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Golts Central Municipal Hospital in Fryazino: Equipment Modernization at the Ophthalmology Department

The hospital in Fryazino dates back to 1944 when the former kindergarten was transformed into a 10-bed in-patient facility for treating infectious diseases. In the post-war years, Fryazino developed into a center of the radioelectronics industry; in 1951, the settlement became a town. The population grew quickly to almost 60,000 people in 2015. The Fryazino Municipal Hospital also grew together with the town.

Today, it is a multidisciplinary healthcare facility offering medical services to those who live in the Fryazino municipal district and Grebnevo rural settlement. In addition, up to 15% of patients who receive medical care in the hospital on a day-to-day basis are residents of Shchyolkovsky District, Moscow Region, Moscow, and other Russian towns and cities.

The Ophthalmology Department provides medical assistance to almost 40 patients every day: 25 of them are day patients and 15 patients receive twenty-four-hour treatment. In addition to non-surgical treatment of various forms of retina, optic nerve, vascular tract, and corneal pathologies, the department performs surgery on common conditions such as glaucoma and cataracts, including intraocular lens (IOL) implantation. The department also offers surgical treatment for adnexal diseases and eye injuries. Surgical operations are carried out twice a week, not counting emergencies.

In 2014, a comprehensive equipment modernization project was carried out in the ophthalmology unit of the Traumatology Department at the Golts Central Municipal Hospital. Olga Minakova, Chief Visiting Ophthalmologist, talks about the introduction of advanced eye care technology at the hospital.

What were the goals of the modernization project?

 — A decision to modernize the ophthalmology unit was taken in 2014. Our goal was to bring eye care up to an advanced competitive level. The ultimate goal was to improve the quality of services offered to the town’s population. All our patients should have access to the full range of high-tech eye care services at our hospital, from diagnostics to treatment and rehabilitation.
Our top priority was to improve the quality of diagnostics. If the diagnosis is right, the treatment will also be right.
Also, we found it important to expand the range of services directly related to treatment, e.g. to have more cataract surgery capabilities.
Our department did not have all the necessary equipment, so patients had to go for an examination and sometimes pay to get treatment at other medical centers. More often than not, we did not receive the results and could not see the bigger picture. For example, last year almost 200 patients were sent to the Cross-Sectoral Research and Technology Center «Eye Microsurgery» for phacoemulsification; about 200 patients, to the Vladimirsky Moscow Regional Research and Clinical Institute. These are the patents we lost over one year, not to mention those who applied to other hospitals, usually on a paid basis.

How did you select the vendor for the equipment and services?

 — At the first stage of the procurement process we reviewed the offers and came up with certain requirements concerning equipment quality, maintenance services, package integration capabilities, and ongoing modernization. We had a high regard for the excellent reputation of Carl Zeiss Meditec on the ophthalmology market and OPTEC offered a solution for integrating ZEISS equipment into a single package. We liked the fact that we can enjoy constant access to information, gain knowledge, and benefit from the flexibility provided by the ZEISS FORUM eye care data management system. The solution offered by OPTEC experts can be upgraded and expanded in the future. For instance, the offer included a modern and reliable surgical microscope, which was another factor that prompted us to accept the offer, because a microscope is indispensable in our everyday practice. This is why we went for OPTEC’s offer and ZEISS equipment.

How did you implement the solution?

 — During the development and implementation of the solution we received professional advice from OPTEC experts who helped us select the best equipment configuration, deploy the FORUM eye care system, and integrate all hardware components into a single information network. It should be noted that service engineers have always helped and continue to help us with all the issues we face, and they do so quickly and efficiently. Let me give you an example: once I called a service engineer who was in Germany at the time and could not talk to me. But he called me back in 5 minutes and helped me resolve the situation. A human approach and contact with real people are always of great importance and help in these situations.

After the equipment was installed and the solution customized, we were trained to use the equipment. As for cataract surgery, we are currently using the services of a visiting surgeon who operates our equipment. However, we plan to complete phacoemulsification training in the very near future and soon we will start performing cataract treatment operations using IOL implantation on our own.

Please tell us about the equipment you are now using.

 — Today, the Ophthalmology Department has the most advanced ZEISS equipment for precise diagnostics.

We have a fully equipped ophthalmologist workplace, including the SL 120 slit lamp and an autokeratorefractometer. We also have a HFA 745i visual field analyzer, a VISUCAM 500 fundus camera, and a Cirrus OCT 5000 optical coherence tomography solution, which facilitates laser tomography for the retina and the optic nerve, which is very important for diagnostics. The IOL MASTER 500 optical coherence biometer calculates IOL power for cataract phacoemulsifications. All equipment is integrated into a single information system using ZEISS FORUM software.

The department’s operating room now has a ZEISS OPMI LUMERA 700 surgical microscope, which allowed us to start using a new method of subtenon injections. We couldn’t do this earlier because we didn’t have the necessary equipment.

Could you please tell us more about this method?

 — The method is based on injecting a drug which concentrates right near the posterior pole of the eyeball. This is why the drug is better targeted at the optic nerve and the retina. It is not absorbed into the blood flow or stream and is thus delivered directly to the affected area. We had been planning to introduce this method for some time and now, thanks to the new high-quality microscope, we are using it extensively.

An additional advantage of using the microscope is that it is now easy to follow the surgical procedure: it is displayed on a monitor and can be recorded. Anesthesiologists also appreciated the new product because they can see everything that is going on. Nurses are also more involved in the process; they keep a close eye on the surgical procedure and perform their tasks more accurately.

Could you please tell us about the FORUM system?

 — The FORUM workplace connects the perimeter, the fundus camera, and the coherent tomography scanner into a singe system. Data from all devices are stored electronically and we can see the big picture, which makes it easier for us to diagnose, for example, initial glaucoma. At a later stage, we can follow up on everything that happens in a patient’s eye: FORUM keeps track of all patient visits and provides access to examination data for comparison purposes, which makes our job so much easier.

In addition, FORUM integrates with both diagnostic and operating room equipment. The surgeon now has immediate access to diagnostic patient data from the equipment in electronic format.

What do you think about the results of implementing this solution?

All processes at the Ophthalmology Department are now better organized.
Accurate diagnostics is key to effective treatment. This was the first advantage delivered to us by the new equipment and the FORUM system. Flexibility and remote access are also critical for us. Now even if a colleague is far away, we can always log into the system on a tablet and discuss the case. We always know what’s going on with the patients.
Many of our colleagues, even those who work in Moscow clinics, are surprised by the capabilities we have in our department. We can save all the data we need in electronic format. This is very convenient if we need to get a second opinion: we download the data from the system on a data storage medium and doctors from other clinics can see the full picture. This is a totally different standard of performance.
It’s important to emphasize that we have many elderly patients to whom we provide treatment under the compulsory health insurance scheme. High-tech treatment becomes more accessible to all patients who could previously not afford it.
Now we can perform surgical operations such as phacoemulsification. We didn’t have this opportunity before and now we are delighted that we can operate on our patients right here in Fryazino.

What are your plans for further development?

 — We face new challenges in our work every day. The equipment the hospital received thanks to our sponsor, IRE-Polyus Research and Technology Association, and its CEO Valentin Gapontsev, DSc, State Prize Laureate, opens up a whole new world for patients and doctors. We are going to master new diagnostics and treatment techniques and exploit each and every opportunity to keep up with the times in our practice.

There is more enthusiasm about what we do and a desire to do it, because we have escaped the routine and can now spend all our time on more challenging tasks.

Olga Minakova, Chief Visiting Ophthalmologist, Golts Central Municipal Hospital, Fryazino