You spend years studying pharmacological treatments, surgical procedures and technology used in eye surgery, but their knowledge and terminology doesn’t always translate well when communicating with your patients. Having educational ophthalmic resources can help inform patients about their options before undergoing a procedure. Fortunately, ophthalmologists don’t have to create their own unique patient education program. There are many companies and organizations that offer credible resources to educate patients. Here’s a list of some educational programs that can help physicians prepare their patients for surgery.
AAO Products and EyeSmart
For decades, the American Academy of Ophthalmology has been offering a product line of print materials and videos to assist ophthalmologists with patient education. The AAO shop features booklets, brochures, videos and online animations in both English and Spanish to ease the educational process for a larger patient demographic. Alternatively, the AAO created an entire website called EyeSmart dedicated to patient information that features articles, videos and an ophthalmic dictionary for patients.
“Our role is to make sure the Academy interfaces with the public in ways that keep them reasonably informed about ophthalmologic problems, conditions and treatments,” says J. Kevin McKinney, MD, ophthalmologist and chair of AAO’s Patient Education Committee. He’s been using the AAO’s educational materials for 25 years and currently works with a team of volunteer ophthalmologists to continue to generate and maintain credible content for both EyeSmart and the patient education product line.
EyeSmart includes free online resources that AAO encourages ophthalmologists to use. It offers a guide on how to embed educational videos and links from EyeSmart onto a physician’s website. They also provide details explaining search engine optimization (SEO), how to make an accessible medical website, and the various approaches to promoting content online. “A large portion of our patient population, especially younger patients, are using social media. So, an ophthalmologist putting their materials online or in social media increases their visibility. It reaches the population with relevant material more effectively, and it allows for the possibility of the information going viral,” says Dr. McKinney.
Kierstan Boyd, director of patient education at the AAO, explains the difference between the content featured in the product line and on EyeSmart, “The website content is designed for the person who is doing their research either prior to or after an office visit, and the products are meant to be given to the patient when they’ve been given a diagnosis, or if they know they’re going to need a certain treatment.
“With regard to accessibility of our content, there are a couple of things that we address. We write our content to be compliant with health literacy standards,” says Ms. Boyd. Health literacy standards are set by the Plain Language Action and Information Network through the Federal Plain Language Guidelines. These guidelines were built on the Plain Act of 2010, which established clearly written government documents to enhance citizen access to information and services.
Dr. McKinney explains further, “The reading literacy rate in the U.S. is rather low and simple printed materials don’t get to every patient. We use a health literacy process to make sure our materials are written at an eighth-grade level, given that the average health literacy level in the U.S. is at that level. There are still some people who aren’t going to grasp what they need to, even from our written materials. So, if you can supplement with video or audio, that really helps the retention rate.”
Video-based media has been proven to be an effective educational tool in ophthalmology, and it can help boost patient satisfaction.1 Rendia offers three subscription packages that allow the user to access a library of videos and graphics for their website, waiting room and/or exam room. For physicians who want all three packages or a custom package, Rendia provides consultations and quotes.
“We use Rendia in several different ways. When somebody schedules a cataract visit, we get their email and send them a playlist of videos about cataract surgery and the different lenses,” says Edward Meier, MD, ophthalmologist at the Cincinnati Eye Institute. “When someone comes in for their cataract evaluation, we have an educator who patients meet with first. They show patients the same playlist of videos describing cataract surgery. We find reinforcement is key to truly educating patients on their choices. Our educator will also use the Outcome Simulator to give patients a view of what their vision might look like with the different lens options.”
According to Dr. Meier, the Cincinnati Eye Institute uses all three Rendia packages. Although the institute’s IT manager handles the waiting room and website graphics, Dr. Meier is familiar with Rendia’s exam room capabilities. “I use Exam Mode when I’m trying to explain something where the patient really needs to understand the eye’s anatomy,” he says. “Narrow-angle glaucoma is a very common condition that I would use Rendia to explain. It shows what the condition is, how it can cause a narrow angle glaucoma attack, and how a peripheral iridotomy helps to treat the condition.”
Dr. Meier says he appreciates Rendia’s organization of content and ease-of-use. “When you’re using it in Exam Mode, it’s broken up into anatomic features, disease processes, and treatments,” he explains. “If a patient asked what a cataract is, you could look under diseases, click on ‘Cataracts’ and it immediately shows the lens of the eye going from clear to yellow-cloudy. If they say, ‘What is cataract surgery?’ Then you can hit the button that shows the patient how the old lens is coming out and a new one is going in. It’s very easy to use in Exam Mode.”
