EHR system for an optometry startup

To support the delivery of on-site eye care services to both individual patients and care homes, an optometry startup sought to implement a flexible and customizable EHR solution. Itransition delivered a custom EHR platform tailored for mobile optometry workflows, enabling efficient on-site patient examinations and supporting the company's future business growth and scalability.

4 months

for the first release

Scalable foundation

for new services and care homes

Consolidated

clinical and operational workflows

4 care homes

onboarded shortly after solution launch

EHR system for an optometry startup

All technologies used

ASP.NET React Microsoft Azure

Itransition Healthcare Platform

About the customer

The customer is a UK-based healthtech startup, specializing in optometry services. The company provides mobile eye care, including vision testing and eye screening services, to care homes and homebound patients.

Company type

Startup

Domain

Healthcare, Optometry

Geography

UK

Company size

SMB

The challenge

The company was aiming to improve early detection of eye conditions and strengthen clinical decision-making. To support its service delivery, the startup initially adopted an out-of-the-box practice management system, but it did not fully align with the organization’s operating model, which uncovered several constraints:

  • Lack of support for group appointment scheduling and delegated patient management
    The startup focused on working with care homes, which revealed the need to provide care homes staff with capabilities to coordinate care on behalf of care home residents. This included scheduling group sessions for multiple patients with varying examination needs and completing consent documentation. However, the existing solution did not support this functionality, necessitating the use of additional tools
  • Workflow fragmentation
    The existing system limitations required switching between multiple tools, reducing efficiency during patient visits

Having evaluated the available market solutions, the customer failed to find a product that met their flexibility and customization requirements. As a result, they launched a project with the aim of designing an all-in-one custom EHR platform.

The solution

At a glance

Itransition analyzed the customer’s pain points and existing processes, designed the architecture of the future solution, and implemented a custom EHR platform, tailored to the specific needs of optometrists, care home staff, and individual patients.

Architecture vision

After analyzing the customer’s challenges and workflows, Itransition’s team developed a vision for the future solution architecture:

  • Cloud-based web application with multi-tenant modular architecture, supporting access for the customer’s staff (optometrists and coordinators), care homes, and individual patients
  • Responsive design optimised for tablets, mobile screens, and web browsers, allowing care home staff and optometrists to use the platform on the go

To accelerate time-to-market and reduce development costs, we proposed leveraging Itransition’s proprietary telehealth and care management platform. It provides comprehensive care management capabilities while being fully customizable to the customer’s specific needs.

Platform overview

Itransition delivered a custom ASP.NET- and React-based EHR solution based on Itransition Health Platform and tailored for mobile optometry services. The solution is deployed in Microsoft Azure, which ensures a secure and compliant cloud environment aligned with GDPR requirements. The platform supports on-site examinations, covering patient management, individual and group appointment scheduling, encounter documentation, and analytics, while ensuring GDPR compliance. Using the system, optometrists can conduct tests and record data during visits with all relevant information accessible in a single interface. The solution integrates with several external services, including Twilio for SMS notifications, SendGrid for email notifications, and MRF (Melbourne Rapid Fields) API for automated retrieval and storage of visual field test results.

The platform is built on a multi-tenant architecture, so that each care home can access only its own resident data. This approach enhanced both data security and privacy, enabling each care home to independently manage patient records and view tailored reports within their dedicated environment, with no visibility into other organizations’ data.

The solution supports multiple diagnostic data inputs:

  • Eye pressure measurement data input from various diagnostic devices
  • Imaging upload from fundus cameras
  • In-platform management and automatic import of visual field test results through integration with MRF (Melbourne Rapid Fields) API

Solution components

The solution comprises three main portals, each designed for a specific user group:

  • Internal optometrist portal designed for optometrists and coordinators
  • Care home portal used by the care home staff to manage residents and coordinate care
  • Patient portal designed for individual patients, providing access to their appointments, requests, and health information
Optometrist portal

The optometrist portal supports clinical and operational workflows for optometrists and coordinators:

  • Patient record management, including demographic and medical data
  • Management of individual and group appointments
  • Encounter management, i.e. real-time clinical documentation during patient visits through structured recording of all relevant data. This includes patient history and clinical context; historical data visualization; diagnostic data from medical devices and integrated tests; clinical examination and assessment including actions taken during the appointment; a structured summary, covering consultation outcomes, follow-up recommendations, prescription details, and recall date; document and attachment uploads (e.g. MRF reports, device outputs, and fundus images)
  • Reporting and analytics, including patient chart view (a consolidated record including dashboard overview, demographics, encounter history, consent forms, and uploaded documents) and system-wide reporting with encounter data across all patients (care homes and individuals)
  • Chat functionality for interaction with patients and coordinators
Care home portal

The care home portal enables care home staff to act on behalf of residents and manage all related interactions with optometrists and coordinators. The portal’s key capabilities include:

  • Resident records management within the care home
  • Group appointment scheduling. For each patient, specific appointment types and durations can be defined, with support for flexible request modification (e.g. adjusting the number of patients) and cancellation, as well as waitlist requests based on preferred dates and times
  • Reporting on resident appointment history and health status, offering a clear overview of all encounters with key details such as appointment dates, summaries of findings, recall dates, and clinician notes. Reports can be filtered to identify upcoming, missed, or overdue appointments
  • Consent form signing on behalf of care home residents, including consent for treatment and data processing
  • Communication with clinicians and coordinators via the system chat
Patient portal

The patient portal provides individual patients with a comprehensive view of their health records and interactions. Within their profiles, patients can access a centralized dashboard with upcoming appointments, visit history, and assigned clinicians, as well as manage both new and existing appointment requests.

Key portal features include:

  • Profile management, including demographic info
  • Appointment scheduling and tracking, including a waitlist option and flexible request handling, with the ability to cancel or edit pending requests
  • Encounter summaries and recommendations, including appointment date, visit details, consultation summary, given prescription, clinician information, final recommendations, and the next recommended test date
  • Messaging with optometrists and coordinators
  • Digital consent form completion
Additional features & regulatory compliance
  • Shortcuts & templates
    As speed was essential for high-volume patient appointments at care homes, we introduced shortcut functionality to support and accelerate patient examinations, allowing clinicians to swiftly navigate the system via hotkeys. The system also features a template-based data entry to further enhance appointment efficiency. Administrators can configure predefined responses for encounter fields, enabling clinicians to complete documentation quickly and consistently during appointments.
  • Notifications
    The system includes configurable email notifications, ensuring clinicians are informed of scheduled appointments, and patients receive automated reminders in advance.
  • GDPR compliance
    The solution aligns with GDPR data handling practices and includes a full audit trail, providing visibility into user activity and data changes, to ensure traceability and accountability.

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The outcome

Itransition delivered an EHR system, enabling efficient on-site eye care services and fully aligning with the customer’s service model. Itransition continues to be a strategic technology partner for the customer, growing the platform by implementing new features and capabilities.

01

4 months for the first release

02

Enabling a care home-centric B2B service model by supporting group appointment requests and delegated patient management

03

Consolidating scheduling, diagnostics, and encounter documentation into a single platform

04

Supporting future business growth through the modular, cloud-based platform architecture

05

4 care homes onboarded 3 months after solution release

06

£50.000 development cost savings

07

50% accelerated time-to-market due to utilizing Itransition Healthcare Platform
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