FIELD OF INVENTION
This clinical workflow, apparatus, method and system relates to conducting an (ID) indirect to direct ocular health examinations, prescription extensions or submissions system via remote administration tool technology, an adapter apparatus (AA), proprietary emulating software, control softwares and mobile applications. The system also may or may not have the ability to switch to direct remote capabilities. Specifically, these systems pertains to the use of ocular health medical equipment kits anywhere in the world that can be remotely controlled and viewed by a remote eye doctor for a telemedicine consultation. The ocular health medical equipment kit contains portable digital slit-lamp, two iris copes, a camera headset apparatus, wireless router, smartphone, ocular tonometer and two portable computers.
At least one of the portable computers has ocular health cameras, software, an apparatus with adapter, proprietary emulating software, electronic medical records software, mobile applications and remote administration tool (RAT) and/or (RAS) remote access software applications. The secondary portable computer works as a vision chart, duo chrome and astigmatic dial chart. The use of cellphone wireless networks or wifi wireless networks provide a remote eye doctor to provide indirect to direct real time or near real time telemedicine ocular health screening or examination to a remote patient anywhere in the world with the connection to portable or non portable medical equipment.
BACKGROUND OF INVENTION
There is a disparity of vision care coverage worldwide, not because of a shortage of vision care providers, but due to a shortage of vision care providers that are within close proximity to their patients and due eye doctor office hours. Uneven vision care coverage leads to underserved populations from obtaining much needed emergency ocular health examination, which decreases their overall quality of life and limits their abilities of daily living. Currently, many emergency room, clinics, mobile clinics, hospitals, opticals, optometric practices, and ophthalmology practices struggle to find a cost-effective strategy that can supply these populations with adequate and easily accessible opportunities for precise, 24 hour, tailored emergency ocular health screenings or examination from a professional vision care provider.
The present invention system seeks to provide adequate and easily accessible opportunities for underserved populations worldwide to obtain precise, tailored telemedicine ocular health screenings and examinations services from a remote vision care provider independent of timezone. Consequently, it seeks to improve the underserved population's overall quality of life and increase their abilities of daily living. This system proposes to achieve this through the use of remote administration tool technology, adapters, softwares, telemedicine video audio connection, mobile applications or software, proprietary emulating softwares, remote access or remote control software to interconnect both systems via ethernet, wifi or cellphone wireless networks worldwide.
BRIEF DESCRIPTIONS OF THE DRAWINGS
FIG. 1—illustrates a workflow diagram of a method for performing ocular medical health check-ups (TPA) Therapeutic pharmaceutical agent check-ups.
FIG. 1A—illustrates a workflow diagram of a method for performing a contact lens prescription extension.
FIG. 2—illustrates an embodiment of a group of devices that can be used by a controller providing service via a smartphone application, program or website that can be used in a smartphone, virtual reality headsets, augmented reality headsets, smartwatches or laptops, or any computer system, where the application mobile application, program, or website has a graphical user interface with sign-up menu to log in, section to put remote controllers (health care professional, or eye doctors) name, health care providers license numbers from each state or country, nation provider identification number (NPI), type of health care provider, cellphone number, and way to receive payment for service.
FIG. 3—Illustrates embodiments of one of a plurality of health care providers and/or eye doctors portable electronic devices with its graphical user interface running at least one program, website, or mobile application on the health care provider's smartphone. Where connecting the device and location of the remote facility gives availability for service location and time for needed remote eye doctor booking, where the controller can select the date, time, and location to provide service and receive an electronic message or text message of the user name, password and day and time to provide service, where the eye doctor can connect to the (MCB) to view control at least one of a plurality of medical equipment from at least one computer system and at least one controller's computer system.
FIG. 4—Illustrates pictorial diagram embodiment of a group of ocular examination equipment kits and secure casing that are portable in nature and can be sent or receive anywhere in the world to establish a remote medical facility setup, where the ocular examination kit have a plurality of wired connection devices, two iris-copes, one (MCB) computer system, fluorescein sodium kit, remote vision chart system, portable slit-lamp with or without robotic adapters and computer system, cellphone wireless router system, (MCB) adapter and a smartphone with an operating system.
