Defining functional requirements for a patient-centric computerized glaucoma treatment and care ecosystem

Abstract

Background: Glaucoma is a group of chronic diseases that cause progressive damage to the optic nerve, resulting in irreversible and potentially debilitating visual loss. A unified, comprehensive and quantitative decision-making methodology is necessary to support clinicians and patients when conducting effective computer-aided glaucoma clinical diagnosis, monitoring, treatment and quality of life (QoL) assessment. Methods: We set out the functional requirements for a patient-centric computerized glaucoma treatment and care ecosystem with a 5-to 20-year time horizon. We evaluate three approaches used for glaucoma diagnosis, treatment and establishment of QoL targets: firstly, the Biomedical Model based on biophysical testing; secondly, conventional QoL assessment approach based on various patient-reported outcome (PRO) questionnaires; and thirdly, Outcomes models to evaluate healthcare based on analysis of Quality Adjusted Life Years (QALYs). Results: We identify many critical issues related to handling and analysis of glaucoma patient health data (technical, regulatory, security and privacy), as well as those related to the assessment of biological, psychological, and socioeconomic wellbeing, risk management, the ability to live independently, with adaptation to different cultures, languages and local healthcare delivery patterns. We address health planners, glaucoma research bodies and healthtech investors. We propose a blueprint for computerized actions required to improve treatment outcomes and to reduce costs while simultaneously providing individualized support to millions of glaucoma patients globally. Conclusions: Such patient-centric methodology must be based on interdisciplinary integration and mutual assistance from these three complementary approaches, as well as on their ongoing simultaneous improvements. To implement an effective healthcare decision support platform globally, all these challenges must be resolved. All this can be achieved in a consistent, cost-effective, high-quality manner.