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Background: At present minimum nursing staff numbers have been defined and are being implemented. In December 2019 the German Medical Association asked the German professional associations about their general experience with planning of medical personnel in hospital departments. As no structured data were available on this subject, the German Ophthalmological Society (DOG) founded a working group in March 2020 to answer this request., Method: In the course of several consensus meetings, the working group on personnel planning for physicians in hospitals of the DOG prepared a questionnaire on previous experiences in personnel planning of eye hospitals, which was sent to the heads of all university eye hospitals and departments of ophthalmology in Germany. The questionnaire consisted of individual items with fixed choices and free answers regarding the procedure and current situation of staffing as well as the range of tasks and organization of the medical service., Results: Out of 104 departments 53 (51%) responded, of which 25 were from university departments (64% response), 23 from departments of other public or non-profit ownership (46%) and 5 from departments with private hospital ownership (33%). Of these 49% stated that there was no transparent basis for calculation of the number of medical positions in their hospital. Of the surveyed departments, outpatient tasks, services and revenues were considered in the calculations in only 47%. There was a statistically significant higher ratio of full-time personnel to the numbers of beds in university departments compared to private and publicly owned non-profit institutions (p < 0.001, t‑test). All departments have to cope with multiple additional tasks in addition to clinical patient care, which are taken into account only to a limited extent in the staffing. Approximately 70% of the departments provide a 24 h/7 day (24/7) medical on-call service on site, 91% have a 24/7 surgery on-call service and 34% have a cooperation with emergency services run by the Association of Statutory Health Insurance Physicians., Conclusion: The results show how heterogeneously and nontransparent German departments of ophthalmology are staffed in terms of medical doctors. On average, university departments have higher personnel resources per hospital bed to cope with additional tasks in research and teaching. Outpatient tasks, which contribute significantly to the revenues of an eye department, and multiple other tasks are often not taken into account in the personnel calculation. A transparent and uniform basis for calculation of the medical staff of the departments is desirable in order to achieve a sufficient personnel staffing for a patient and employee-oriented working environment.

Background: The implementation of an electronic patient health record (EHR) system in the field of ophthalmology can be a challenging project for many hospitals. Although all hospitals have a hospital information systems (HIS), these systems are often not capable of managing the complexity of ophthalmological patient records., Methods: This article reports the implementation of an ophthalmological EHR into the pre-existing HIS (Agfa-ORBIS; Agfa HealthCare GmbH, Bonn, Germany). The digital record management and the connections to the peripheral examination devices are presented., Results: The EHR developed by us has been in clinical use since 2009 and is subject to continuous further development. Through close cooperation with the IT department, all examination devices could be digitally connected, enabling paperless work and avoiding the drawbacks of paper files., Discussion: The advantages of an EHR implemented into the existing HIS are manifold. Through such a system a complete, interdisciplinary and ubiquitous documentation can take place. The alternative is the acquisition of a third system, which must be connected by an interface with the main system and has significantly higher acquisition and maintenance costs.

Background: For more than 60 years patient records of the Department of Ophthalmology at the Saarland Medical Center in Homburg were documented on handwritten paper documents and filed in archives. Increasing requirements for medical documentation, exploding volumes of diagnostic data, overcrowded archives and unavailable files when needed, were the essential rationales for the implementation of an electronic patient archive (EPA)., Methods: The EPA has been specifically adapted to the requirements of the Department of Ophthalmology in order to guarantee a standardized unobstructed documentation and patient care across all sections of the department. Seamless integration into the clinic information system (KIS) and network-compatible diagnostic software were essential as well as a timely digitization of existing paper charts. Decisive factors for using FIDUS (Arztservice Wente GmbH, Darmstadt, Germany) as the EPA software were the visual layout of the EPA, user friendliness and reference installations of the software in other ophthalmology departments., Results: After one and a half years of meticulous preparation with specific adaptations to the requirements of our department, the EPA was finally implemented in January 2016 and since then we have been working on improvements. The EPA software retrieves basic patient data from the KIS and diagnostic data from electronic devices via various interfaces. Expenses for printers could be reduced but computer workplaces had to be expanded or newly created. For previous patients paper files are digitized externally and stored in an electronic archive directly accessible from the EPA., Discussion: Successful reorganization and implementation of electronic documentation during clinical routine is feasible with careful preparation and timely involvement of information technology experts, motivated physicians, nurses, research departments and the administration.

