Telemedicine is “the future” says Orbis Cybersight founder Dr. Gene Helveston

Way back in 1998, Dr. Eugene Helveston, then part of our Volunteer Faculty, created the first ever internet-based ophthalmic telemedicine program. Five years later Cybersight paved the way for landmark changes in ophthalmic education.

Cybersight is Orbis’s award winning online training and education tool. In a nutshell, it improves the consistency, quality and efficiency of training for individuals and eye care teams around the world. Cybersight allows medical professionals to access training and education tools, long-distance mentoring and online courses and lectures anywhere, anytime – from a laptop, tablet, or mobile phone.

It means our team of 400 world-leading Volunteer Faculty can deliver training and consultations without having to leave their home. Under normal circumstances this is incredibly efficient, under the current circumstances it is critical.

Cybersight had a very strong 2019, but it is in 2020 that the platform is really coming into its own. It is breaking records week-after-week with webinar attendance (at the time of writing, 1,352 attendees stands as the record for a single webinar, four times the pre-lockdown record) and has recently passed the cumulative mark of 20,000 registered users.

Building on Dr. Helveston's persistence at the start, Cybersight is in a great position to continue our mission to prevent and treat avoidable blindness in a safe, socially responsible way. As habits and behavior continue to change, and we all learn new ways of adapting and working, the prediction is that Cybersight will grow even further in the second half of 2020.

Dr. Helveston told us earlier this year “The digital age has caused the world to shrink while allowing individual productivity to grow exponentially. Cybersight caught that wave early, grew rapidly, and continues to explore new horizons after two decades.”

We caught up with Dr. Helveston again, virtually, from his apartment in Indiana where he’s spending his lockdown, to dig a little into the story behind Cybersight and get his thoughts on its future.

“Telemedicine is now the word on everyone’s lips. The ground is fertile for Cybersight to grow capacity and innovate further. Behavior is changing and there are new frontiers to be explored” Dr. Helveston told us.

With international travel suffering restrictions that could last for years, Cybersight can plug that gap and prove a vital resource for the future of eye health. While its future is looking fascinating, its past is perhaps just as interesting.

In 1998 Dr. Helveston was on a program visit to Havana, Cuba. He was disheartened by the quality of the facilities at our partner hospital despite it being rated the best in the country.

“The equipment I saw in the operating rooms in Cuba was in disrepair and some looked like of it hadn’t been used in years. This equipment was no doubt a gift from Cuba’s Russian patrons and delivered more than a decade before. Some equipment was useless now because nobody knew what to do with it. The doctors were hard working and sincere and the patients were deserving of our best”

Dr. Helveston, concerned about the needs of the patients, decided to postpone all planned surgeries until he was able to return with better equipment.

At the second visit he brought with him suitable equipment and medicines and helped oversee the surgeries. Despite the difficulties he faced in getting the equipment to Cuba, Dr. Helveston was undeterred and wanted to help further. He realized it wasn’t enough to drop in and fly out again, these committed doctors needed ongoing support.

Dr. Helveston had, in fact, been experimenting with remote consultations and photography diagnoses since 1988 and was already convinced that technology could help improve ophthalmic training and education. So, on his third trip to Havana he took with him a computer, monitor and printer and two digital cameras and a haul of medical supplies.

Accompanying Dr. Helveston on this voyage was Orbis’s then-Vice President of Program & Operations, Jilly Stephens, who predicted “implementing this type of program in Cuba may serve as a pilot for other programs worldwide”. Dr Helveston had an important ally and friend in his endeavors.

They set about training their local colleagues with digital imagery and clinical history recording. This would allow them to email cases to Dr. Helveston at his home in Indianapolis. From there he could send back, via email, a diagnosis, or recommendation for further tests and re-submission, or a suggested treatment plan. In doing so, ORBIS’s first ophthalmic telemedicine system was born.

During fourth visit to Cuba. Dr. Helveston was able to prove that the telemedicine diagnosis was just as effective as in-person. Based on this experience he designed a working telemedicine consultation program connecting Havana and Indianapolis, and started rolling this out in Romania, Albania, Bulgaria, and the Dominican Republic.

These early telementoring with Cybersight lasted over a decade. helping hundreds of patients and advanced the careers of young doctors whose opportunities would likely have remained limited without Cybersight.

