Lumen, in full.

What Lumen is

Lumen is a practice management system built for one specialty: ophthalmology. Most clinical software treats eye care as one specialty among dozens and bolts an ophthalmology module onto a general product. Lumen does the opposite. Every screen, template and data structure is shaped around how an eye clinic actually works, from the cadence of intravitreal injections to the cycle of refractions and the conversation between consult and theatre.

It is cloud-native, so clinicians work in a browser with nothing to install, while a small local agent handles the imaging devices that only speak to the network in front of them. The whole system is designed for Australian practice: the Medicare Benefits Schedule, Australian healthcare identifiers, secure messaging, and data that stays in the country.

The aim is depth, not breadth. Lumen does not try to serve every specialty; it tries to be the best possible tool for the eye clinic, and to give clinicians back the time that generic software takes away.

How Lumen is built

Lumen has two parts that work together: a cloud application that holds the record, and a lightweight Bridge Agent that lives in the clinic and connects the imaging devices.

The cloud application

Clinicians use Lumen entirely in the browser. The front end is a modern single-page application; the back end is a structured API over a PostgreSQL database. Background work such as letter rendering and messaging runs through a job queue so the interface stays responsive. Images and documents are kept in Australian object storage and shown in-browser, and letters and reports are produced as PDFs server-side.

Everything clinical is hosted in AWS ap-southeast-2 (Sydney). Data sovereignty is a design constraint, not an afterthought: clinical data does not leave Australia.

The Lumen Bridge Agent

Imaging devices in a clinic, such as an OCT or a visual-field analyser, speak DICOM on the local network and expect a worklist to tell them which patient is next. The Bridge Agent is one small application installed on a single clinic PC that fills that role. It receives images from the devices, serves a modality worklist from the day's bookings, and syncs everything to the cloud over an encrypted connection. If the internet drops, it queues locally and resumes automatically when the connection returns, so an outage never loses an image. Clinic staff never have to interact with it; it updates itself silently.

Secure messaging and pathology results do not depend on the Bridge Agent: those arrive in the cloud directly (see integrations).

The clinical core

Beneath the ophthalmology features is a complete clinical record that any specialist practice needs.

• Patients and demographics with a clean record, a per-clinic medical record number, and a single patient timeline that brings every encounter, image, letter and result together in one place. Shipping
• Appointments and scheduling, a waiting-room view, and SMS reminders, confirmations and recalls to reduce no-shows. Shipping
• Encounters and notes. The notes engine is versioned: every save is a new immutable version with full history, written for clinicians who care about defensibility. Templates speed up routine documentation. Shipping
• Referrals with the 12-month validity rule and automatic linking by Medicare number, and recalls generated automatically from the diagnosis (for example glaucoma review at 3 to 6 months, diabetic review annually, an injection series at its own interval). In build
• Coded diagnosis from a clinician-curated favourites list, backed by ICD-10-AM and SNOMED CT-AU. In build

Ophthalmology depth

This is where Lumen is unlike a generalist system. The clinical content is built for the eye, captured as structured data rather than free text so it can be trended, billed and acted on.

The eye exam, as a workflow

Visual acuity, refraction, intraocular pressure, slit-lamp findings, posterior segment, glaucoma assessment and diabetic retinopathy grading are entered as structured fields, once, and then plotted as trends across every visit. Reviewing a glaucoma patient becomes reading a chart, not re-reading five notes. Shipping

Eye diagrams

Clickable anterior and posterior segment diagrams, with drawing tools for retinal tears, laser, lesions and more, are saved with each encounter as part of the record. Shipping

Injection tracker

For medical retina, Lumen tracks an injection series with a treat-and-extend interval calculator and a visual-acuity trend overlay, and prepares the intravitreal item with each visit so the clinical work and the billing stay together. Shipping

Clinical intelligence

Because the exam data is structured, Lumen can surface what matters over time: intraocular pressure trends, cup-to-disc ratio history, visual-field progression (MD and PSD), and diabetic retinopathy grading. In build

Imaging and the Bridge Agent

Eye care is an imaging specialty, and Lumen treats imaging as a first-class part of the record rather than a separate system to switch into.

OCT, visual fields, fundus photography and biometry are received from the devices by the Bridge Agent and viewed in the browser through an embedded DICOM viewer, beside the note rather than in a second application. The scan opens in the patient's record, where it belongs, and is stored in Australian object storage. A modality worklist served from the day's bookings means a device knows which patient it is imaging without manual entry. In build

The result is that the clinician reviews the image, the exam findings and the history in one place, instead of stitching them together across a viewer, a device console and a separate record.

Surgical, biometry and IOL

Lumen carries the surgical side of an ophthalmology practice through to theatre.