Background: The Homburger Curriculum was introduced in 2012 to enhance the medical resident education and professional satisfaction. At the same time different steps were taken to encourage applications of eligible candidates., Methods: To address candidates, the Homburger Curriculum is presented on the department's website and a short-term hospitation was introduced. The curriculum has been divided into time slots of 4 months throughout the 5 years of residency. In addition, a booklet of documented evidence of the rotations and a Resident's Compendium were introduced. Internal and external teaching programs, additional research projects and involvement of the residents in the organization of their curriculum were introduced. The paper describes the rationale behind the new structure of the curriculum and its practical outcomes for the department (e. g. a regular standby resident to fill in unexpected gaps)., Results: It is discussed in detail which steps were easy to implement and which steps were more difficult to introduce. After consolidation of the numerous steps, the number of resigning residents dropped significantly and the number of applicants increased., Conclusions: The new rotation schedule guarantees every young resident to be able to work at each work area of the Department of Ophthalmology. External training courses can be planned suitable to his/her rotations. An "internal competition" for popular rotations is no longer necessary. Clear organization and transparency in all areas provide good interpersonal climate in which much work still has to be done, but by motivated and satisfied residents.

Background: Eye diseases that are relevant regarding their macroeconomic costs and their impact on society include cataract, diabetic retinopathy, age-related maculopathy, glaucoma and refractive errors., Objectives: The aim of this article is to provide a comprehensive overview of direct and indirect costs for major eye disease categories for Germany, based on existing literature and data sources., Methods: A semi-structured literature search was performed in the databases Medline and Embase and in the search machine Google for relevant original papers and reviews on costs of eye diseases with relevance for or transferability to Germany (last research date October 2013). In addition, manual searching was performed in important national databases and information sources, such as the Federal Office of Statistics and scientific societies., Results: The direct costs for these diseases add up to approximately 2.6 billion Euros yearly for the Federal Republic of Germany, including out of the pocket payments from patients but excluding optical aids (e.g. glasses). In addition to those direct costs there are also indirect costs which are caused e.g. by loss of employment or productivity or by a reduction in health-related quality of life. These indirect costs can only be roughly estimated. Including the indirect costs for the eye diseases investigated, a total yearly macroeconomic cost ranging between 4 and 12 billion Euros is estimated for Germany., Conclusion: The costs for the eye diseases cataract, diabetic retinopathy, age-related maculopathy, glaucoma and refractive errors have a macroeconomic relevant dimension. Based on the predicted demographic changes with an ageing society an increase of the prevalence and thus also an increase of costs for eye diseases is expected in the future.

This review is intended to give supportive information for beginners in contact lens fitting who are interested in providing a quality-related service to customers and patients. In Germany the proportion of contact lens wearers is significantly lower than in most other countries; therefore, there is a potentially fast growing market. The aim of this paper is to provide comprehensive guidelines for practitioners to develop and improve contact lens fitting practice and minimize unnecessary or preventable complications. The fundamental requirement for starting in contact lens fitting is to have correct education in the field and for the practice to be appropriately equipped. The key to providing a safe a reliable contact lens fitting practice is to continually update knowledge in the field and to maintain the practice to the highest professional standards.

Electronic storage of patient-related data will replace paper-based patient records in the near future. Because of the high visualization needed in ophthalmology integrated electronic data storage and usage will be very useful. Chronic diseases like glaucoma, macular degeneration and diabetic retinopathy would benefit from long-term data storage and analysis. Unfortunately there are nearly no widely accepted systems available providing these options. Another important point is the simplification of existing diagnostic procedures and nomenclature on an international level. Increasing mobility of patients requires a better portability of existing medical examination data between different physicians. This is the only way to provide continuously high levels of quality in patient care and to simultaneously reduce costs and prevent unnecessary secondary examinations.

Electronic storage of patient-related data will replace paper-based patient records in the near future. Some steps in medical practice can even now not be achieved without electronic data processing. Both systems, conventional paper-based and electronic-based records, have advantages and disadvantages which have to be taken into consideration. The advantages of electronic-based records are e.g. good availability of data, structured storage of data, scientific analysis of long-term data and possible data exchange with colleagues in the context of teleconsultation systems. Problems have to be solved in the field of data security, initial high investment costs and time consumption in learning to use the system as well as in incompatibility of existing IT systems.

Background: The electronic or paper-based patient record is the most important documentation file. The electronic patient record has many advantages compared to a paper-based record., Methods: An example of an electronic patient record (EPR) system accessed by several departments of the Faculty of Medicine of Magdeburg is presented., Results: To guarantee faculty-wide communication with sharing of clinical pictures and findings, e.g., with the Departments of Radiology and Pathology, the system of MEDOS Inc. is used in our department. Several examination devices, for example fundus camera, slit lamp, and ultrasound, are equipped with an digital picture storage and communication system via a DICOM interface to the MEDOS system. The software AnalySIS is used as a gateway for picture transferation. The MEDOS system also supports the clinical workflow., Conclusions: The use of an electronic patient record system in ophthalmology is already possible, but still needs further tuning and improvement.