Lecturer: Joscelyn Daguna, Cybersight Senior Program Manager

This Live Demo demonstrates the new Cybersight Patient Case Templates.

Transcript

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>> Hello, everyone. And thank you for joining this Cybersight live demo. My name is Joscelyn Daguna, and I’m the senior program manager of Cybersight, and I’m speaking to you from our Orbis headquarters in New York, where it is 10 a.m. and a warm summer day. If you’ve joined any of our live lectures in the past, you know that we generally keep the chat box closed, but today we’re going to try something a little different and leave it open, so that if you have any questions throughout the demo, we have our Cybersight support guru, Lawrence, and he will answer your questions in realtime. So to familiarize everyone with this new feature, I would like to give everyone a chance to let us know where you’re joining from. So if you can open the chat box and type in the country or city, that would be great. We can all see where everyone is joining from. Natasha from London, Vietnam. This is awesome. San Francisco. Cool. Up very early for this. Thank you. All right. Thank you, everyone, for joining from across all of these different time zones. So as I mentioned, you can use this to ask any of the questions that you may have, that come up throughout the demo. And you can also use the Q and A box, which you’re already familiar with, hopefully. And we will answer your questions as they come in. So welcome, everyone. Wow, Nigeria, China. Welcome. So for those of you who haven’t attended a live lecture before, I’m going to share my screen now, so you can see where to register for that. This is our Cybersight website. You can visit it by going to http://Cybersight.org. And if you go to the live lectures page, you can see the upcoming lectures, register for them, see what they’re about, and at the bottom of our website, on any of the pages, you can sign up for our newsletter, which is a very useful resource. It’s sent out every second Thursday. And the newsletter lets you know about our upcoming events. New courses, new features, it also includes a really fun quiz, and highlights interesting patient cases that we’ve seen. So before we dive into the demo, I would like to start off with a few poll questions so we can get a sense of who is in the room. So our first question is — oh, actually, no, it’s not. The first question is have you attended a Cybersight live lecture before. Yes or no. Simple question. Go ahead and give you a moment to answer that. All right. 93% say yes! That’s incredible. So you already know where the registration pages are. That’s great. 7% no. So welcome to our new timers, and welcome again to our veterans. So now the second poll question: what Cybersight service do you find most useful? Online courses, the patient case consultation, or the live lectures? I’ll give you a few seconds to answer that. And see what everyone says. All right. Live lectures. That’s awesome. 69% say that. And then 23% online courses, 8% case consultation. Which is interesting, and also very awesome, because that’s exactly what we’re going to be demoing today. So hopefully everyone can find more benefit from the case consultations, moving forward. The second question is related specifically to patient cases. How many patient cases have you submitted on or to Cybersight in the past? I’ve never submitted a patient case, 1 to 5 cases, 5 to 10, or 10 or more. So this is for that small subset of our audience. And let’s see what they say. 92% say they’ve never submitted a patient case. This is very interesting, and exciting. Because hopefully this is an opportunity to convince you to submit more patient cases, and get more use out of that service. Because it’s very important, and I think very useful. So the next poll question — approximately how often do you see a patient case that you would want to submit and get a second opinion on? Every day, once a week, once a month, or once a year? Just give you a few seconds. All right. Once a month. So not so often. Three people say once a week. All right! So it’s very useful. And then for those of you who we have engaged in the poll questions currently, what would you say is the biggest challenge to submitting a patient case? I don’t know how or where to submit a case, I don’t have the time, my internet connection is too slow, there usually isn’t a computer nearby, or some other reason that isn’t listed there. We’ll give you a few seconds. Okay. I don’t know how or where to submit a case. Well, you’ve come to the right place, because that’s exactly what we’ll be demoing today. I don’t have the time. We hear that a lot, and one of the things that we hear about submitting a patient case is that it takes a long time. And hopefully that’s something we’ve addressed with this new design. There usually isn’t a computer nearby. So for that individual I would like to remind you that all of our Cybersight services have been optimized to work on mobile, and especially over low bandwidth. So that is always an option, and hopefully something that you can use to access Cybersight as well, in the future. And then one other. And if that person doesn’t mind sharing with us in the chat box what that reason is, that would be super helpful. All right. So for those of you who are unfamiliar with Cybersight, it is Orbis International’s telemedicine program. As I just mentioned, it has three main components: live lectures, which it sounds like a lot of you are very familiar