Seva Foundation Technology Blog

Category: Digital

  • World Sight Day Webinar 2025

    World Sight Day Webinar 2025

    We’d like to thank those who joined us for our webinar on October 16, 2025, and invite everyone to watch it on demand!

    Timestamps for Reference

    1:40 – Welcome, Kate Moynihan

    4:10 – Technology Introduction, Katie McMillan

    6:23 – Vision Center Management Software, Dr. Shalinder & Team at Dr. Shroff’s Charity Eye Hospital

    15:18 – Pre-School Vision Screening with SPOT, Dr. Manisha Shrestha & Team at Bharatpur Eye Hospital

    23:29 – Retinal Imaging in Outreach, Dra. Gabriella Pena at INVIS

    29:25 – Pristine 5.0 in Africa, Dr. Tamara Chirambo Nyaka, Malawi

    36:30 – Panel Discussion & Questions

    Additional Questions

    We had some questions we didn’t have time to answer live. If you have comments or additional questions, we’d love to hear from you on this post!

    1. Does anyone have insight into digital ocular pathology?

    Katie: I admit I’ve not researched this topic deeply. Do you mean taking digital images/photographcs of the pathology so that it can be interpreted elsewhere?  I’d love to talk more about your use case and questions – please feel free to send an email to kmcmillan@seva.org!

    It is quite a futuristic question, and an exciting one. It reminds me of the Zeiss Artevo 800 retina operating microscope which I am looking forward to experiencing. It combines 3D viewing (like the Alcon NGENUITY VS) for improved ergonomics; and has a fully integrated intraoperative OCT (iOCT) for real-time microscopic tissue viewing for both the surgeon and assistant (and others in the room via a screen). It is for both anterior and posterior segment surgeries. I can only imagine the impact It has on surgical and hopefully visual outcomes as well, as it should improve the surgeon’s precision greatly intraoperatively. Additionally, digital images can be shared for consultation while at it. It ought to make teaching much easier as well.

    Having said the above as an example, digital ocular pathology would come at a great capital cost to pool images and formulate algorithms for pattern recognition to improve diagnosis, consistency and access to expert opinion. There are data storage issues amongst others. I think the provision by, for example, the Remidio 5.0 fundus camera with its cloud storage for images are baby steps towards digitization and AI assisted patient management. 

    1. What are your tips for making the best use of technology in remote areas, where power and connectivity and staff education may be challenging?

    Dr. Manisha: There is a device called arc light, which is battery operated but also has a solar charging option, a very light portable device for fundus examination. I feel teaching the health care personnel at the community level at least for fundal eye reflex screening in children ( at birth, at time of vaccination or when they visit when they are sick) holds significance for detecting amblyogenic risk factors early and then can be referred to eye care facilities.

    Katie: We also talked during the live Q&A about supporting systems – uninterruptible power sources, satellite internet, compensation for staff who are trained on critical technologies – that have helped in certain projects.

    1. How do you organize your documentation (SOPs, technology instructions), and how do you evaluate progress and quality within technology projects?

    Katie: For Seva projects, we help with quarterly check-ins that ask about quantitative metrics and offer the opportunity to discuss what went well and where there are challenges.  I’ve seen the most successful projects have clear leadership buy-in and they tend to follow common practices.  So if you have an SOP for infection control, your retinal camera SOP could be found in a similar spot.  That way all staff members have a common understanding of where to look for help.

    1. How can technology improve the quality of eye care?

    Katie: In the SCEH conversation, we talked about how the capturing of data (patients seen, returning patients, outcomes of treatment) was very helpful in sharing with the vision center staff so they could tell what had happened and compare against similar clinics.  These types of electronic medical records assist in tracking visual acuity after cataract surgery, for example, or spectacles that have been returned in the optical shop.  

    Defining the key metrics and confirming you have a system that is properly tracking them can give opportunity for regular (e.g. monthly, quarterly) strategic conversations about the current status and necessary improvements.  

    1. There are groups adding free eye camps and awareness events in Nepal – what are some tips on how they can get the best results?

    Dr. Manisha: In a survey sent out via google forms to the Pediatric Ophthalmologists of Nepal (total 40)  to find about the status of pre-school vision screening in Nepal, response was obtained from 22 (55%).  Out of them 13 (60%) responded that they have conducted the pre school screening, and out of them 10 (77%) said they do it via loose lens retinoscopy by ophthalmic assistants/ optometrist and 3 (23%) responded it was being done by community eye health workers using Snellen’s chart. Everyone responded that vision screening devices for preschool screening had not been used. This shows the gap area for pre-school vision screening in Nepal, traditional way of screening children using loose lens retinoscopy/ snellen’s chart is not feasible for pre-school children (3 to 6 years) and maybe using technology like Spot vision screener or other photoscreener device to detect amblyogenic risk factors in them holds significance.

    1. As you evaluate technology partners, what are some factors to keep in mind?

    Have a look at the blog post from SCEH or we’d love to hear what your ideas are!