FIG. 4A—Illustrate pictorial diagram embodiment of a group of ocular examination equipment kits and secure casing that are portable in nature and can be sent or receive anywhere in the world to establish a remote medical facility setup. Where the ocular examination kit have a plurality of wired cable connection devices, two iris-copes, at least one extra (MCB), an automatic digital lens-meter, at least one cellphone wireless router, smartphone with an operating system and at least one phoropter or refractor. Where the refractor or horopters can be an automatic objective refractor, an automatic or digital phoropter and/or subjective refraction equipment, variable focus liquid lens refractor, and/or liquid lens subjective refractor or phoropter,
FIG. 5—Illustrate pictorial diagram embodiment of the connection of the ocular examination kits with at least one or more equipment can be connected to a secondary computer called the (MCB) in a remote medical facility anywhere in the world. Where a remote administration tool, screen share, screen control and screen mirror connection is established between the remote distance eye doctor or health care professional and the remote medical facility via the (MCB) and a smartphone connection via a HIPPA compliant audio video call where audio video call is mirrored to a television screen in the remote medical facility.
FIG. 6—Illustrate pictorial diagram embodiment assistant or (Assistant or technician) connecting with live remote eye doctor where the (Assistant or technician) or eye doctor can collecting retinal images via “store and forward” technique with the option of having remote control eye doctor control the softwares the controls the retinal camera and also take and review the images via real-time Tele-imaging via remote administration tool, emulating softwares, screen share, screen control, and screen mirror softwares via a the any type of internet network or network. Where the remote vision chart is set to on the wall to remotely review patient visual acuities before or after.
FIG. 7—Illustrate pictorial diagram embodiment of a method performing a real-time Flourecein sodium cornea staining examination using real-time tele-imaging via remote administration tool, emulating software, screen share, screen control, and screen mirror software via the internet network or network. With iris copes camera, that has cobalt blue filter. Where the iris copes can be installed into a head-mounted apparatus in order for the (assistant or technician) and eye doctor to achieve a binocular view of external ocular images.
FIG. 8—Illustrate pictorial diagram embodiment of method to perform a remote slit-lamp evaluation via the slit lamps first computer adapted to the (MCB) secondary computer where a remote or distance eye doctor can view the images, videos and can control the slit-lamp robotic adapted parts to view ocular adnexa health of the patient both eyes. Wherewith the robotic adapted slit-lamp eye doctor can control slit, magnification, angles, filters, and angles.
FIG. 9—Illustrate pictorial diagram embodiment of an (assistant or technician) in a remote medical facility retaking retinal images while eye remote eye doctor view, control, and types patient data from examination to the EMR from his portable electronic device via real-time remote administration tool, emulating software, screen share, screen control, and screen mirror software via any internet network or network.
FIG. 10—Illustrate pictorial diagram embodiment of a head-mounted apparatus adapted to two iris-copes system relaying images to the (MCB) secondary computer where remote health care provider or eye doctor can visualize fine details such as eye movements when testing for extra-ocular motor function and pupil size when testing for pupillary reflexes. To detect strabismus, disorders of the eyelids, conjunctival disorders via real-time remote administration tool, emulating software, screen share, screen control, screen record, and screen mirror software via the wireless or non-wireless internet network or network. Where the video audio call can be screen mirrored from the smartphone to a smart television.
FIG. 11—Illustrate pictorial diagram embodiment of a patient is holding a modified iris-cope with filters or no filters where the images are sent to a secondary computer (MCB) where the (remote eye doctor or controller) is connected via real-time remote administration tool, emulating software, screen share, screen control, and screen mirror softwares via the internet network or network. Where the remote eye doctor can control the softwares that control the lighting filters and zoom mechanism of the iris-cope. Where the interconnection control and view is from remote eye doctor electronic device to view, document, record and take pictures to diagnose disorders of the eyelids, conjunctival disorders and external ocular structures of the eye.