All the packages Rendia offers start at $199 a month, while the Full Suite package, which includes website, waiting room and exam room accessibility, is priced at $249 a month. The Website package includes more than 1,000 videos accessible to embed online or post onto social media. Physicians can also send videos to patients, but they can’t communicate directly with patients through Rendia since it isn’t HIPAA-compliant. The Waiting Room package allows the user to customize video playlists for the waiting-room screen. Lastly, the Exam Room package provides the user with the aforementioned Outcome Simulator and Exam Mode, in addition to 3D anatomy visuals. Physicians who own a tablet can use the Exam Room features with a stylus to better write and highlight notes in Rendia.
|Side-by-side comparison of EHB (left) and Eye Patient (right). Physicians can register on each app to communicate with other physicians and notify their patients about upcoming appointments. (Courtesy Cloud Nine Development).|
Eye Handbook/Eye Patient
After the original iPhone was released, Ken Lord, MD, and Vinay Shah, MD, brought together a team of developers – Cloud Nine Development – to design an app for ophthalmologists and optometrists. Eye Handbook (EHB) features eye tests, calculators, ophthalmic codes, media and online forums to assist eye care professionals with basic day-to-day operations. Years after the development team launched EHB, the team decided to create an app for ophthalmic patients.
“We realized that there was a need to develop a comprehensive app that was more patient facing. Not only are apps in front of a patient every day, but there was a clear need to develop something that was more than one little bite,” says Dr. Lord, an ophthalmologist and chief editor for EHB. “I think there’s a lot of apps in the store that target eye patients, but we felt like we were in the best position to build a comprehensive one that met many needs.”
Eye Patient is Cloud Nine’s latest app that’s equipped with features similar to EHB. “So, the goal of Eye Patient is fourfold: vision monitoring; patient education; physician connection; and treatment adherence. Those four tenets are kind of the goals of Eye Patient and what we’re trying to achieve,” says Dr. Lord. “Every few months we come up with another feature that could be useful not only to patients but for doctors to provide to their patients, and if you go through it, you can see there’s a lot of different functionalities.”
The four tenets refer to the key features in the app. Eye Patient offers vision tests to users to ensure vision monitoring, and a library of definitions, articles, videos and images make up the patient education aspect of the app. If a user is struggling to find a physician online, then they can search for one using the Eye Doctor Directory. After visiting with a doctor, the user might receive a prescription or a follow-up appointment. In that case, registered users can store their vision and/or medicine prescription in the app and set appointment reminders.
Physicians around the world can register to join the Eye Doctor Directory through the physician-facing Eye Patient website. Physicians and patients can take advantage of the different simulation tools by trying on new glasses, selecting an IOL or taking a vision test. However, Cloud Nine added a disclaimer to both apps stating that the tests aren’t FDA approved and results shouldn’t substitute a doctor’s diagnosis. Clinical discretion is advised.
“A number of things on the road map: we’re always trying to get a little more user-friendly. I mean, you have a ton of information you’re trying to deliver onto this little, tiny screen,” notes Dr. Lord. “Also, we want to make it so patients who don’t have great vision can navigate and get the same benefit out of the app that people who do have normal vision get. As physician developers we always look for improvements to help the doctor and the patient.”
|“Your Library” can be accessed through the Eye GIFs menu. Here is where physicians can store animations to later present to their patients. Physicans can access this feature online and in the app. (Courtesy Eye GIFs).|
Art enthusiasts who are familiar with the work of medical artist Stephen F. Gordon will appreciate this program. Eye GIFs was created to catalogue animated visual aids for eye-care professionals based off of the conceptual images from Gordon’s Eye Flip Charts. As an online resource, Eye GIFs provides digital content such as storyboards, brochures, narratives and animated GIFs.
According to the app, Eye GIFs’ storyboards are collections of related GIFs that assist with patient consultations. Each animation can be added or removed to a physician’s personal Eye GIFs library, and offices can embed the clips onto their website. Storyboards come with drawing and editing tools to allow the user to annotate and edit content. For patients with hearing issues, closed captions can be toggled on and off as well as edited to meet the patient’s needs.