with, patient cases, and online learning. These are all free of charge and publicly available, with the exception of our patient consultation service, which is only available to medical professionals. So now that I know a little more about you all, I’d like to move into our Cybersight demo, which shouldn’t take too long. No more than 10 to 15 minutes. And we’ll leave the rest of the time for questions and answers and feedback, which is very important to us. In order to access our online learning and patient consultation platforms, you will need a Cybersight account. If you don’t already have an account, you can join by clicking here. Join us. And if you have an account, you can access your account by clicking sign in, or going to consult.Cybersight.org. This is our log-in page, where you will enter your screen name, if you already have an account. Your password. If you’ve forgotten your password, you can always click here to reset it, and if you have any issues at all signing in or otherwise, you can always email us at support@Cybersight.org for assistance. So now I’m going to sign in. Once you’ve signed in, you will see the home dashboard, where you can see recent community activity over here. You can find public cases to study. You can select multiple subspecialties, you can also search for special diagnoses, and other criteria here. In the search box. And if you haven’t already taken a look at our public cases, I highly recommend it. There are hundreds of patient cases to learn from. You are welcome to read and comment on them, and also rate them. So they’re an excellent resource. And if you are here to submit a case, you can do so by clicking on “new request”, or start a new case. And you’ll see two options here. One is general question, and the other is patient case. So if you’re submitting a question that isn’t related to a specific patient, you will want to select “general question”. And if the question you have is about a particular patient, you’ll want to click on “patient case”, which I will do now. For those of you who have submitted a case before, you’ll remember a very long three-part process, with a complicated form. We received a lot of feedback about the complexity of the form, and how the three-step process was difficult to manage over slower bandwidths. So we’ve taken that feedback and simplified the form and condensed it into one step. And a number of you who are on the line now actually helped us refine the design and simplify it even further. So a special thank you to all of you. So now that we’ve opened the patient case template, you’ll see that you’ll start off by selecting a subspecialty. This selection will ensure that the appropriate mentor is responding to your case, and it will also modify the form slightly to ask for specific information relevant to that subspecialty. So, for example, if you select strabismus, you’ll see that this motility section is here, alignment, torsion, and head posture. And those are specific to the strabismus form. In some cases, clicking on a specific field will open more information, and you can share that information as necessary. Fields that are required have a red asterisk. So these have to have an answer in order to submit the case. If there is no red asterisk, then it’s completely optional to you, but do keep in mind that the more information you share with the mentors, the more useful it is to them, and the easier it is to respond and understand the case. You can open and close the different dialogue boxes to add information. And that’s just kind of a quick glimpse at what the case looks like. So I’m going to begin to submit a fake patient case. This is not based on a real person at all. So you’ll start by selecting the subspecialty, enter the age, it can be years, months, or weeks. Select a gender. If a field is required, and the form is sensing that you haven’t filled it in yet, it will prompt you to enter something there. So I’m going to put… Trauma one year back. When you get to visual acuity, one fun thing about the patient case form is that you can select whatever method you are used to doing your work in. And the mentor will automatically see the converted units. So there’s no need to enter units in a kind of measurement that you aren’t used to. You can just select whatever it is you use locally. So now I’m just going through and entering information. As much as I have, about my patient. Don’t forget that if there isn’t a red asterisk, you don’t have to include that information to submit the case successfully. But the more information you include, the better. IOP. So I’m just clicking through, to give you a sense of what these fields can look like. If it isn’t something that you want to enter, you can skip through it. Lens, however, is required. And don’t forget that if there are any questions that you have at all, we can answer that live, if you enter your questions into the chat box. Test results are especially useful to mentors. So if you have those, you can enter those values here. Or attach any scans you have in the “choose files” section. Diagnosis is required. And mentors want to see what you would think should be the tentative treatment plan, or if this is exactly what you’re going to do, then go ahead and enter that there. And any specific questions you have also help the mentors direct their advice even better. As I mentioned, you can add files here. These can include photos, scans, test results, et cetera. And we encourage people to leave the cases public, so that other people in