FIG. 12—Illustrate pictorial diagram embodiment of a sample set of fluorescein staining technique, where the technician or assistant instills one drop of fluorescein sodium dye to patient both eyes. Where the patient eyes can be examined, viewed and recorded if cornea damages are seen or if no cornea damage are seen via iris cope, iris cope headset apparatus, slit-lamp. Where the eye doctor is connected via smartphone and screen mirrored to office smart television. Where the eye doctor can view the images saved on the (MCB) of patient cornea and conjunctival damage with and without fluorescein staining dye and with without cobalt picture via real time remote administration tool, emulating softwares, screen share, screen control and screen mirror softwares via a the internet network or network using his portable or non portable electronic device. Where the first one image from top to bottom are fluorescein staining of the cornea via a cobalt blue filter, the top first one is superior punctate keratitis, second is staying skating rink core abrasion caused by possible trapped foreign body trapped under the upper eyelid, third is staining foreign body material metal, wood, plastic or glass in the cornea, and fourth is staying corneal abrasion or laceration.
FIG. 13—Illustrate pictorial diagram embodiment of an iris-cope with its part and its lights, cup assembly and a portable digital slit-lamp with a robotic adapter configured for remote control software to control slit lamps parts. Where an eye doctor in a remote location can con both device simultaneously via control of the (MCB) second computer using tele-imaging control software via remote administration tool, emulating softwares, screen share, screen control and screen mirror softwares via a the internet network or network. Where the eye doctor can control via his electronic device magnification or zoom of the iris cope, cobalt blue filter lights, white light intensity, slit, and angle. Where the eye doctor can take picture, record images via the software or while viewing real-time.
FIG. 14—Illustrate pictorial diagram embodiment a (Assistant or technician) taking ocular pressure via a portable handheld ocular pressure tonometer. Where the pressure are inputed by the doctor via his his electronic device (smartphone). Where the (Assistant or technician) can also input the information in the electronic medical record on the (MCB). Where the remote eye doctor on a video audio call with the remote facility smartphone at the same time.
FIG. 15—Illustrate pictorial diagram embodiment of a (remote eye doctor or controller) portable electronic device (smartphone) connected to the (MCB) via the mobile application, program, or website. Where the remote eye doctor can view, and control the electronic medical record, review, input information, fill out results, fill out diagnosis, plan treatment and sign electronically. Where the application can has the call video conference window open and the geolocation and phone number of the remote medical facility the eye doctor is providing service.
FIG. 16—Illustrate pictorial diagram embodiment Illustrates a remote eye doctor or controller's portable electronic device running the mobile application where the eye doctor is filling out an electronic prescription for a patient, filling out name, date, NPI, License number, expiration date, and signing with an electronic signature. Where in case of using blockchain technology prescription systems, a transaction hash will be displayed on the bottom.
FIG. 17—Illustrate pictorial diagram embodiment of a (remote eye doctor or controller) providing service to a remote medical facility via the mobile application, program and/or website. The eye doctor is connected to the network and established a video audio call where the eye doctor is connected to the (MCB) main control unit via remote administration tool technology, screen share, and screen control. Where after receiving service, the patient can pay the remote facility directly or via health insurance. Where the eye doctor may receive payment for the service he rendered by the remote medical facility via the application, program or website.
FIG. 18—Illustrate pictorial diagram embodiment of an (MCB) main control base computer system with adapter apparatus and an emulating software connection. Where the (MCB) is connected wirelessly to multiple eye examination equipment and is able to view all user interfaces of all equipment connected ocular image software, slit-lamp control, lice slit lamp or iris cope video, payment checkout system, and its Electronic medical record system, where a remote eye doctor portable electronic device (smartphone) can connect via the network (LAN, wireless or non-wireless network) to view and control the (MCB) via remote administration tool, screen share, screen mirror, and screen control.
FIG. 19—Illustrate pictorial diagram embodiment of a group of eye doctors types of third computer systems or controllers portable electronic devices that can run the mobile application, program or website application to connect to at least one (MCB) that is connected to ocular or medical equipment. Where the eye doctor portable electronic devices can be Virtual reality headset, smartwatch, augmented reality headset, Laptop, smartphone. Where any of the equipment may run an operating system that can be Windows, apple, android, Linux or any other operating system. Where the connection of the remote eye doctor or controllers portable electronic device is using internet to connect to the (MCB) via a combination of softwares. Where the (MCB) main control base or secondary computer system can be tablet, Laptop, smartphone or personal computer. Where the (MCB) or secondary computer system can be of any operating system windows, apple, android, linux, chrome OS, raspberry pi os or any other operating system. Where the (MCB) adapter apparatus and softwares are connected to the ocular exam medical equipment first computer that is connected to the eye examination equipment. Where the (MCB) is connected via an Internet network or local area network to the remote eye doctor or controllers portable electronic device. Where a patient is at the remote medical facility waiting to be seen by the assistant or technician.
