidth environment. Consequently,

the program should be designed to accept

images collected with a basic digital camera

(typically 10k or less) to ensure the successof all submitted images into the system.

Program Accessibility

When working within the medical community,

it is essential that any and all appropriate

parameters of doctor and patient privacy are

identified and met. Ensuring that partnering

medical professionals are correctly verified

and properly registered prior to granting

them access to any critical information or

resources is an important part of the design

process. Additionally, the highest program

security measures must be incorporated

to ensure patient privacy is maintained

and that the patient has approved of theirinformation being shared in this way.

On the ORBIS website, partner doctors can

only access their own cases a nd Telementor

doctors can only access cases they have

been assigned. Clarity also ensured that

to patients situated in everexpanding

geographical areas. Some initial analytical

considerations that are beneficial to take

into account include:

Who Are the Target Users?

In order to design an effective and efficient

telemedicine program/website, it is vital to

accurately identify the ta rget users. This can

include partnering doctors, hospitals and

clinics or the provision of general diagnosis

and information services directly to patients.

The needs of these different user groups

significantly affect the internal informationflow structure, delivery of information and

services as well as the privacy requirements

the program incorporates.

Information Processing

Clearly establishing the consultation agenda

is critical to determining the best forms

of information gathering, processing and

sharing with th e target users. This qualitative

system typically includes using one or two

methods of data acquisition and processing

known as open and closed processes. A

closed process is defined by asking people

very specific questions and giving them

boxes to tick. The open process is definedby asking people questions and giving

them space to formulate their own replies.

Traditionally, using a combination of both

open and closed processes produces the

richest and most useful responses.

the EConsultation system incorporated a

patient consent form that they must sign to

give their personal physician permission to

send their information and relevant images

to the Telementors that can only be used

for specific diagnostic and/or educational

purposes. Further patient safeguards

also clearly outlines to them that their

healthcare and well being always rests with

their personal physician and not with the

Telementor(s) who have been asked for

professional input.

Claritys extensive experience within the

medical community has taught them thatthe key challenges in electronic learning

and consultation program design are not

just technical but also conceptual. ORBIS

needed the ELearning and EConsultation

programs designed with the capacity

for precise data capturing of extremely

specific information to facilitate the most

accurate diagnosis possible. In order to

accomplish this, it was imperative that

every aspect of the program analysis and

design requirements were based upon both

relevant and verifiable data.

Taking A Closer Look Photo by Polly Braden

Photo by Kiran Ridley



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The most important data that really matters to ORBIS is the fact

that 37 million of the worlds people are blind and another 124

million have low vision and are at risk of becoming blind and75% of those dont have to be. Millions can be cured with lowcost

techniques routinely practiced in many countries and ORBIS has

long since risen to the challenge to find new ways to deliver these

techniques to the people that need them on an international level.

Twenty-five years ago, ORBISs first eye care treatment and

ophthalmic training programs were launched on board the worlds

only Flying Eye Hospital, a former passenger a ircraft converted into

a state-of-the art surgical training facility. Accompanying the ORBIS

plane is an international team of dedicated health professionals from

around the world, working together to share ophthalmic technology

and skills with their counterparts in developing countries. It has

been the success of the Flying Eye Hospital program that paved the

way for ORBIS to expand its mission to the Internet. It has been the

success of the Flying Eye Hospital programs that paved the way for

ORBIS to extend its mission to the Internet.

As the Flying Eye Hospital programs were pu t in place, Dr. Helveston

noticed what could be phrased as a kind of disconnect once the

plane had left a location. This prompted him to conduct an informal

study using an email consultation process with patients in Cuba. His

original instructions to the partner doctors were to note but not

requirements of the health care industry. For

the last 8 years, Clarity has been successfully

designing unique website applications

tailored to meet the exacting needs of a

broad range of healthcare organizations

working within a wide variety of technicalenvironments. Claritys industry specific

expertise combined with their unwavering

commitment to finding new ways to serve

their community, locally and globally, resulted

in the perfect partnership both professionally

and personally between Clarity and ORBIS.

The ORBIS Telemedicine site a lso clearly

showcases the potential of exchanging

and managing knowledge with remote

locations globally via the Internet for any

type of organization that works within

the international arena . Clarity has always

understood that while technology is the

basis of their business, their business

is actually about meeting the very realneeds of the very real people that are

using the technology. Consequently, all

of programs Clarity designs utilize the

most current technological business

tools available to produce highly intuitive,

userfriendly applications.

act upon the resulting recommendations

and diagnosis offered through email.

