As an ophthalmologist, Dr Chan Jan Bond loves experimenting with various features… not of the eye, but on his smartphone.
The specialist has been creating ripples with his numerous innovations in telemedicine, using smartphone technology.
It all started when he was pursuing his masters in 2011 whilst attached to Hospital Selayang in Selangor and Hospital Universiti Sains Malaysia in Kelantan, and had to examine patients in rural areas.
Often, the environment was noisy, and patients, illiterate. The instruments used at the hospitals were also old, and images were not of the highest quality.
Usually, an optometrist or ophthalmologist will take pictures of the eye’s anterior (front) segment using a simple point-and-shoot camera that focuses through a slit lamp eyepiece.
Dr Chan, 35, has innovated this technology by developing a slit lamp camera adaptor that will plug in directly over the eyepiece of a slit lamp. This innovation allows doctors to take videos, which are useful for fundus (the posterior part of the eye) photography.
“This adaptor is important because not every hospital or clinic has a slit lamp with camera. In these hospitals, the slit lamp is unable to take pictures. With this new innovation, any slit lamp can be converted to a full-functional anterior segment camera,” he says.
If the doctor doesn’t have a camera, he or she can also use a smartphone, attach a slit lamp to it and take the picture.
“Pictures are important for ophthalmologists to refer cases to other hospitals, to monitor the progression of a disease, documentation and for medico-legal purposes. The smartphone camera is good because it is cost-efficient, portable and very handy, compared to conventional cameras.
“Any high quality phone camera can do this,” shares Dr Chan.
His second innovation is smartphone videography, a further modification of his first effort. “Most of the surgery-recording systems in general hospitals are too old, non-functioning or non-existent. I wanted to improve the methods available and took a month to come up with the first prototype.”
With the help of the EZcast/AppleTV, the video is wirelessly transferred to an LED te- levision, making this a wireless smartphone video surgery system.
“It is an alternative to the conventional video recording system in the operating theatre. I have also modified it so that it can be used for any type of surgery, including those using microscope or non-microscope (i.e. open surgery, such as open laparotomy, any orthopaedic surgery, ENT surgery, etc),” he elaborates.
“This system is versatile and even easier to use, as the retrieval system of the video is easier compared to the conventional one.”
Videos are an essential component of any surgery, especially for learning purposes – though not everyone records it.
Dr Chan explains, “If anything should go wrong, we want to view back the recording and identify the root cause and areas for improvement. This also comes in handy in the training of junior doctors.
“The videos are not for public viewing unless it is questioned. Prior to every recording, we obtain the patient’s consent.”
For his slit lamp adaptor effort, Dr Chan won the best innovation award by the Health Ministry in 2012.
For his sophomore effort, it clinched him best oral presentation at the Asia Pacific Association of Cataract Refractive Surgery 2015.
Thrilled, the self-confessed techie continues to modify and innovate existing gadgets for the betterment of the medical industry.
Next, Dr Chan created free phone apps. Instead of using the traditional Snellen chart to test visual acuity, he designed the Rapid Eye Screening Test (REST) app, which is freely available for download from Google Playstore and Apple Appstore.
He says, “Vision screening is very important and there are various smartphone apps available in the Google Playstore and Apple Appstore. However, most of the apps are non-standardised in measurement, rendering it inaccurate. I have designed this app for fast screening while still retaining its accuracy. It can be used by doctors, parents or teachers.
“If I’m in a ward and the space is confined, it’s easier to use REST. It is unique because it can be calibrated to match standard charts. It’s fun and relatively easy to use. It will show when the sign is read wrongly. All I’m doing is reading you and swiping the way you’re pointing.”
Another app of Dr Chan’s is the Cataract Screening app, which is still in its conceptual stage, but progressing well. With the camera and flash from a standard smartphone, it creates a red reflex, which helps to classify if the patient has a cataract and grades its severity.
Initially, he started distributing these innovations to friends, and as word spread, a number of local hospitals contacted him to use his technology in their surgeries.
Now, Dr Chan gets tons of enquiries from around the world.
He says, “It takes a lot of time to do these things, but I enjoy it. It is my passion and I want to share my ideas to promote this new era of technology as a substitute for the conventional recording system worldwide.
“This system is unique as it can be used for recording microscope or non-microscope surgeries in rural hospitals with limited resources, or even in a clinic setting. All the gadgets are portable and data can be backed up immediately.
“I’m not seeking publicity or money, or selling any products. I just want to share my ideas globally so that others will be able to benefit from it.”