the community can learn from it. If for any reason you feel uncomfortable doing that, if the patient hasn’t given their consent to have it be public, and it’s only consent for sharing it with a mentor for advice, then you absolutely have that option. You can keep it private by checking here. If not, leave it blank, please. That could be awesome. And as a gentle reminder, patient consent is required. That is the responsibility of the treating physician. So please do obtain your patient’s consent. In the way that you are used to doing that. It can be a form or a verbal, as long as that has been secured, then we are fine to save it as a draft or submit it to the mentor. So drafts are automatically saved. As you can see now, I received a notification that the draft is automatically saved. Those are saved every five minutes. So you don’t have to worry about losing information, and if you want to save it more frequently, or if you’re not quite ready to submit the case, you can do that by clicking save draft here. If you’re ready to submit the case, you can go ahead and click submit. Mentors respond to patient cases within 24 to 48 hours. And when a mentor has responded to your case, you will get an email notification. You’ll also see a red number appear right here, to let you know that you’ve received however many responses to your cases. And this is where you will find all of the cases that you’re working on. So if you have any new responses, you’ll see them under new requests. Any of the open cases you have that you’re working on currently will appear under “in progress”. Saved drafts is where you might have saved your drafts for submitting later, or you’re just not ready to submit quite yet. And we ask that once your communication with your mentor is finished that you close the case. Because cases that are open will not be made public until they are closed. So that is the demo of our new patient case design. Again, a huge thank you to the people who have done user tests with me and given feedback. And please do know that we are still accepting feedback. If there is anything here that is unclear, or something is missing that you think should be there, then please do share that now. Or via email. To support@Cybersight.org, or to anyone on our team. All right. So it looks like there have been a few questions in the chat box. I’m just going to spend a few more minutes showing you the different kinds of templates since we do have quite a bit of time. And please do continue to submit your questions, and we’ll take a moment to review that in a bit. And if there is a specific template that you’d like to see, or that you’re most interested in, please do let us know, and we will accommodate that as well, and give you a quick peek. But if you have a Cybersight account and access to patient cases, then you’ll be able to access this immediately. And you can look around yourself, and let us know if there is any feedback or ideas that come up later. All right. So it looks like we have a couple questions in the queue. I’ll go ahead and move into that. Okay. Sounds like I was talking a little too fast. Hopefully most people could understand the demo. Sorry about that. Another question. Is there provision for systemic features? As some conditions will require such. Dr. Bature, welcome. Dr. Bature is actually someone who helped give us feedback. If you wouldn’t mind just elaborating a little bit more in the chat box, that would be great. So I can understand the question a little bit better. I’ll stop sharing and look at the chat box. Is there a facility to send outcome of case from Arvind… Outcome of case. Also results of investigations, for example, MR scans, blood tests, et cetera. That’s a great question. I’m going to share my screen again, so I can show you. So if there are any — if you have any follow-up, such as the outcome of the surgery, or anything like that, that kind of communication happens once the mentor has responded, and you’ll be able to see kind of a chat back and forth, where the mentor has added their comment. You can comment back. And the communication about the case will continue for as long as necessary. Whoever has submitted the case has the power to open and close the case as needed. So there is really no limit to how long a communication can go, and you’re welcome to submit outcomes. In terms of sharing results of scans, or anything like that, this attachments and images section will accommodate any kind of file. So that can be uploaded here. And that remains an option throughout the case communication. If you have more resources or images or scans to send, you can always attach that. Hopefully that answers your question. And please feel free — if the question hasn’t been answered, do let me know. Please give us examples of case responses. This is a good question. So there’s a little bit of sensitivity to this, because there is patient information… In the case responses. But what I can do is show you an example of the types of cases that you can find. So I’m just going to select strabismus. Do a search. So for any given subspecialty, you can do a search and see what cases are publicly available. Dr. Neely has answered a lot of these cases for strabismus. He is our senior medical advisor on Cybersight. So a strong part of our team. And this is just kind of all open for anyone to view. And as you can see, there are 16 attachments here. Probably mostly photos. This is where you will see how many times the mentee and mentor have gone back and forth. You can rate