Over the course of three separate visits to

Cuba, purely by coincidence, Dr. Helveston

ended up working directly with some of thosesame patients and produced an independent

diagnosis and treatment pla n. The partnering

doctors then showed him the diagnosis and

treatment plans that had been previously

offered via the email consultations and

they found that there was no difference

between the inperson consultation and

diagnosis and what was produced via the

email exchange. These surprising results

prompted Dr. Helveston to then seek

independent diagnosis confirmation with

10 different consulting ophthalmologists,

who all independently confirmed the same

diagnosis in each case. It was these results

that propelled Dr. Helveston to take the

next step and begin the development of aTelemedicine service website with Clarity.

In 2002, when ORBIS decided to create a

Telemedicine website, they recognized the

necessity to partner with an organization

that truly understood the specialized

Seeing the Potential

Photo by ORBIS International Photo by ORBIS International

How to Make a Gl obaHow to Make a Global HouseCall6


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Theres an old quote Out of sight, out of

mind and when it comes to creating any

program, no matter how complex, thats

something Claritys program designers

always remember. Clarity uses a variety

of proprietary technological tools that act

as the nervous system linking everything

together to create one cohesive, seamless

multifunctional program.

The ORBIS Telemedicine website is no

exception. Driving the primary program

is Claritys Content Manager (CCM 5), a

straightforward Webbased application

enabling content owners to work

together on the creation, management

and publication of any type of content. The

CCM 5 flawlessly determines, integrates

and applies the new automated business

processes of each organization into their

existing business processing system.

Supporting the complex information

exchange that both the ELearning and

EConsultation facets of the ORBIS

Telemedicine website requires, is Claritys

ELearning infrastructure known as

LiMe (Learning Information Management

Environment). This highly specialized core

system tool is designed to enable non

technical users to create, manage, track

and deliver web based information to the

clients target users. Additional system

features of LiMe includes the ability to

not only track, but assess the results and

status of the ongoing information that is

exchanged between the organization and

its user groups.

The union of Claritys CCM 5 content

management system and LiMe information

infrastructure, provides the perfect platform

to optimize the multiple forms of case

sensitive data that must be gathered and

Out of Sight

analyzed to ensure the most accurate

diagnosis in the shortest time period. This

program foundation enables what is a

technically complicated information sharing

process to appear and work in a highly

intuitive format for the users.

One of the most critical components that

most users never see is the administrative

feature of the program. Clarity believes its

absolutely essential that the program be

designed for their clients to easily manageand update. Through the administration

features of the EConsultation application,

authorized ORBIS staff can set up new

partner locations, add partner Ophthal-

mologists and link partner Ophthal-

mologists with Telementor teams. The

global reporting also allows ORBIS staff

to view all cases managed through the

system and accurately report the number

of people benefiting from this program.

Every facet of Claritys approach to program

development and design is based upon the

clear understanding of how important it is

that the users experience be as effortless

and as rewarding as possible. The ORBISTelemedicine website is a great example

of using a truly innovative approach to

sharing knowledge to facilitate the healing

process on a global level, to areas that might

not otherwise have access to this level of

excellence in resources and information.

A New Perspective

As more organizations realize the almost

unlimited potential that ELearning and E

Consultation applications present, they are

also recognizing the very distinct difference

between the success that a well designed

program offers versus the significant drainon their personnel, financial and operational

systems that an inefficient, awkward

program can cause. Clarity designed the

ORBIS Telemedicine website to ensure that

both form (ease of use) and fun ction (results

obtained) work together flawlessly.

From the p artnering doctors perspective, the

ORBIS Telemedicine process involves initially

registering and receiving authentication

from ORBIS to access the EConsultation

site. Once a doctor has been verified, The E

Consultation program enables the partner

ophthalmologist to login to the system,

create new cases and view their own

existing cases. When a new case is created,the partner Ophthalmologist specifies the

response priority of the case, the medical

specialty the case requires, downloads

diagnostic information and uploads

pictures with the case file to be reviewed

by the Telementor (ORBIS doctor). The

EConsultation application is designed to

automatically notify Telementors possessing

the appropriate specialties, when new cases

arrive and allows the Telementors to login

and send recommendations back to the

partner Ophthalmologists. Partner doctorscan also review relevant active and/or

completed cases they have been authorized

to examine.

