Background: Teleophthalmology services are considered capable of supporting screening, early diagnosis, and monitoring of leading causes of blindness on a global scale. Therefore, standards and best practices are needed to seamlessly exchange medical ocular images and related data among relevant stakeholders with maximum interoperability. Objectives: This paper provides an overview of current standards in the field of store-and-forward teleophthalmology data exchange and further developments in this area. Methods: A literature review was conducted for healthcare standards with a focus on data exchange in ophthalmology. Results: IHE, HL7 FHIR, DICOM, and clinical terminologies are considered the most important standards, providing distinct concepts, solutions, and guidelines for ophthalmology. Conclusion: Available standards provide the necessary base for teleophthalmology on technical and semantic interoperability, but practical use is limited due to missing process interoperability resulting in proprietary interfaces of vendors and rejection by ophthalmologists. Further investigations should analyze processual needs on ophthalmology data exchange standards.

Background: The integration of innovative imaging technologies into clinical workflows requires the utilization of a standardized data exchange format. The “Digital Imaging and Communications in Medicine” (DICOM) standard is widely used in healthcare to process and transfer medical images. However, no simulation environment is ready to use for development. The objective of this paper is to provide an open-source DICOM platform for integrating a novel ocular photography system into a clinical setting. Methods: After a thorough analysis of the available open-source tools, a subset was selected and aligned with the U-Eyecare Profile of Integrating the Healthcare Enterprise (IHE). Results: Orthanc served as a PACS with a modality worklist and the OHIF-Viewer for image retrieval. Minimal interfaces for the electronic health record and image modality were created. Docker-compose further integrates all components and simulates the network protocols DICOM Message Service Element and DICOMWeb. Discussion: The platform was used to develop and integrate the developed image modality and will be further utilized for teleophthalmology and processing eye images. The platform could be useful for other researchers to integrate an image modality into a clinical environment along IHE.

<b>Hintergrund:</b> Teleophthalmologische Dienstleistungen gelten als geeignet, das Screening, die Frühdiagnose und die Überwachung der wichtigsten Erblindungsursachen auf globaler Ebene zu unterstützen. Hierfür werden Standards und bewährte Verfahren benötigt, um medizinische Augenbilder und zugehörige Daten nahtlos und mit maximaler Interoperabilität zwischen den relevanten Akteuren im Gesundheitswesen auszutauschen. <b>Zielsetzungen:</b> Die vorliegende Arbeit gibt einen Überblick über die aktuellen Standards im Bereich des Store-and-Forward-Datenaustauschs in der Teleophthalmologie und erläutert weitere Entwicklungen in diesem Bereich. <b>Methoden:</b> Es wurde eine Literaturrecherche zu Gesundheitsstandards mit Schwerpunkt auf dem Datenaustausch in der Augenheilkunde durchgeführt. <b>Ergebnisse:</b> IHE, HL7 FHIR, DICOM sowie klinische Terminologien gelten als die wichtigsten Standards und bieten unterschiedliche Konzepte, Lösungen und Richtlinien für die Augenheilkunde. <b>Schlussfolgerung:</b> Die verfügbaren Standards bilden die notwendige Grundlage für die technische und semantische Interoperabilität in der Teleophthalmologie. Dennoch ist die praktische Anwendung aufgrund fehlender Prozessinteroperabilität nur bedingt möglich. Dies zeigt sich in den häufig herstellerspezifischen Schnittstellen der Soft- und Hardwareanbieter und in weiterer Folge auch in der Ablehnung der Technologie bei den Augenärzten. Weitere Untersuchungen sollten den prozessbezogenen Bedarf an Standards für den Datenaustausch in der Augenheilkunde analysieren.

Data-driven decision-making in health care is becoming increasingly important in daily clinical use. A data warehouse, storing all the clinically relevant information in a highly structured way, is a primary basis for achieving this goal. We are developing a clinical data warehouse where more than 20 years of clinical data can be persisted, and newly generated data from different sources can be integrated. A back room was created to store all hospital information system data in a PostgreSQL database. Due to the enormous number of diverse forms in the hospital information system, a broker service was developed that integrates the individual data sources into the data warehouse as soon as they are released for storage. The front room represents the interface from the infrastructure to the targeted analysis. Database query and visualization tools or business intelligence tools can display and analyze processed and interleaved data. In all areas of business and medicine, structured and quality-adjusted data is of major importance. With the help of a clinical data warehouse system, it is possible to perform patient-centered analyses and thus realize optimal therapy. Furthermore, it is possible to provide staff and management with dashboards for control purposes.