Functionality and Usability: A Narrative Review Evaluating Teleglaucoma System in Malaysia

Introduction: Teleophthalmology has become much more popular after the Coronavirus Disease 2019 (COVID-19) pandemic because it can be implemented at a distance without contact with the patients. However, teleophthalmology for glaucoma has not been implemented in Malaysia. The present study project adapted an in-house Electronic Medical Record (EMR) system for teleophthalmology in glaucoma (teleglaucoma). Aim: To evaluate the functionality of a teleglaucoma system in Malaysia. Materials and Methods: The present cross-sectional research was conducted in July 2023, which involved eye healthcare professionals working at a primary health clinic and an eye clinic affiliated with a tertiary university hospital in Malaysia. The participants were recruited using a purposive sampling method. A google form questionnaire, consisting of three sections -demographic information, evaluation of functionality (yes/no), and an open-ended question for system improvement were given to participants after they had completed using the teleglaucoma system. Descriptive analysis was used to analyse the data. Results: Ten eye healthcare professionals were recruited for the study. The findings of the study revealed that most eye healthcare professionals were able to use the functions in the system. Most ophthalmic personnel (71.4%, n=5) could use 90% of the system functions, while the rest (28.6%, n=2) could use 80% of the functions. All ophthalmologists were able to use the function in the system. Some participants suggested several system enhancements, including the ability to upload multiple images, an improved interface with a standardised template for patient history, and a side-by-side image display. They also suggested an ‘edit’ button to modify clinical sheets after they have been submitted. Conclusion: The adapted EMR-based teleglaucoma system was found to be functional by eye healthcare professionals. The EMR enables ophthalmologists to review patient information, diagnose, and manage glaucoma remotely. Therefore, this system can be used for glaucoma screening in healthcare clinics that are virtually connected to a hospital with ophthalmology services. Future studies comparing the teleglaucoma system with opportunistic case finding should be conducted to determine the effectiveness of the system.