Members of the global vision community discussed the concept of a shared "vision portal" to meet the needs of eye care professionals. Over 180 individuals from 77 countries registered for the online discussion. Key points from the discussion included: - Recognizing the diversity in users' needs, resources, and contexts around language, internet access, and technology availability. - Building communities of practice would be more effective than content-driven sites alone. - Incentives, standards, local champions, and technology support could encourage participation and sharing of knowledge. - Future iterations of a vision portal could explore creative uses of mobile technology, real-time consultation, and revenue models to expand access and engagement.

1. Jam Analysis Brief
Part 1 of 2
Presented by
Knowledge in the Public Interest
This work is licensed under a Creative Commons Attribution 4.0 International License.

2. “
Imagine a world where a Vision Portal support(s)
open-source, device-independent capture,
transmission and advice from global VF.
!
J. Scollard

3. 183
Individuals
Registered
Members of the global vision community came together for a Jam
on the concept of a shared “vision portal.” The object was to
discuss the role such a portal might play and how it might be
structured if it were to meet the needs of a broad and diverse
community of potential users.
73
registered in advance
112
registered on the day

4. Registrants came from
77
Countries
Top 5 Countries
USA, Ethiopia, India, Bangladesh, China

5. 32
1
people posted in the Jam
1 1
1
1
1
11
5
1
1
3
1 1
1
1
2
US 11
China 5
Ethiopia 3
South Africa 2
Bangladesh 1
Canada 1
Ecuador 1
Germany 1
Ghana 1
India 1
Ireland 1
Mongolia 1
Nigeria 1
Palau 1
Switzerland 1
United Kingdom 1

6. Who Participated?
Most Jam posters are associated with ORBIS International as program
managers or consultants/doctors. Those not associated with Orbis
are heads of programs, medical institutions and companies.
23
2
5
1
1
ORBIS
Private Company
Hospital / Eye care clinic
University
Other

7. The concept of a global vision portal that
supports all eye care professionals is both
tantalizing and overwhelming.
•
How to serve all of the different roles in the field?
•
How to respond to those with robust and affordable internet access and those without?
•
How to be a trusted resource in a “real time” environment?
•
How to serve the global eye care field but respond to local needs in terms of language,
context and timeliness?
Jam participants acknowledged these concerns while embracing the goal of a
global vision portal and charting a potential path towards realizing it.

8. A shared vision of a shared vision portal

9. Begin by thinking broadly about the potential
audience of users of a vision portal
“
…A global portal should have wide()
coverage -include paramedics, managers
and other eye health/development
professionals globally and have relevant
content to serve them. I feel such a
global portal should be open to all and
encompass as many healthcare
providers as possible to help them serve
their communities better.
!
M.Kumar

10. Avoid duplicating what others are doing. Learn
from the best of their techniques but do not
compete by providing similar training or content.
“
(A vision portal) should
complement what's already
out there and not become
redundant. I think maintaining
the quality of and confidence
in information is a really
important part of this.
!
M.Hanbidge
“
Maintaining controls is a huge
challenge on the web. There
must be other sectors who
have dealt with these
challenges and maybe we in
eye care should look at their
successes etc.
!
K.Naidoo
“
e-learning tools are being
developed by several
institutions… as (they) can
cover many regions, including
rural participants… and that
has lower cost involved.
!
N.Awal

11. Recognize the reality (limits) of internet access,
hardware availability and language proficiency
on the ground today and respond to it
– but, also recognize that the landscape is shifting rapidly
and it will be important to be agile as opportunities and
expectations change.
“
I had a conversation with 2
gents from COECSA
yesterday who reported that
mobile internet in Kenya
(well, Nairobi...) is now faster
than they experience when
traveling to the UK or US as a
result of the new east Africa
undersea fibre optic
connection.
!
J. Scollard
“
In the Indian context, real
time would be the best
solution with the advanced
IT infra available. With the
advancements available in
country, people expect quick
answers.
!
“
“
Recently in Ethiopia we used
cell phone technology to
gather and transmit data to a
central location.
!
Alexmita
!
M. Kumar
I have seen some of our
partners in Zambia, with
reference material on their
tablets, on their person while
doing clinics.
!
P.Ramson
!
“
(For) a global vision portal,
important points are
usability; especially in crosscultural and multi-lingual
contexts, and importantly,
balancing usability and
attractiveness with
accessibility for everyone.
!
N.Awal

12. If the goal of the portal is leverage – effectively
supporting as many professionals as possible as they
work to deliver care to as many people as possible
- then a broad view of “tele-medicine professional
development” may be the most compelling design frame.
“
Telemedicine can mean many things. It can
mean virtual surgical demonstration, where
we broadcast surgeries live with audio
communication. It could be virtual grand
rounds, or flipping demonstration on its
head and having a mentor watch as a
trainee is performing surgery thousands of
miles away and offering support during a
case. It can also mean telemedicine in the
traditional sense, instant consultation.
!
J. Brown

13. Content-driven sites have proven to be
underutilized in the web environment. Building
vibrant communities of practice is a more fruitful
way to begin and to “drive usage.”
“
Great content (is terrific).
But, it is a PUSH approach.
Today, website and learning
platforms are more
collaborative - sharing
oriented.
!
K.Youngstein

14. Identifying a group of local champions in a particular role (nurses
or bio-meds for example) and giving them the forum and
structure to discuss issues of shared interest can create
connection and trust, allow for peer learning and the targeted
inclusion of experts on particular issues. Content is identified in
response to questions and issues and linked to users.
“
I think the first thing we need is a clear
champion for a community - someone for
ophthalmic nursing, someone for biomed, etc. from there we can build content and
engagement strategies. If we had a handful of
really engaged leaders for certain professions we
could set them up as community leaders on the
vision portal - they could moderate, advise etc.
There may also be some geographic affinity - it
might be interesting to have a nursing lead for
India, one for Africa or southern Africa', etc.
!
J.Scollard