FIG. 20—Illustrate pictorial diagram embodiment of an (EMR) electronic medical record running on the main control base or second computer system user interface. Where (MCB) user interface, it is viewed, controlled and edited by a remote eye doctor or controllers portable electronic device (smartphone). Where the eye doctor can view, control and edit the electronic medical record system remotely and sign remotely, save documents remotely via mobile application with remote administration tool, screen view, screen mirror, and screen control.
FIG. 21—Illustrate pictorial diagram embodiment Illustrates a network of remote medical facilities all over the world that can be connected to remote eye doctors or controllers anywhere in the world. Where remote eye doctor can schedule date, time and location to provide service via the mobile application, program or website via the network. Where the remote medical facility may or may not have all its equipment connected to the (MCB) via multiple tree topology system configuration to reduce lag and speed up transmission time.
FIG. 22—Illustrate pictorial diagram embodiment Illustrates a patient in a remote medical facility viewing a remote vision acuity chart on a computer system. Where the remote vision chart is connected to the (MCB) via adapter, infrared, bluetooth, wifi, LAN or any wired or non wired configuration. Where a (remote eye doctor or controller) can control the vision chart via the (MCB), while established video audio call to the patient via the remote facility smartphone.
FIG. 23—Illustrate pictorial diagram embodiment Illustrates a way to connect the systems via multi-topology and multi-tree topology configuration using a wired or wireless connection to establish a low latency, low lag, and using wire, proprietary adapter apparatus, and proprietary emulating software. Where at least one (MCB) main control base or secondary computer base can control multiple equipment concurrently via the network topological connections via special softwares, adapter apparatus, emulating software, remote administration tool technology, emulating software, screen share, screen control, and/or screen mirror. While the eye doctor or controller third computer system or portable electronic device can control via the network, the (MCB) main control base user interfaces indirectly controlling all medical equipment while still being able to access cloud storage, files sharing system and/or IPFS to control, view, review and edit all patient medical data. Where the eye docs can provide indirect to direct visual acuity examination, near distance subjective refractions, external ocular health examinations, retinal examination, and can control the electronic medical record in at least one (MCB).
FIG. 24—Illustrate pictorial diagram embodiment Illustrates via the topological connection used to connect the medical or eye examination equipment embedded system or non-embedded system computer system called the first computer. Where the first computer can control the equipment directly. Where the first computer is connected to a secondary computer system called the (MCB) or secondary computer system. Where at least one first computer is connected to the (MCB) via emulating softwares and other types softwares. Where the first computer user interface is emulated to second computer interface. Where at least one or more first computers can be connected by the second computer (MCB) system. Where a third computer system or remote eye doctors portable electronic device can control the second computer to indirectly control the first computers that control the eye examination equipment, robotics or its parts. Where each (MCB) base can control multiple equipments via the network topological connections via a network and where the (remote eye doctor or controller) with a third computer system or portable electronic device can control via direct means the first computer systems of the equipment via direct connection means via a switch mechanism to perform the same task indirect instead of indirect technique.
DETAILED DESCRIPTION
A secured (IDD) indirect to direct or direct on-demand doctor to patient telemedicine remote ocular health examination system. Where the indirect to direct on-demand connection can be switched to direct connection in some cases or situations. This service system allows telemedicine ocular health examination to be made via an ocular examination equipment kit (OEK), mobile applications, emulating software, an adapter apparatus, multiple software, and/or remote administration tool technology. (FIG. 4). The ocular examination kits can be assembled in any location schools, emergency rooms, clinics, mobile clinics, military bases, aircraft carriers, or any mobile or non-mobile location. (FIG. 4) (FIG. 20).