Thanks to Dr. Helveston’s commitment, perseverance and foresight telemedicine was becoming a credible learning tool. These early activities were privately funded and involved days of travel and red tape, to get medical and computer equipment into some of the most secretive countries in the world.

Two decades ago Dr. Helveston was sharing the exciting news with peers and colleagues: “In April 2000 we presented our initial results with Cybersight at the annual meeting of the American Association for Pediatric Ophthalmology and Strabismus, San Diego, California, April 12-16, 2000 in a paper titled: “E-consultation for Strabismus” with Dr. Faruk Orge and our Cuban colleagues, he told us.

The medical world was beginning to take note, but there were still many obstacles to overcome to turn this vision into a reality. Unlike Dr. Helveston, many of his peers were unable to anticipate the internet boom and the dawn of the digital age. At that time, many of Orbis’s resources were being directed into the Flying Eye Hospital - it was clear to Dr. Helveston if this would be a success, he would have to be very resourceful.

He was not to be stopped. He found help from the Bryson Family Foundation, Canadian International Development Agency, and Al Ueltschi, one of the Orbis founders who had made his name in flight simulation and was keen to help pioneer similar innovation in eye care. On the back of this Dr. Helveston recruited an initial Volunteer Faculty of 20 to answer consultations and promote Cybersight through Flying Eye Hospital and local country programs.

“I knew telehealth would be the future and wanted to write it into all the work that Orbis did. Virtual relationships would expand the scope of teaching and training in eye care and I’m happy to say I did all I could, and the current team at Orbis are doing all they can, to help meet the needs of medical professionals and society in general. There is nothing but a great future for Cybersight.”

After launching the website in 2003, Cybersight experienced steady growth in the first decade under Dr. Helveston’s stewardship. By the time he retired in 2012, handing the reins over to his protégé Dr. Dan Neely, there had been over 12,000 online consultations and Cybersight had won the highest award of the American Telemedicine Association President’s Award for Health Delivery, Quality and Transformation.

Dr. Helveston and Cybersight were ahead of their time and needed to wait for technology to catch up. By the mid-teen’s smartphones, laptops and tablets were ubiquitous, even in developing countries.

But even then, a change in behaviour was needed according to Dr. Helveston: “There were enormous barriers to telemedicine in our own country but some of them have been brought down by this virus. We’re all getting used to digital communications replacing face-to-face, making it easier for volunteers and local doctors to bond and develop a strong mentor/mentee relationship.”

Orbis has a history of innovation and technology. From our Flying Eye Hospital to virtual reality and artificial intelligence, we know the importance of innovating to solve problems. This is in large part down to people like Dr. Helveston who had the foresight and passion to drive technology into the heart of our mission.

“Technology is all about making the best of people’s talent and time,” he reminds us. Seen through this lens, our Flying Eye Hospital and Cybersight are the tools needed to help share the immense skills and experience of our medical volunteers with peers around the world, faster and better than ever before.

Thank you Dr. Helveston for your rich lifetime of achievements. Your legacy lives on and is helping the eye health community in ways, perhaps, even you could not have expected.

Dr. Helveston and Cybersight were ahead of their time and needed to wait for technology to catch up. By the mid-teen’s smartphones, laptops and tablets were ubiquitous, even in developing countries.

But even then, a change in behaviour was needed according to Dr. Helveston: “There were enormous barriers to telemedicine in our own country but some of them have been brought down by this virus. We’re all getting used to digital communications replacing face-to-face, making it easier for volunteers and local doctors to bond and develop a strong mentor/mentee relationship.”

Orbis has a history of innovation and technology. From our Flying Eye Hospital to virtual reality and artificial intelligence, we know the importance of innovating to solve problems. This is in large part down to people like Dr. Helveston who had the foresight and passion to drive technology into the heart of our mission.

“Technology is all about making the best of people’s talent and time,” he reminds us. Seen through this lens, our Flying Eye Hospital and Cybersight are the tools needed to help share the immense skills and experience of our medical volunteers with peers around the world, faster and better than ever before.

Thank you Dr. Helveston for your rich lifetime of achievements. Your legacy lives on and is helping the eye health community in ways, perhaps, even you could not have expected.