Storyboards go hand-in-hand with brochures. When presenting a storyboard, physicians can access an associated brochure to read more about a treatment or disease. Brochures can also be edited and embedded onto a website. If a physician needs to communicate the material to a patient, then they have the options to either send an email or text that includes the brochure. Also, Eye GIFs provides downloadable QR codes as another way to present their brochures to patients.
Narratives are meant to be shown to patients in the waiting room. Patients can access associated brochures and storyboards in correspondence to the narrative. This tool is used to explain high-level concepts to patients through a narrator and text captions. Physicians are able to edit the captions and animations shown during the narrative depending on what concepts they determine are necessary to show their patient.
There are three subscription plans to choose from: Solo Doctor; Solo Practice; and Group Practice. The Solo Doctor plan is priced at $9.99 a month, the Solo Practice plan is priced at $19.99 a month, and the Group Plan is priced at $29.99 a month. Each plan includes access to the entire library of animated GIFs, but other features are limited depending on which plan the user chooses. The Solo Doctor plan doesn’t allow the user to embed videos onto their website, nor does it allow them to access brochures. The Solo Practice plan allows up to 10 user accounts to embed videos and access brochures. The Group Practice plan provides a broader range of usability by allowing a single sign-on and unlimited user accounts.
As stated previously in the article, video-based media is an effective educational tool, and ViewMedica has an extensive library of digital media for health-care professionals. Although the program doesn’t focus solely on ophthalmology, they provide several videos on care, management and ophthalmic conditions.
ViewMedica’s On-Demand service features content specifically for a health-care website or the exam room. Physicians can select from a catalogue of medical videos and topics to support their practice, and then they have the option to present those resources in a multitude of ways. One of the ways physicians can use the videos is by downloading them and presenting them on the ViewMedica app. The app and desktop program work similarly in that physicians can access ViewMedica’s library and their downloaded content. By using Markup Mode, physicians can draw, highlight and add text labels to videos online or in the app.
Another service ViewMedica offers is VMcast, a content creation tool for the waiting room. This service allows physicians the opportunity to create their own unique loop of slides for their waiting room. Physicians can add themes, QR codes, social media account information, weather updates and more to create a personalized channel to better inform and educate their patients. If users don’t want to implement videos from the ViewMedica library, then they can download accessible content from the CDC and other health centers to boost their waiting room channel’s watchability. For pediatric ophthalmologists, ViewMedica partnered with Health Nuts Media, a producer of animated health content, to provide engaging pediatric cartoons.
ViewMedica offers both services in various plans. Depending on the plan, ViewMedica will limit the number of videos a user can download for patient education. The cheapest plans for On-Demand and VMcast cost $85 a month and limits the user to 25 videos. If physicians need access to the entire library of ViewMedica videos, then they can opt into the all-inclusive plan that provides them access to over 2,000 videos, which costs $1,665 a month.
There are clinics and offices across the country that have used iHealthSpot Interactive to develop their websites. iHealthSpot is a medical web developer and health-care marketing company that provides patient education materials during the web design process. Instead of using a third-party program to embed content, physicians can work with iHealthSpot to embed content prior to launching their website. Their patient education content covers an extensive field of medical practices, including ophthalmology and optometry. All their content is generated and edited by a medical editorial team at iHealthSpot as well as the Health on the Net Foundation, a non-profit promoting reliable and transparent health information. These patient education materials aren’t standalone products and can’t be accessed without partnering with iHealthSpot for website development or marketing.
“[The best way to educate patients with materials is] by giving it at an appropriate level of understanding, so at a health-literate level,” says Dr. McKinney. “You should use the method of asking the patient to repeat back to you what you’ve said or what they’ve read to confirm that they actually understand. Also, provide that information via more than one method, so provide verbal communication, but also hand them written communication, or give them a link to a video that they can watch online or provide them with access through your website.”
Dr. McKinney is the chair of American Academy of Ophthalmology’s Patient Education Committee. Ms. Boyd is the director of patient education at the American Academy of Ophthalmology. Dr. Lord is the chief editor for Eye Handbook and Eye Patient. Dr. Meier has no financial interests to disclose.
1. Farwana R, Sheriff A, Manzar H, et al. Watch this space: A systematic review of the use of video-based media as a patient education tool in ophthalmology. Eye 2020; 34:1563–1569.