    Some helpful questions to consider:

    • Who owns the source code and/or intellectual property (IP)?
    • Who is responsible if there are infringements on someone else’s IP?
    • If a technology partner can longer work with you in the future for updates or maintenance, do you have all rights to change partners?
    • Who is responsible for acceptance testing? Or bug fixes within the initial use period?
    1. Have we given a thought on smart phone fundoscopy, which I feel is something we can teach our residents to take fundus images with their own smart phones..

    Katie: The AAO has a resource that can be located here: https://eyewiki.org/Smartphone_Funduscopy_-_How_to_Use_Smartphone_to_Take_Fundus_Photographs

    There is also a 2024 review article which lists several adapters that can make your smartphone easier to use and offer better image quality.  https://www.sciencedirect.com/science/article/pii/S0039625723001327 

    1. Can anyone explain the role of AI in these technologies? Is AI reliable enough to support a trusted diagnosis? And is AI currently integrated into any of the cameras mentioned today?

    Katie: AI for retinal imaging is pretty mature, with some applications specific to diabetic retinopathy having regulatory clearance and therefore having proven safety and efficacy.  Retinopathy of prematurity has also shown very impressive results.  Other conditions (Glaucoma, AMD, opportunistic infections) have fewer options and varying degrees of research.  https://www.sciencedirect.com/science/article/pii/S2162098924000975 offers a recent review. 

    Remidio, for example, does offer a commercial AI feature for their fundus on phone camera but it is focused on specific retinal conditions.  So it’s critical to know exactly what the specifications for AI are and that you have adequate coverage to find conditions out of scope for the algorithm use.  

    It is a developing field. There are already AI-based Retinal imaging tools for diabetic retinopathy screening such as IDx-DR (Digital diagnostics, USA), EyeArt (Eyenuk), among others.

  • “Own the Source Code” – Maintaining Vision Center Management Software

    “Own the Source Code” – Maintaining Vision Center Management Software

    Dr. Shroff’s Charity Eye Hospital was awarded one of the 2021 Technology Call for Ideas awards to develop two pieces of software with a local technology partner – 1. Vision Center Management Software and 2. Door to Door Screening Android app. Both software projects have been successfully launched and continue to evolve through discussions of strategic priorities as well as user feedback, a process common to any institution who decides to create and maintain their own digital tools.

    We had a conversation about maintaining their Vision Center Management Software (VCMS), which is essentially a mini-Electronic Medical Record that includes the following elements:

    • Patient Registration
    • Payment (or Subsidized)
    • Clinical Exam
    • Diagnosis & Advise
    • Teleophthalmology
    • Optical
    • Referrals

    “We have noticed is that once a patient enters into a network, it could be at any level, it could be at the community level, vision center, they want them themselves to be identified at the next level automatically,” notes Dr. Shalinder Sabherwal, Director of Public Health and Projects at SCEH.

    We talked about change management – not just in the launch of the software, but in the continued improvements and upgrades. Security standards change, particularly when handling sensitive personal and payment information. Teams may stumble over workflow challenges that can be corrected by a new drop-down menu. Or teleophthalomlogy or optical modules are added as those programs mature in vision centers.

    So how do you help manage that change?

    • Serve a clear need: Collecting high-quality data gives confidence to the patients, vision center staff and management that quality care is being delivered and improvements are identified.
    • Involve stakeholders: “There were extensive meetings and roundtables and brainstorming along with the people on the ground to actually capture the pain points,”
    • Set a clear schedule: The SCEH team works on a 6 month cycle to review input, discuss priorities and define scope, budget and timeline for new features or updated functionality.
    • Clarify cost of customization: Weighing the budget of new features against their value to the team and sustainability is an important part of the prioritization process.
    • Contract Clarity: Relationships can change over time – people move, priorities shift and there can be unexpected glitches. While this hasn’t happened – and isn’t anticipated – in this project, SCEH ensured they owned all source code and the rights to continue development. So if anything were to change with the technical partner, a new one could be found and work could continue.
  • From Pilot to Progress: How Lumbini Eye Institute Is Scaling EMR with Staff and Patients in Mind

    From Pilot to Progress: How Lumbini Eye Institute Is Scaling EMR with Staff and Patients in Mind

    What does it take to move from a paper-based system to a hospital-wide EMR? At Lumbini Eye Institute and Research Center (LEIRC) in Nepal, it’s not just about technology—it’s about teamwork, thoughtful change management, and putting patient care at the center of every decision.

    Lumbini launched a staged expansion of their EMR system in 2024. Their story offers powerful lessons for other hospitals that already have an EMR in place and are thinking about scaling it further.

    🧠 Key Learnings for Hospitals Considering EMR Expansion

    1. Build buy-in from the ground up.
    Lumbini’s leadership involved staff early—designating internal “super users,” encouraging feedback, and creating a sense of shared ownership. By engaging teams from the start, they created momentum and trust in the process.