15. Surround a group of active communities with vetted
resources, structured training options and use
technology creatively to demonstrate or model,
observe and give feedback.
“
The "Army Knowledge Online
(AKO) electronic e-mail system
has a “tele-consultation service"
that uses both clinical
champions and project
managers for quality assurance
and to ensure that responses are
timely. It could be interesting to
explore their methods further.
!
A.Chamberlain
“
In the CREST project in China,
we now have cameras in all ten
rural centers connected with
our Grading Center at ZOC, and
also have an electronic medical
record system which connects
all the centers. We have used
photos from this system for
HBPs. We also have an
automated SMS system which,
sends reminders to patients 1
day and 1 week prior to their
appointments. In the future, will
also send them health care
messaging in this way. 95%+ of
our patients have cell phones,
and in pilot testing we found
this system tripled long-term
follow-up.
!
N.Congdon
“
Today, website and learning
platforms are more collaborative
- sharing oriented. I propose
that, along side formal high level
content, there is a platform for
users to share videos, images,
information. It is key that each
user retains ownership of the
content - like YouTube. Giving
up ownership is often a barrier
to sharing. This less formal
approach will result in local
language content being
uploaded.
!
K Youngstein
“
In the private sector the
program "Second life" is being
used to create virtual training
centers that are accessed by
employees all over the world –
(and) not just restricted to those
with special knowledge of
computer technology and
software.
!
A.Chamberlain

16. Consider incentives for participation in formal
training and accessing portal content
“
(It is important to provide)
local credit that speaks to
country or sub-regional
accreditation standards or
CPD points.
!
C.Robinson
“
(I agree that) monetary
incentives need careful
consideration - but if you are
a poor medical student in a
developing country, the cost
of accessing our content may
be a barrier to uptake
!
J.Scollard
“
A way of incentivising would
be to make (portal
participants) members of an
elite club of some kind,
which would allow them to
share/exchange ideas with
the big-wigs of eye care,
business, etc.... some kind of
special privilege. (Or give the)
gift of a book of choice, one
year free subscription to
some portal, journals, attend
conferences...If we can
decipher the value add that
the user is looking for it can
be done and it is only an
operational matter.
!
M.Kumar

17. Supplement asynchronous consultation
with creative real time inputs.
Think “mobile”
“
What if the forum for such a realtime consultation were to be text/
image based? Or maybe, further
down the line, what if a virtual "call
center" group were formed with
approved mentors, etc. where
mentors had designated "office
hours"? That way no matter what
time you login and seek
consultation, someone is there to
answer? The time for a resource/
technology like that might not be so
far off. It exists for so many other
private-sector organizations…Real
time consultation could work on a
local level where schedules and time
zones might be more synchronized.
This would be an interesting
development of a regionalized
approach.
!
D. Neely
“
“
“
“
If we can provide a smart phone
platform to users it will increase the
rate of using online resources.
Most doctors in Mongolia use smart
phones.
!
C.Chuluunkhuu
Q.Lu
Young generation (in China), whether
they are living in rural or urban, are
using smart phones. (They use a)
domestic brand, cheap and reliable,
about 100usd, android system.
!
P.Xu
!
Doctors rarely have time to sit at a
computer or laptop, but mobile
makes access easier.
!
P. Ramson

18. Consider a revenue model – perhaps a combination of
ophthalmic company ads and global NGO contributions.
“
I would think that ophthalmic
companies would jump at the
chance to have inexpensive
ads that reach a global
audience of users.
!
D.Neely
“
I think a direct revenue model
would be difficult in
developing countries - both
because of the cost and also
logistics (how would revenue
be collected where credit
cards or services like Paypal
don't exist?). I think the idea of
the portal partners bearing
some responsibility warrants
discussion - if it removes a
barrier to access and there is a
return on investment I think it
is feasible.
!
J.Scollard

19. Work towards standards and protocols for
participation and contributions. Match to
metrics to assess the value of the portal.
“
…An open group forum would of course still need to
have regulations, standards and procedures. It would
not make sense to allow just anyone to give advice on
such a forum. But perhaps making (a) case more open
would allow for more collaboration and a better
response on a more global scale than a closed, private
exchange in a singular organization. I think standards
and protocols should be developed in tandem to a
global vision portal. In my mind assessing needs goes
hand in hand with assessing standards.
!
J.Daguna

20. Pair community champions with local/regional
project management and technology support.
“
The article about the use of IT/TeleHealth in the US
Army speaks of the use of dedicated management/
managers for IT/Telehealth. In Africa we have
Childhood Blindness and Low Vision Coordinators
attached to partner hospitals. Apart from their regular
work, they can be supported to take on some IT duties
if needed. Also, having that good relationship with local
Government one can engage them on trying to find HR
to assist.
!
P.Ramson

21. What an amazing rich discussion we've had over these past 7 hours. Our goal was to
hear from the field, what is needed in an online tool. We wanted to answer the
question- how can we build on our past success, expand our user base, engage a
broader community and provide a tool that allows them to engage one another. We
wanted to know whether this was useful and something those in the field were
interested. Now that we understand your global perspective on experiences and
challenges, I hope to share this with our global ophthalmic community and rally the
group to develop a Vision Portal that will offer high quality content, mentor ship and
build community within ophthalmology and all its associated clinical disciplines.
!
J.Brown

22. For questions about this Brief or the Vision Portal Jam please contact
Susan Restler srestler@kpublic.com
Presented by
Knowledge in the Public Interest
This work is licensed under a Creative Commons Attribution 4.0 International License.