Once logged in, the ORBIS Telementor

doctors see all active cases they have been

assigned. Telementors then have the choice

to examine new cases or view active cases

they have already begun work on. Working

with the specially tailored screen templates

Clarity designed to meet the exacting case

information needs to facilitate an accurate

diagnosis and information sharing process

between themselves and the partner

doctors, the Telementors can analyze and

begin to work with the partner doctorsto help find the best treatment for their

patients. Telementors can also search and

review all completed cases for reference and

research purposes to assist in their ongoing

diagnostic efforts.

Photo by Patrick Saine

Photo by Paul Lowe

How tCall


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Photos by ORBIS International


Clarity is extremely

proud of our work with

Orbis to make the web a

key tool in the elimination

of avoidable blindness and

restoration of sight in the

developing world.~ Rob Sykes, Clarity

The development of this

ELearning and EConsu

process represents what th

cycle of overseas volunteer

can really accomplish. Thi

creates an extended prese

within the global medicalcommunity, enabling the t

and mentoring process to

from what used to be a we

visit, to an ongoing profes

relationship that can ben

patients for a lifetime.

~ Dr. Eugene Helveston, M.D.,

OphthalmologistinChief

of ORBIS International

In 2004, Dr. Eugene M. Helveston of ORBIS

International and Mr. Robert G. Sykes

of Clarity.ca Inc. were honored with the

prestigious Most Innovative Project Award

for 2003, from the Canadian Development

Economic Agency. This Award recognized theamazing results that the ORBIS Telemedicine

program had achieved in less than 12 months

of operation, successfully linking 40 leading

Canadian and American Ophthalmologists

with 100 Ophthalmologists in 21 developing

countries to mentor and consult on over

600 cases.

By March 28, 2007, CyberSight received

their 3,000 consultation request from

Krakow, Poland. A total of 541 partners

across the globe have enrolled in the program

for consultation on difficult patients with the

team of experts at ORBIS CyberSight.

To date, the ORBIS Telemedicine programhas established 17 partner programs in 15

countries. While the initial emphasis was

on pediatric ophthalmology and strabismus,

mentor teams are now being established

and partners selected for consultation in

all of the subspecialties of ophthalmology.

So far, patients with glaucoma, cataract,

retinal disease, uveitis and brain tumors

have already received evaluations employing

EConsultation. Additional benefits this

program development has garnered include

the fact that this platform has since beenadopted by one of the world leading

childrens hospitals, St Judes Childrens

Hospital in Memphis.

Claritys partnership with ORBIS has once

again proven not only the compatibility with,

but the very real need that the design and

implementation of an effective ELearning

and EConsultation program fulfills in todays

medical and caregiving community, whose

limited internal resources are being asked to

meet the needs of an increasing population

spread out across evergrowing geographical

areas. This challenge is, of course, not merely

limited to the medical community, but one

that many corporations and organizationsare faced with in a wide variety of industries

and business environments. Thankfully, its a

challenge that Clarity knows how to meet.

Just as our world grows and changes on a daily basis, so do the

methods we are finding for technology to help better connect

us with each other to improve our lives in meaningful and

positive ways. Working together, Clarity found a way to maximize

technology to bring Dr. Helvestons original vision of extending

the presence of their Volunteer Faculty to partners on a global

scale, into a working reality that has had significant impact and

value on the lives of many people.

As the needs of todays world changes, so too, do the needs ofthe original ELearning and EConsultation program. Clarity

designed this system with the flexibility and capacity to grow and

change with ORBIS Internationals partners as their requirements

evolved. New system design refinements include expanding the

internal consultation parameters so Telementors can request direct

feedback from authorized colleagues on specific cases, as well as

initial exploration into the provision of providing some mentoring

services in Spanish and traditional Chinese languages.

Whether its providing expert consulting, application development,

application integration, creative design, employee training and/

or intranet development services our impressive team of

experienced multidisciplined professionals enables us to ensure

that our clients are presented with only the most effective and cost

efficient solutions available to support and achieve their unique

organizational and customer service goals.

To explore what innovative solutions Clarity can provide your

organization with or to request more information, please call:

(403) 7055900 or select Clarity. To learn more about the ORBIS

Telemedicine program, please selectTelemedicine.

Conclusion

A New Perspective (continued)

HowCall

Photo by Kiran Ridley
http://www.clarity.ca/content/bins/page.aspx?cid=535http://telemedicine.orbis.org/bins/home.asphttp://telemedicine.orbis.org/bins/home.asphttp://www.clarity.ca/content/bins/page.aspx?cid=535

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