cases. So hopefully this gives you a little bit of a flavor of what kinds of cases there are to view. What I can do is open one such case. And show you kind of an example of the back and forth, and just scroll quickly through the patient information. So here is a case that was submitted by Dr. Pop, another person who has given a lot of feedback on our new designs. So thank you, Dr. Pop, if you’re listening. And here is an example of her back and forth with Dr. Neely. And just as a reminder, if you have access to patient consultation, these cases are available now. So you can always go back and log in after a demo, and read the case in detail. And you can always comment on the case. And rate it. So I believe that answers that question. Looks like we have a couple more questions in QA, which I will answer now. Some disease conditions will require systemic symptoms and signs. For example, blood pressure and BMI. So Dr. Bature has elaborated on his question about systemic symptoms. Let me go back to our patient case template. So if there are any items like that, where you don’t see a specific field that is identifying something like BMI or anything like that, you can always enter that in ocular and family and medical history. You can also enter that in diagnosis, if that’s relevant there. So there are a number of areas where you can enter free text, and hopefully that will accommodate that need. And if not, if it’s something that you believe is necessary and something to add, please do let us know, and we’ll take note and keep that in mind for future design iterations. So Kishore Bhandary has said: the demo is very good. I think specialty fitting cases like keratoconus, et cetera, can also be included in the demo. All right. Thank you for that feedback. Arvind Chandna… Should outcomes be encouraged/essential, as feedback on outcomes will help mentors and help with usefulness of Cybersight? So the question is: should we include outcomes in the case communication? And absolutely, we definitely encourage that outcomes and postop details are shared, so we can see what transpired, whether the advice was useful, whether you dealt with any kinds of complications. All of that is an opportunity for everyone to learn. So we absolutely encourage you to share that on the patient cases. You can do that by going to your closed cases, if you’ve already closed it. And once you select the appropriate case, you will find an option to open the case again, and you can enter that information there. All right. Let’s go back to the chat box. So someone was also wondering if you can upload images and videos to the case. I am happy to show that again. So all of the attachments that you would want to add to a case can be included at the bottom. Choose files is where you will add that. And yes, any videos, photos, any kind of file type is accommodated. So feel free to add anything that you would want to share with a mentor, that they would find useful. The more information you share, generally, the better the response can be. Okay, so moving up in the chat… Okay. Another follow-up question to that. Ghada was also wondering: can I submit my case more than one time? For example, for strabismus mentor or neuro mentor? That’s an excellent question. Thank you for asking. So one thing that we have allowed our mentors to do is to refer cases to each other. So if a strabismus mentor gets a case, and there is a question they can’t answer, because it’s more suited for a neuro expert, they have the option of sharing that case with them. So I would start off with selecting the main subspecialty that you have the question about, and if there is something else that is relevant, if that mentor can’t respond it it, respond to it, they will find another mentor as well. So thank you for that question, and hopefully that answers that. Moving up in the chat box, is there a facility to send outcome? Okay, I think we already responded to that. Can I upload images and videos? Yes, definitely. Okay. And it looks like Lawrence has responded to most of these questions. Yeah, Lawrence? Okay. All right! It’s 10:30. We’re still here and open to feedback, further questions. If there’s anything else you’d like to see, please do let us know. Otherwise, I’m just going to continue to talk your ears off. If you haven’t already looked at our online courses, you can find that once you’ve signed into Cybersight Consult, here on the left hand panel, under courses. I’ll go ahead and open that. And everyone who has a Cybersight account automatically has access to our online courses. This is a new platform that we launched at the end of last year. So please do keep in mind that we are constantly adding to our library of courses. It’s a little bit limited now, but what we have there are courses that have been completely redesigned, edited, and enhanced to be as comprehensive as possible. And this is an ongoing project for us. So if there are any ideas or needs that aren’t being met here, please do let us know. And we’re happy to take that feedback and prioritize the work that we do, based on your needs. So I’ll just go ahead and show you an example of what we have. We have manuals, that are very useful, and available for download. And fundamentals of MSICS is one of our more popular courses. This is structured in such a way where you will take a pre- and post quiz. In order to do the courses. And courses are also — people who submit or complete courses will get a certificate that says that they’ve completed the course. Courses like