Joining the dots: Correlating ocular diagnostic lab and clinical findings through electronic medical records

Introduction Medical records have a history of 4000 years of evolution. Some of the first medical records date back as old as Hippocrates in the fifth century bc and medieval physicians.[1,2] The modern medical records were developed in the twentieth century—data about each patient, including clinical data and laboratory findings, were recorded, organized in a standardized format, and stored.[2] Earlier, the data were only stored in these systems—preferable for safekeeping, and not many people had access to such data. The data were retrieved only in urgent situations or never at all. Slowly, as time evolved, many robust electronic medical record (EMR) systems were developed. The first modern EMR was developed in 1972 by the Regenstreif Institute in the United States and was then welcomed as a major advancement in medical practice.[3] The L.V. Prasad Eye Institute launched their eyeSmart™ EMR systems in August 2010, which is also being used in our center, and has revolutionized the whole data recording and interpretation systems.[4] For the microbiology team, EMR has a different, whole new horizon. Starting from the minor history correlations with smear findings to studying the entire chronology of disease progression in chronic patients and comparing their previous and current microbiology reports. The samples are sent from the clinical department with patient details and EMR numbers, through which the entire history and clinical data of the patient can be retrieved, and the diagnostic team knows what to look for in the slides. As evident from Figure 1, on the EMR system, we can see the patient’s demographics along with the outpatient department follow-ups. Supporting the clinical suspicion, the images (illustrated in Figure 2) and well-documented history and findings aid the microbiologist to go in-depth into the case and aid as a detective to find the root causative organism for the entity, not merely just playing with the slides. This helps the team to actually keep in mind an array of differentials before jumping into the ocean of diagnostics without a clue where to swim, which was previously a common routine. Earlier, the slides that were sent were seen only as a gram’s/potassium hydroxide mount or cultures that were incubated to show some surprise. However, now, due to the rise of information exchange in the form of the new EMR systems, the diagnostic team is also well-equipped and knows what to look for after getting a proper review through the medical reports and records available on the systems. The smear findings, rare organisms identified, and other vital records can be maintained for longer periods of time. We can clearly see in Figure 3 how a separate microbiology bar appears on the EMR, and each report can be accessed anytime. This also increases the publication potential of an institute and contributes to the medical literature worldwide. The microbiology photos are well preserved and can be reproduced through the system [Figure 4].Figure 1: Demographic details and outpatient department follow-ups of patients appear on the electronic medical records systemFigure 2: Clinical photograph of the patient available on the electronic medical record systemFigure 3: Microbiology panel as available on the electronic medical records systemFigure 4: Microbiology slide photo of the patientColor-based Ocular Lab Diagnostics provide an additional dimension to ocular pathology, microbiology, and their clinical interpretation. Analysis of subtle variations in tissue hue from digital images and histopathology, microbiology slides can reveal early or nuanced disease changes. Integrating these color-coded findings with clinical data in electronic medical records enables precise correlation, supports accurate diagnosis, and informs individualized patient management strategies. As far as clinicians are concerned, apart from safekeeping of the records of their patients, they can access the microbiology reports through the EMR. The sequential history and laboratory reports can be accessed. The drug sensitivity can point toward what actually has the targeting action rather than prescribing a blanket treatment. In case of confusion, old data and rare case scenarios can be retrieved if some similarity can be thought of. In addition, evidence-based medicine safeguards the doctor against many legal obligations [sample report, Figure 5].Figure 5: Sample microbiology report available on the electronic medical record systemAs for the patients, the treatment now depends on a multi-disciplinary, coordinated approach providing a more accurate diagnosis and a targeted therapy. Conclusion The EMR systems have not just a single or dual but honestly a triple benefit. Not only the microbiology team but also clinicians get to see the trail of reports the team has sent to them and can provide evidence-based therapy to patients. The patients, who were earlier treated based on the microbiology results, now get definitive early treatment, which aids in better prognosis. Data availability statement De-identified data may be requested with reasonable justification from the authors (email to the corresponding author) and shall be shared after approval as per the authors’ institution’s policy. Authors contributions MG was involved in literature search, conduct of case, data acquisition, data analyses, manuscript preparation; AG was involved in concepts, design, defining the intellectual content, review and approval. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.