In some cases, the addition of a portable digital phoropter or subjective refractor apparatus can also be connected to the system to provide Indirect to direct subjective refraction service via mobile app. The ocular examination equipment kit can be installed inside rooms, offices, mobile trailers, mobile exam rooms, kiosks, booths, anywhere in the world. (FIG. 20). The ocular examination equipment kit contains two portable computers but may include more computers in the future. One of the portable computers which together with the OS, interface, adapter apparatus (AA), proprietary emulator software, connection to the equipment and software that will be called the (MCB) for main control base. (FIG. 4; 15).
The ocular examination equipment kit (OEK) contains a MCB, wireless cellphone router, smartphone, slit-lamp, two iris-copes, non mydriatic retinal camera, multiple USB connectors, and a head-mount ocular examination apparatus (FIG. 4; 23,24,25,22,20,23,26,17,16,18). The ocular examination kit can also include future upgrading to provide digital phoropter or (subjective refractors apparatus), lens-meters, and auto refractor systems to be connected to the MCB. In some cases, in the future, one or more MCB may or may not be added to the systems. The current system has portable computers (MCB) that run multiple software including remote doctor scheduling software, machine learning software, emulating software, electronic medical record software, remote administration tools (RAT) software, and multiple ocular cameras control software. All doctors in the on-demand service network may sign up to the mobile application and run a mobile application on their personal electronic device (smartphone, tablet, smartwatch, or laptop). (FIG. 2; 1,2,3,4,5,6,7) (FIG. 3).
The mobile application can be a running a mobile app that can vary depending on operating systems. The mobile application can also be a DAPP decentralized application running on a blockchain system. This mobile application facilitates connection to the remote facility designated for the location, day, and time they will provide service and payment for medical service rendered. (FIG. 3; 67,55,8,9,10,49,68). Each remote medical facility with their (OEK) will include a user name and password for the on-demand eye doctor to provide service on the day and time the service will be rendered. (FIG. 20; 55,30,56). Payment to the eye doctor can be sent via the mobile application from the remote medical facility to the eye doctor or, in some cases, direct payment from the patient to the eye doctor. (FIG. 17; 58).
The payment can be made to the eye doctor via credit card, cryptocurrency, or any other type of payment method. An assistant will be at the remote location and will set up the ocular examination equipment Kit (OEK) and connect online. (FIG. 5; 31). The assistant may be a (nurse doctor, optometric technician, ophthalmic technician, or any health care provider). (31). The assistant will help with the connection to the mobile application and help with the connection to the on-demand eye doctor. (FIG. 5; 31, 21,50,49,2,29,30,1,50,31,30,27). In cases of the same day on demand service, the request can be from facility to eye doctor or from eye doctor to facility depending on the application setting used. (FIG. 3; 67)(FIG. 20; 55,30,56).
The remote eye doctor will be able to control the portable computer (MCB) without having to be in the exam room. The exam room can be in a mobile location or a non-mobile location. (FIG. 5)(FIG. 6; 30,29,15). The system interconnection is made by remote administration tools software application technology via the internet using ethernet, cellphone wireless networks, or wifi. (29). The interconnection of the on-demand eye doctor and the remote medical facility (RMF) will be delegated to the mobile application, a decentralized application (DAPP), or website similar to Uber or Lyft where the eye doctor can provide telemedicine ocular health examinations service to multiple locations in the world depending on the selection on their mobile application, DAPP or website. (FIG. 2; 2). The medical equipment (digital slit-lamp, digital iris-cope, digital retinal camera) is controlled directly by the portable computer (MCB) in the exam room via a wired or non wired connection. (FIG. 5; 16,19,17,22,26,14,15). The portable computer (MCB) will run software that controls software that controls the medical equipment. (FIG. 12; 39).
The portable computer (MCB) will also have a remote administration tool technology software or application installed into its main operating system. (FIG. 18; 12,15). The portable computer (MCB) may also have the ability to use a browser as a (Remote connection to the eye doctor). The possibility of using a browser with a (remote connection) can be facilitated with a secondary commercial or non-commercial company if needed. The portable computer (MCB) can be of any operating system Android, windows, or Linux depending on the computer used with its interface software. (FIG. 18; 15,69). The eye doctor can have any portable electronic device (smartphone, tablet, laptop) with any operating system Android, Windows, or Linux with a mobile application. (FIG. 2; 1).