MSICS have the postquiz, which I mentioned, and you’ll have two chances to get 80% or more, and if you’ve completed that, and met that criteria, you’ll get the certificate. Others are structured in different ways. And to see the transcript of all of the courses, then you would go to this side panel. Click transcript. I haven’t taken very many courses. So this is my little transcript. So that’s Cybersight courses. Just a brief overview of that. Back to Cybersight consult. It looks like we have another question. Are there any certificates after attending the courses? Yes. Great question. All of our courses have certificates. Another feature that we have on Cybersight consult — or Cybersight, in this platform, I guess, in general — is the discussion board. This is where you can join or begin a discussion about a topic. We have mentors who moderate these. So if it’s something that you want to have more in-depth conversation about then you can do that here. If it’s not just a one-off question, or something that you would like to engage with other people in the community about, you can definitely do that here. Often our mentors will share resources that they think are useful and helpful, on any given topic. They’ll do this for patient cases, general questions in the discussion forums, so a lot of opportunities to learn on Cybersight. I’ll show you briefly what a general question looks like. So again, this is for questions that aren’t related to a specific patient. You can select the category, as you would for a patient question. If you have a specific mentor assigned to you, because you completed an Orbis program, or you have an existing relationship with a mentor, you’ll see that option here. Otherwise a mentor will be assigned upon submission of the case. So the case will be assigned to the first available mentor. You would enter your question. I’m just going to make this up right now. And then, as always, you can attach any files, images, videos, that you have, that would be helpful. And save as a draft, or submit it. Looks like we’ve got one more question in the chat. Thank you for joining us, Chandna. So happy you could make it. All right. So the community activity is a fun way to see what else is happening and who else is submitting cases, responding to cases, if the case is made public, we’ll see that as well, you can like activity. This case was made public yesterday. So it looks like there was a fair amount of activity over the past couple days. All right. Are there any other parts of Cybersight that you’d like to see? Or have demonstrated? While we’re here? Or any feedback at all? Please do let us know. I’ll just continue to click through. The new design. So everyone can see what it looks like. And oculoplastics we have… Other specific items. Ptosis, specific to oculoplastics… So hopefully this new design makes it a little bit easier to digest the information in the forms. And faster to go through. As you know what information is available to you, and what information you don’t have. So you can just kind of skip over those boxes. And now that it’s one step, instead of three, hopefully that helps with the low bandwidth, which we know is an important barrier for a lot of our users. Also, if you’ve started a case, and you’ve decided that actually you don’t want to submit it anymore, you can always cancel a case. And start from scratch, or engage in other parts of our site. All right! if there are no further questions, or things that you want to see at all, I will just leave you with a final reminder that you can access all of our services and find out more about what we do at http://Cybersight.org. I recommend making a bookmark for http://consult.Cybersight.org, so that you can easily access the login page, or you can click here for sign-in. If you aren’t subscribed to our newsletter, you can do that at the bottom of any page in our website. Here. If you want to see our site in a different language, we have this option as well. And do follow us on Twitter. That is another area where we share upcoming events and let you know what new things we’re up to. Looks like we’ve got one or two more items in chat. Thank you. Thank you so much for joining us, Ghada. Thank you, Dr. Bature. Happy to see that you were able to join. All right. And then the last thing that I just want to point out while everyone’s here is that our library is where you can find a lot of the different resources that we post. With the exception of the courses, which you have to sign in for. But the library is where you can find surgical video demonstrations, quizzes, all of the recordings of our live lectures, including this one, are posted here, this recording will be posted later on today, textbooks and manuals you’ll need to sign in for. But you can see our catalog of textbooks and manuals here. And to see a complete list of the courses that we have available, which, as I mentioned, we’re constantly adding to, you can go to our online courses page and see that there. You can sign in or join the community here as well. Thank you all so much for joining. I hope that you found this useful, and if you think that this kind of demonstration would be useful to have in the future, please let us know in the survey, and any and all feedback about this demonstration and Cybersight in general would be much appreciated. So with that, have a good day, evening, and good luck to all of you.

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July 19, 2017

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