Introduction
Improvements in local and national level ophthalmic practice requires high-quality real-world evidence (RWE) to understand the gaps in care. RWE supports the successful adoption of new guidance or quality improvement standards. Medisoft are the largest provider of data and support to The Royal College of Ophthalmologists (RCOphth) for completion of the National Ophthalmology Database (NOD) Audit. The NOD Audit is an annual RWE study investigating the outcomes of Cataract Surgery and Age-related Macular Degeneration (AMD) services for the UK, covering two of the most prevalent and impactful conditions affecting vision in the UK.
The Challenge
Patient safety remains a key priority for the National Health Service (NHS), particularly in the context of ophthalmic diseases. This includes both maximising positive patient outcomes and minimising risks for patients who are treated for or at risk of developing eye conditions. Therefore, the RCOphth need RWE to guide decisions that ensure continued improvements, specifically in two major treatment areas:
- Cataract surgery: the most common ophthalmic procedure performed worldwide.
- AMD: UK cases are steadily rising due to an aging population
mediSIGHT provides seamless data collection that can be utilised for rigorous analysis of clinical practice. The alternative – manual data extraction – would be time-consuming, error-prone, and discourage broad participation.
Further to high-quality data, the RCOphth require robust, timely, and reliable management of extracted data that can be used for annual analysis, and review of these key treatment areas within tight deadlines.
Medisoft’s Role
Medisoft Data Services was selected to provide a full-service data solution, ensuring the audit meets all scientific and operational milestones. Our contributions included:
- Data Extraction: Leveraging Medisoft’s established ophthalmic EMR infrastructure, we extracted and managed high-quality real-world data from multiple UK NHS Sites after clinical lead and Caldicott guardian approval.
- Data Management: Collaborating with the RCOphth, including key clinical stakeholders, we cleaned and structured the data to allow comprehensive analysis that provides evidence for improved clinical understanding.
- Stakeholder Collaboration: Engaging with the RCOphth and statisticians, we ensure seamless communication, alignment, and timely delivery of yearly audits.
Critically, the existence and success of the NOD Audit itself have been made possible by Medisoft’s foundational EMR infrastructure. The consistent, structured clinical data collected in Medisoft’s EMRs forms the backbone of the audit, ensuring data integrity and comparability across multiple NHS sites. Without this comprehensive and standardized data architecture, the national scale and clinical insight of the NOD Audit would not have been achievable.
Impact and Results
The audits provide critical real-world evidence on; the prevalence of complications in cataract surgery, visual outcomes following cataract surgery, clinical outcomes on AMD treatment, and key processes involved in AMD treatment. This evidence is essential for commissioners, hospitals, clinicians and patients to use as a baseline for comparison, allowing evaluation and improvement of patient care at local and national levels. Results of the audit include:
- Improved Patient Outcomes: Enhanced data visibility has allowed clinicians to identify variations in care, adopt best practices, and improve surgical and therapeutic outcomes across cataract and AMD treatments.
- National Clinical Insight: Medisoft-enabled submissions contributed to the most comprehensive data sets ever captured for cataract surgery and AMD treatment in the UK, supporting national benchmarking and service improvement.
- Clinical Engagement: Streamlined workflows led to higher audit participation, reducing administrative burden while empowering clinicians to take ownership of their data and outcomes.
- System-wide Benefits: Health systems now benefit from a clearer understanding of treatment patterns and patient response, supporting evidence-based decision-making.
Conclusion
Medisoft’s partnership with the RCOphth demonstrates the transformative potential of integrated EMR and audit infrastructure. By simplifying and providing structured data capture, and audit submission, Medisoft has helped elevate the standard of cataract and AMD care across the UK. The result is not just better data, but better outcomes for patients and a deeper understanding for clinicians and the broader medical sciences community.
This collaboration exemplifies how strategic use of real-world data can lead to measurable clinical impact, making Medisoft an essential contributor to the future of ophthalmology care.