Ken Lord, MD and Vinay Shah, MD are two of the ophthalmologist founders of Cloud Nine Development. In 2009, they recognized that a mobile app providing eye health and surgery reference content would be valuable to themselves and other eyecare professionals. As a result, they created Eye Handbook for providers, and later, Eye Patient to better meet patient needs. Dr. Lord practices as a vitreoretinal specialist in St. George, Utah and Dr. Shah is a Fellowship Director of Vitreoretinal Service and Clinical Professor and Thelma Gaylord Endowed Chair in Ophthalmology at Dean McGee Eye Institute.
A labor of love
Referring to their efforts as a “labor of love,” Dr. Shah said they’ve been working on their endeavor for about 12 years. He said Eye Handbook was launched first and is a free application available for download on both Apple and Android devices. Describing it as currently “the most popular eyecare app in the world,” Shah said it has an approximately 50/50 distribution between U.S. and international users with about five million downloads.
When asked which functions within the app are accessed most frequently, Shah said the calculators are the most popular, followed by vision screening and then the eye atlas—which is an extensive library of eyecare images and videos that providers can share with their patients. Other popular features include peer-to-peer forums and coding resources.
“So there's a plethora of different tools available to help you in your practice,” Shah said, adding that building such an extensive array of resources has required a great deal of help from others.
“We’ve had a lot of partners over the years who have helped us—given us calculators, given us images. Somebody gave us their whole library of images. It just keeps growing,” he explained. “So we are just the aggregators for your content.”
Plus, they continue to add tools based on the requests they receive from those in the industry—such as an optometrist who recently requested that a contact lens manual be added and another eyecare professional who wanted an ocular trauma score calculator.
For ophthalmologists and optometrists
Dr. Lord said there’s an ongoing flow of work to be done, such as keeping up with requirements from Apple and Google, as well as continual improvements to make the app more user-friendly and to provide relevant content that is “contemporary with what's out there on other platforms.”
He also emphasized that the app is geared toward both ophthalmologists and optometrists, estimating that at least 30 percent of users are the latter.
“Our goal has been to be very neutral in the product and its offering and to appeal to both doctors,” Lord said.
As an example, Shah cited the dry eye center they’re in the process of building, which is “very optometric driven” and is being created with the help of an optometrist.
“We’re trying to make it a very comprehensive area for dry eye,” he explained. “That's one of the next big steps now.”
Lord said that, by design, registration isn’t required to use the majority of the resources. However, it is needed to access some areas of the app, such as the peer-to-peer forums. He also addressed how their free offering receives financial support.
“To get it funded, we seek out pharmaceutical companies that want to use our platform as a medium,” he said. “To get that funding, they want data. They need the metrics. So, we give them as much as we can without [being] intrusive or prohibitive from a user interface standpoint.”
For eyecare patients
When asked about their other app, Eye Patient, Lord said it started about four years ago with a growing understanding of what’s needed in the market by various stakeholders—including patients, providers, and pharmaceutical companies.
“We realized that there was going to be a need for a patient-specific product and platform, not only for doctors to reach their patients, but for companies to reach patients and also for the patients to benefit from,” he explained.
Underscoring all the changes in healthcare over the last 18 months in terms of virtual care and the availability of new and innovative products, Lord said, “We are kind of on that wave, because we knew there was a need for a patient-specific product and came out at the right time with this concept of Eye Patient.”
He also described the “four main thrusts” they wanted the Eye Patient app to fulfill:
- Autonomous vision monitoring: “With the major diseases we have, we needed an inexpensive, efficient way to determine disease progression.”
- Patient education: “If your patients are contemplating surgery, or they need information about dry eye, or a procedure, or medicine, this is a very good resource for them.”
- Treatment adherence: “We wanted to use the technology available to us to get patients to adhere to their treatments and get better outcomes.”
- Physician connection: “We knew that having a relationship with patients results in better [care] outcomes for their diseases. And so a positive patient-physician relationship, not only does it help you on the web, it helps you with their disease regimen or treatment.”
“All those we've kind of packed into the app in different facets. But it seeks to achieve those things,” Lord explained. “So many great innovative products are being developed, and we’re kind of in that trend, trying to develop the same [type of] innovative product that your patients can benefit from.”
In terms of how the Eye Patient app integrates into practice flow and related benefits, Lord said they built the physician interface for Eye Patient within Eye Handbook.
“So if you want to be listed as a doctor in Eye Patient, you register in Eye Handbook and put in your physician information within Eye Handbook,” he said.
Once that’s done, the provider’s information will be listed in the Eye Patient doctor directory and available on the patient’s device.
Lord said that in light of the four needs cited previously, the goal is that “every eye doctor recommends this app for their patients.” When the patient downloads the app and selects their provider, the app then becomes the doctor’s app on the patient's phone.
“So to the patient, Eye Patient looks like their doctor's app on their phone,” he explained. “And that's kind of the goal, that it’s this seamless handshake. That the patient would download the app, they'd select their doctor, and have this connection with their physician, right from the get-go.”
