End-to-End Impact of a Cloud-Based Surgical Planning System on Efficiency in Cataract Surgery: A Time-and-Motion Study.

Abstract

Inefficiencies from manual data entry and non-integration exist throughout the cataract surgery workflow. The aim of this study was to evaluate the impact of SMARTCataract, an innovative cloud-based digital surgical planning platform (SPS) on efficiency in preoperative (diagnostic workup, surgery planning), intraoperative, and postoperative phases of cataract surgery. The primary objective aimed to assess time and number of manual transcription data points (TPs) required for all pre-, intra-, and postoperative devices that integrate with the SPS and surgery planning time across three patient types (post-refractive, astigmatic, conventional). The secondary objective aimed to assess the overall efficiency impact of the SPS on the surgery workflow for the three patient types by leveraging time-and-motion methods and workflow mapping. This prospective, observational, real-world, pre- and post-cohort time-and-motion study included patients undergoing evaluation for cataract surgery and/or surgery at the study site. Assessed variables included time and TPs required for clinical activities and devices associated with traditional manual methods (pre-cohort) versus the SPS (post-cohort). Statistical analyses (t-test) were performed comparing performance time using the SPS versus traditional methods for each integrated technology and surgery planning activity. The SPS demonstrated statistically significant time savings over traditional methods in TP data input time taken across all integrated pre-, intra-, and postoperative devices (p<0.0001). The SPS additionally demonstrated statistically significant time savings in preoperative surgery planning across post-refractive (p<0.0001), astigmatic (p=0.0005), and conventional (p=0.0004) cataract patient groups. Overall, the SPS reduced end-to-end patient workflow time and TPs for post-refractive, astigmatic, and conventional cataract patients by averages of 13.2, 12.6, and 4.3 minutes and 184, 166, and 25 TPs per patient, respectively. Through the SPS' integration and surgery planning capabilities, substantial time efficiencies can be achieved for cataract surgery practices, clinicians, and patients compared to surgery planning with traditional manual methods.