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Putting Care in the Patient’s Hands

Putting Care in the Patient’s Hands

Tablet survey allows for more feedback

Mona Kaleem believes it’s important for doctors to listen to their patients, but because of high demand, many doctors don’t have time to talk to patients enough about their quality of life. Through a new research project, she hopes to get more input from the patient — and in turn, be able to provide more personalized care — before she even says hello.

Kaleem, an associate professor of ophthalmology in the glaucoma division at Wilmer Eye Institute, Johns Hopkins Medicine, and her team — which includes Ecosse Lamoureux and Eva Fenwick from the Singapore Eye Research Institute and adviser Pradeep Ramulu, the Sheila K. West Professor of Ophthalmology at Wilmer and chief of Wilmer’s glaucoma division — are evaluating the feasibility, acceptability and information obtained from the Glaucoma Computerized Adaptive Test, or GlauCAT, a tablet-based survey given to patients with glaucoma prior to seeing a doctor that could measure quality of life factors.

GlauCAT is a computerized survey developed by doctors at the Singapore Eye Research Institute. It curates questions based on a patient’s responses and provides instantaneous feedback, giving relevant information to the health care provider. The tool measures quality of life in up to 12 domains — including visual symptoms, ocular comfort systems, activity limitation, mobility and emotional health — at a single site of care. By asking the patient about each of these categories, it allows the doctor to enter an interaction with a plan of care.

Kaleem says there is no standardized, objective way to benchmark the quality of care provided to glaucoma patients. Depending on the results of her team’s research, GlauCAT could, potentially, fit the bill. “We’re really excited about it,” she says. “We hope it’s going to revolutionize medicine.”

The team started collecting data at Wilmer in September and will continue to do so for about two years. Ultimately, Kaleem hopes to get a sample of hundreds of patients to help gauge GlauCAT’s feasibility. She has already received $50,000 in grant funding and hopes to acquire more funding as the study continues to help fund her work.

The research Kaleem and her team will be doing will target two questions.

First, Kaleem’s team is determining whether GlauCAT would be better administered in the doctor’s office via a tablet, via an in-person interview at the doctor’s office, or at home via a website before a patient arrives at the doctor’s office. If the at-home experience is user-friendly enough, there is potential for the patient to spend less time in the office and for smaller waiting area crowds.

The second question deals with how the survey is personalized for people with varying severity of glaucoma as well as differences in patient demographics, and if the survey can be narrowed down to specific domains.

Kaleem says it’s important to get feedback from patients to eliminate any communication gaps and provide individualized care. “What it all comes down to is making care for patients more focused on what they call patient-related outcome measures,” she says.

A mentor’s inspiration

Kaleem says she was led to GlauCAT by Ramulu, whom she described as one of her mentors in ophthalmology and one of the reasons she joined Wilmer in 2020. It was Ramulu who told the researchers at the Singapore Eye Research Institute about Kaleem’s interest in GlauCAT. “He very much guided everything,” she says.

Kaleem and Ramulu meet weekly to go over data and discuss the progress being made. She calls him a great role model, a mentor and a friend. “I really look up to him and admire him immensely,” she says.

Pradeep Ramulu and Mona KaleemA team led by Mona Kaleem (left) and advised by Pradeep Ramulu (right) is researching the feasibility of the GlauCAT tablet app in patient care.

Ramulu says the GlauCAT project aligns with Kaleem’s philosophy on patient care. “She’s very patient centered, and a big focus of her care and her research is making our efforts and care more patient centered,” he says. “She’s really done a good job with that.”

Exploring the feasibility of GlauCAT is a practical project, Ramulu says, as the responses from the questionnaire can help physicians focus their time on a patient’s needs. “It seems like it’s very theoretical, but it’s actually very pragmatic,” he says. “This is something that if it really goes well — and I think it will — we can all incorporate it into our daily care, and it would be a very, very powerful tool.”

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