Ergonomics, Human Factors & Device Agnostic Software in Remote Internet based Optometry

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IbisVision develops software-based products and infrastructure for testing vision. Our equipment and software is normally used by an optometrist in an examination room but during lockdown we responded to the need for socially distanced testing by bringing forward a work programme to develop a remote tele-optometry system.The underlying technology and infrastructure needs to be secure, reliable, clinically validated and with encrypted data and communications handling. Our goal is to enable the optometrist to attend the consultation remotely by engaging in real-time with the patient via the patient's own internet and devices. This approach is innovative and different from most other approaches because others are trying to remove the physical need for an optometrist through the use of computer algorithms. We believe it is important to support optometrists and optometry businesses and also take advantage of all their human skill and training by providing a conduit for them to maintain continuity of care, personal relationships and business development through a mixture of digital and real consultations but always clinician-led with full clinician accountability and a synchronous audio, video and data engagement with the patient- as close as possible to a real examination room experience for both parties.A big challenge and one that has previously been pointed out to us is that to conduct a clinically valid eye examination for any reason one needs to have some means of quality control at the patient (remote) end, over which we have very little control.This application is to understand the factors introducing noise and variability at the remote location looking at:**Suitability of the patient's device and screen.**Variability across a screen (brightness, colour, contrast) may affect the validity of the result. We are developing ways to assess suitability of individual screens remotely and to either work around or compensate for the lack of uniformity.**Ergonomics**It is important that the patient is at the most relaxed and comfortable position relative to their screen and input device. We are developing methods to ensure they are optimally positioned using the limited domestic resources they have to hand, and ensure their movement and fidgeting during the test is minimised.**Human Factors/psychology**We are developing standard operating procedures and scripted instructions to optimise the relationship between the patient and the technology and to help build rapport and cooperation between the optometrist and the patient.**Project output*** A means of working around or compensating for variability in the patient's display device (screen) sufficient to ensure a high probability of a valid result.* A means of ensuring the patient is in the best possible position so they don't move during the test.* Procedures and scripts to conduct the tests in the most engaging and collaborative way to optimise compliance.To help us we will recruit a test population of those who have been introduced to virtual meetings during lockdown but are otherwise not technically minded. We know church and charity groups willing to help and we believe these individuals will be representative of our target demographic.