    2. Start where it matters.
    Rather than going live across all departments, they prioritized cataract patients—the hospital’s highest volume and most standardized workflow. This approach allowed them to build a strong foundation before expanding into more complex services.

    3. Invest in tools that make EMR easier, not harder.
    From deploying barcodes for smoother patient ID to launching a local server for better stability, the Lumbini team made thoughtful tech decisions to ensure adoption was sustainable—even in areas with limited internet access.

    4. Make data actionable.
    The EMR system now allows Lumbini to track patients across the full continuum of care—from outreach through surgery and follow-up. That means fewer missed visits, better post-op care, and ultimately, better outcomes.

    👏 Key Accomplishments

    If you ask us, Lumbini’s progress is about more than digitization. It’s a story of leadership with vision and service. Here’s what we think deserves special recognition:

    • Change Management Done Right: Staff were trained, encouraged, and given room to lead. The result? High adoption and growing demand to expand the system further.
    • Local Ownership: The hospital made key decisions—from server setup to protocol design—that reflect deep understanding of their own clinical context.
    • Patient-Centered Focus: At every step, the question was “How will this help the patient?” That clarity has guided smarter, more targeted technology use.
    • Sector Leadership: By sharing their journey, Lumbini is helping other hospitals learn, adapt, and accelerate their own EMR progress.

    📈 What’s Next?

    With outpatient services now digitized and follow-up care more consistent, Lumbini is already planning further EMR expansion into surgical workflows and community outreach. They’re also exploring how better data can support hospital management and long-term planning. They’re also tackling back-up servers and focusing on specific departments to move to a fully paperless workflow.

    For other hospitals with an EMR system already in place, Lumbini’s story is a reminder that scaling thoughtfully is just as important as starting boldly. Progress isn’t about pushing faster—it’s about building trust, listening to staff, and always coming back to what matters: better care for every patient.

  • Scaling Digital Impact: Bharatpur Eye Hospital Expands IHMS Across Community Clinics

    Scaling Digital Impact: Bharatpur Eye Hospital Expands IHMS Across Community Clinics

    At Bharatpur Eye Hospital (BEH), technology is more than an upgrade—it’s a commitment to patient-centered care and operational excellence. BEH has embarked on an ambitious plan to expand their Integrated Hospital Management System (IHMS) from four pilot sites to a network of 12 eye care centers. Their experience so far offers practical insights for any clinic or hospital considering a similar step.

    Why Expand IHMS?

    For BEH, visibility into daily operations across its network was limited. Each eye care center operated with different processes for patient intake, billing, referrals, and inventory. By rolling out a unified IHMS platform—Midas software—BEH aimed to:

    • Streamline registration, referrals, and optical/pharmacy sales
    • Enable faster patient visits by eliminating redundant paperwork
    • Ensure continuity of care between community clinics and the base hospital
    • Improve inventory tracking and resource planning
    • Enhance data collection and decision-making at the management level

    Benefits for Patients

    With the IHMS, patients can now experience seamless, coordinated care. A woman needing eyeglasses can visit a community clinic, have her details entered once, and access those records again for future visits—without needing to start from scratch. A man referred for cataract surgery arrives at the base hospital with a barcode and complete referral data already entered, reducing delays and improving the patient experience. Technology is making these journeys faster, smoother, and more respectful of each person’s time and trust.

    Progress So Far

    Two clinics—Parsa and Ratnanagar—have completed full installation, training, and go-live of the IHMS. The implementation team used several smart strategies to support staff:

    • Self-paced video training via an internal intranet portal
    • Real-time help through a dedicated WhatsApp group
    • Daily online Q&A sessions to address issues and share solutions
    • Dashboard monitoring to track progress during training and dummy data entry

    These tools helped create a supportive learning environment, even when clinics were facing high patient loads and limited hardware.

    Challenges and Lessons Learned

    As with any major rollout, BEH encountered real-world challenges that other clinics can learn from:

    • Training Overload: Attempting to train all modules at once overwhelmed staff. The revised approach now introduces modules in phases—starting with registration and billing, followed by pharmacy and optical services.
    • Hardware Delays: Late procurement of computers forced staff to practice on shared devices. Future clinics are encouraged to secure all equipment ahead of training.
    • Network Reliability: Internet disruptions affected system performance. Training staff on backup solutions like SIM card hotspots ensured continued operations.

    What’s Next?

    BEH plans to expand the IHMS to 10 more clinics over the coming months. Each implementation will build on these lessons to make future rollouts smoother and more efficient. A final impact survey will assess improvements in patient satisfaction, wait times, and system usability across all sites.

    For Partners Considering Expansion

    BEH’s journey shows that technology adoption is not just about software—it’s about thoughtful planning, hands-on training, and persistent support. For any partner looking to scale their EMR or IHMS, BEH’s phased approach, real-time communication tools, and early troubleshooting are valuable strategies to consider.

    By learning from BEH, other clinical sites can feel more confident in embracing technology that not only simplifies operations—but delivers measurable improvements for patients and staff alike.