The mobile application will be used to connect to a remote medical facility (RMF) with the portable computer (MCB) that runs (RAT) software technology. (FIG. 21). The portable computer (MCB) has to have the remote administration tool technology application, adapter apparatus, emulator software, ocular control software running at the same time to be controlled by a remote eye doctor from anywhere in the world. (FIG. 18; 11,52,51,39,12,54,53,15,69). The eye doctor needs to have the mobile application running on his portable electronic device. This application may have remote administration tool technology capabilities that can be used to interconnect to the remote medical facility (RMF). (FIG. 2; 1,2). The eye doctor will receive a text message with the user name and password to interconnect to the remote medical facility portable computer (MCB). (FIG. 3; 1,67,55).
The main purpose of the portable computer (MCB) is direct control of the electronic medical records software, ocular camera software, or any other medical equipment via wired connection, but via a remote administration tool software, it can be controlled by an eye doctor providing service. (FIG. 5) (FIG. 18). The (MCB) with adapter can also be connected to any eye examination equipment from any maker in any optometric or ophthalmology office. The portable computer (MCB) will always be connected to the internet via ethernet, wifi, or any cellphone wireless network. In the event that the remote medical facility (RMF) does not have its own internet service, the ocular examination equipment Kit (OEK) also comes with a wireless cellphone network internet router to provide an internet connection to the system. (FIG. 4; 20,21,15,69). The person connecting to provide service can be an (optometrist, ophthalmologist, or any other health care provider) with a portable electronic device (VR headset, AR headset, smartphone, smartwatch, laptop, and/or tablet) running the mobile application. (FIG. 2; 1). The eye doctor or health care practitioner's portable electronic device (PED) can be a smartphone, smartwatch, tablet and/or laptop.
The main control base computer can be remote-controlled over Internet protocol networks using an applet running on the communication device, and the eye doctor (PED) can control the exam room (MCB) portable computer by using a (RAT) applet running on their portable electronic device (smartphone, tablet, laptop, VR headset, smartwatch and/or AR headset). The remote administration tool technology can interconnect between any type of computer independent of the operating system. (FIG. 19). When the assistant or mobile application sends a text message or message via the app to request an on-demand (eye doctor), he or she can accept or decline the request for (RAT) interconnection. In some cases, the mobile application can also work by having the eye doctor look for a location on the mobile application to provide service similar to Airbnb, Uber, or Lyft. If and when the eye doctor accepts the request, they have to insert a user name and password via the remote administration tool software.
The (RAT) remotes administration program installed within its system may randomly generate a user name and password authentication for the (eye doctor or controller) to be able to log in and connect to the portable computer. The remote medical facility can also delegate a username and password for the remote eye doctor to connect to the system if needed. This random user name and password facilitate a secure connection to any eye doctor scheduled or that accepts to become a supported controller to provide service with their portable electronic device. By way of indirect to direct connection, the eye doctor can control the exam room portable computer (MCB), which will directly control the ocular health cameras software that may be running software that controls the EMR, retinal camera, iris copes, or digital slit-lamp. In the case of a robotic digital slit lamp, the parts can be controlled remotely also. (FIG. 23).
The eye doctor can control indirectly remotely operate the digital ocular cameras and digital slit-lamp remotely to refine images and videos for a proper remote ocular examination from a patient at the office. Adapters on the digital slit-lamp can be added to facilitate the remote control of the slit control, click stop, filters, magnification changer, and joystick elevation knob. Some portable or non-portable slit lamps may already come with built-in robotic or electronic control of all: slit control, illumination arm, click stop, filters, magnification changer, and joystick elevation knob. In any case, the control system can be connected via an adapter apparatus, emulating software, or run via OS—compatible control software via the MCB to have complete control remotely by a remote eye doctor providing service. The eye doctor that is connected to the system will be able to control the iris copes and slit-lamps to gather video or pictures of the patient's ocular health of the anterior segment of the eye. In some cases, the eye doctor may switch from the indirect to direct to (direct to direct) connection method to get a better connection.
