Exploring Technology to Increase Eye Donation in India
Each year, SightLife and our partners across India come together to celebrate National Eye Donation Fortnight (August 25 to September 8) and highlight opportunities for expanding eye donation’s impact, including policy actions that bolster the country’s eye donation system.
The COVID-19 pandemic has significantly impacted cornea donation in India, with some regions experiencing reductions by more than 80%. Much like the U.S., the Indian health care system has been stretched thin by the pandemic and eye banks are no exception. In addition to investing time and money into the requisite safety measures, many were temporarily transformed into care wards during the country’s recent second wave.
This, in combination with India’s consistently low rate of death notification of potential donors to eye banks, further underscores the need to establish a national mandatory death notification process. When hospitals, mortuaries, or other partners in donation are required to notify their local eye bank about a recently deceased individual who is eligible for donation, it helps expedite a process that bolsters the success of sight-restoring transplants for patients suffering from corneal blindness. Until this is rate is improved, nearly 70% of potential eye donations are missed, leaving thousands of men, women, and children waiting for the sight-restoring transplant(s) they need to thrive – and communities need to prosper.
To strengthen the case for mandatory death notification, SightLife in collaboration with our hospital and eye bank partners, recently launched two separate pilots to assess the potential of low-cost, user-friendly cell phone technology applications – specifically, WhatsApp and a custom QR Code. The goal of these pilots is to build on the success of local process improvements and demonstrate a connection between timely death notifications and an increase in cornea donation.
Identifying and Scaling Promising, Cost-Effective Technology
A range of local efforts are already making an impact, including the All-India Institute of Medical Science (AIIMS) in New Delhi, which uses a custom hospital-level software – the National Death Registry of India (NDRI) – to notify the National Eye Bank (NEB) of deaths within the hospital. Unfortunately, this software is not licensed for outside use. Another hospital-based software, E-hospital, shows promise but will require significant time and investment by hospitals and other partners to ensure broad adoption and standardization.
To leapfrog these barriers, SightLife and KGMU UP Community Eye Bank, Lucknow, are working with KGMU Hospital to assess the feasibility of WhatsApp to facilitate the rapid, real-time notification of potential donors and enable the timely recovery of corneas by local eye banks. WhatsApp is a mobile-based texting application that is widely used in India. Its functionality also provides hospital staff the opportunity to share motivational donation stories, conduct primary screenings of the deceased, and ensure a quick resolution of issues.
The second pilot we are seeking to launch explores QR Codes – specifically, how displaying them in prominent areas of a hospital might bolster staff usage, and moreover, their rapid communication with the local eye bank. In contrast to WhatsApp, the QR Code helps hospital staff access and submit a basic notification form, helping eye banks quickly deploy eye recovery technicians at the right time and place. In addition, the data auto-populate into a backend system that can be monitored and analyzed by eye bank administrators.
Bolstering the Evidence Base for Policy Change
Each pilot is set to continue for 3-4 months, after which we will review and discuss our findings with local and national government authorities. Early evidence, however, has already demonstrated that rapid death notification policies and procedures are key to increasing donor volumes and helping eye banks ensure no one waits for the corneal transplant they need to thrive.
SightLife will continue to strengthen the case for mandatory death notification – and we are hopeful these programs will further demonstrate the connection between consistent, timely notification and cornea donation. As India navigates a dramatic decrease in eye donation during the pandemic, it is even more imperative that policies are put in place to help reverse this trend.
Doing so will also ensure eye banks can meet the growing demand for corneal transplants, especially given the backlog of transplant surgeries due to COVID-19. Doing so will also help ensure an exponential number of people can to school and work, which helps themselves, their families, and their communities to thrive.
If you have any questions about our pilot programs or the benefits of mandatory death notification, please email us at lorraine.misquith@sightlife.org.