In some cases of unstable connection, the eye doctor can instruct the assistant to control and take the images or videos of the anterior segment of the eye via the iriscope and slit lamps systems. The patient eyes can be tested for a number of conditions using the different lights and magnification on the ocular cameras. The remote (eye doctor or controller) can review the ocular retinal pictures and zoom in and out to analyze via a cloud storage system or via the memory built-in into the camera's computers. If and when the connection is optimal, the eye doctor can review the images realtime via the system. In realtime viewing and control of the iriscope and slit lamps, the remote doctor can control the lights and filters of the slit-lamp and or the iriscope contraption. The filters used in both eye iris copes contraption, and slit lamps are cobalt blue filters, green, red-free filters, and neutral density filters.
Any of these filters will be used for diagnosis purposes. The iris copes, and slit lamp will be used to evaluate the health of the anterior segment of the eye as far posterior as the anterior portion of the aqueous humor. The eye doctor or the assistant can vary the angle of illumination arm, magnification, and type of slit beams via manual or remote means using the software running inside the MCB. The option of the type of slit lamps beams may be from diffused, wide parallelepiped, narrow parallelepiped optic section corneal beam wide parallelepiped narrow parallelepiped to view the appropriate ocular structures. As part of the examination, the assistant at the remote office may instill fluorescein sodium on the patients eye and the remote doctor or assistant may view or control the lighting and filters on the digital slit-lamp and iris cope with determining anomalies in the cornea or conjunctival tissue.
The eye doctor may also control the digital slit lamp, and iris copes realtime during the examination if needed. The controller of the iriscope or slit-lamp will take image photos or videos to review but can also be review by the doctor realtime. During the iriscope and slit-lamp examination, the anterior segment of the eye will be examined by the assistant, including: Lids, lashes, cornea, conjunctiva, and anterior chamber. In the event of no cornea problems, the remote doctor may instruct the assistant to perform ocular pressure tonometry on a patient to view intraocular pressure results. (FIG. 14). The ocular pressure tonometry may be transmitted automatically to the portable computer (MBC) interface and can be viewed by the eye doctor remotely via the remote administration tool interconnection. (FIG. 14).
In the case of an unstable connection, the assistant can take the tonometry reading and type the results to the EMR software or send the results to the eye doctor via text. (FIG. 20). At the end of the remote telemedicine remote control connection, the remote eye doctor may prescribe proper medications for the ocular conditions via the mobile application or via a prescription via email. All information may be edited by the remote eye doctor as they will have access to the electronic medical record (EMR) at the exam office portable computers system via remote control and remote sharing technology. (FIG. 15). The on-demand Optometrist or Ophthalmologist (eye doctor) anywhere in the world can perform the ocular examinations remotely and can communicate with the patient via HIPAA compliant encrypted video and voice or voice call. The video audio or audio call can be done via the remote medical facility smartphone in the (OEK).
The support controller (eye doctor) can also use portable wireless headphones with a microphone to maintain clear communication with the patient. The Optometrist or Ophthalmologist (eye doctor) will ask the patient if the patient has any questions. Payment to the remote eye doctor may be made via the mobile application or via a contract with the remote facility company. Payment can also be made via connection to a mobile application on the patient's smartphone or portable electronic device. (FIG. 17). The eye doctor can send out a prescription via picture or email to the eye exam office, pharmacy, or to the patient's email. (FIG. 16).
The system will be operated by a network of healthcare providers with the application running on their portable electronic devices. The mobile application has the capabilities to have a scheduling system for each remote medical facility needing service. The system is built to be upgradable to provide extra equipment adaptability. Some of the equipment adaptability may be any digital phoropter and/or subjective refractor apparatus from any company. With a proprietary special proprietary adapter apparatus and software, any system or equipment can become remotely controlled by the network of healthcare providers. In the case of the digital phoropter or any portable digital phoropter technology, a remote healthcare provider may be able to control the robotic equipment inside the phoropter that changes the lenses that changes the shape of the lenses depending on the digital phoropter technology used. (FIG. 23).
No matter which vision refraction system is used, the ability of the adapter apparatus being and software being connected to the device becomes an (IDD) indirectly to directly direct or an indirect to direct (ID) remotely operated via MCB. This will enable any remote health care practitioner to provide remote subjective refraction to any person in the world. The way the system is configured with the proprietary adapters makes it capable of being operated anywhere in the world as long as we have internet connectivity and wireless cellphone networks connectivity. (FIG. 24).