• Theatre lists and operation notes, with a pre-operative checklist and a structured record of each procedure. In build
• Biometry import and an IOL calculator covering the formulae practices rely on, including Barrett Universal II, SRK/T, Haigis and Hoffer Q, with biometry brought in from common devices rather than re-keyed. In build
• Outcomes audit, so refractive results can be reviewed against prediction over time. Planned

Billing and Medicare

Australian billing is built in, not approximated. Lumen carries the current Medicare Benefits Schedule with an item picker and a rules engine that understands the realities of eye-clinic billing: items that cannot be claimed together, multi-operator and bilateral rules, bulk billing and DVA. Invoicing flows from the visit. Shipping

For Medicare claiming, Lumen ships with a Tyro Health bridge so a clinic can claim from day one without waiting on software certification, while native ECLIPSE conformance is built in parallel. When ECLIPSE certification is complete, claiming moves to the native path; until then the bridge keeps the clinic operating. In build

The MBS changes every quarter, so the schedule is refreshed on a regular cycle and billing rules are re-checked after each update.

Australian integrations

Lumen is designed to sit inside the Australian healthcare stack as a first-class participant. Some integrations ship with the platform; others are progressing through Australian government conformance queues, which run in the background while the rest of the product is built. The current state of each:

• MBS billing Current schedule, item picker, multi-operator and bilateral rules, bulk-bill and DVA. Shipping
• SMS reminders Appointment confirmations, no-show reduction and recall workflows. Shipping
• Medicare claiming Tyro Health bridge from day one; native ECLIPSE conformance in the pipeline. In build
• Medical Objects Secure inbound and outbound messaging for referrals, pathology and correspondence, over HL7. In build
• ICD-10-AM & SNOMED CT-AU Coded diagnosis from a clinician-curated favourites list. In build
• VIP.net migration Full-clinic import path for practices leaving Best Practice VIP.net. In build
• My Health Record ADHA conformance underway for consult and discharge summary upload. Conformance
• HI Service IHI, HPI-I and HPI-O lookups, pending Services Australia approval. Planned
• NASH PKI Certificates required for ECLIPSE and the HI Service, progressing through registration. Planned

Lumen names these standards and services factually; it does not imply any commercial endorsement. Where a capability depends on a government approval, it is described as in progress rather than finished.

Security and compliance

Clinical software lives or dies on what it can prove, not what it claims. Lumen is built to the standards Australian clinical software actually needs, with the controls in the architecture rather than the marketing.

• Hosted in Australia. All clinical data resides in AWS ap-southeast-2.
• Encrypted end to end. AES-256 at rest, TLS 1.3 in transit, encrypted backups and an encrypted Bridge Agent cache.
• Strong authentication. Argon2id password hashing, JWT access and refresh tokens, and mandatory TOTP multi-factor authentication for clinical users.
• Least privilege. Role-based access control with permission checks on every endpoint, and tenant isolation enforced at the database layer so one clinic can never see another's data.
• Idle lock. Every authenticated session locks after a short idle period behind a PIN, because exposure of patient information is not limited to clinical roles.
• Audit trail. Every read and write on clinical data is captured at the database layer and retained, so the question "who saw this record, and when" has an answer.
• Versioned, not overwritten. Clinical entries are versioned and soft-deleted, never silently destroyed.
• External testing. An independent penetration test against the OWASP Top 10 is planned before general availability.

Lumen is designed to align with Australian regulatory requirements, including the Privacy Act 1988 and the Australian Privacy Principles, and to work toward the relevant Therapeutic Goods Administration software pathways where they apply. These are described as design intent and work in progress, never as a finished certification.

Data residency and retention

Health information carries obligations that ordinary software does not, and Lumen is built around them.

Clinical data is held in Australia and is not transferred offshore. Records are kept for the periods Australian practice requires, broadly seven years from the last entry for an adult and longer for records created while a patient was a child, and are then destroyed or de-identified at the end of their lawful retention period. De-identification is treated as a discipline with limits, not a guarantee that data can never be traced back. The Privacy Policy is the source of truth for how data is handled, and this documentation never claims more than it.

The Notifiable Data Breaches scheme is part of the design rather than an afterthought: because every access to clinical data is audited, Lumen can determine what was actually accessed if something goes wrong, which is exactly what a breach assessment requires.

Migrating an existing clinic

A practice does not start from an empty system. Lumen is being built with a full-clinic migration path for practices leaving an existing system, beginning with Best Practice VIP.net. The goal is to bring across the whole record, patients, clinical history, letters, billing, appointments, recalls and images, in a single per-clinic import, so the clinic opens in Lumen with its history intact rather than a blank slate. In build

Migration is handled as a careful, reviewed process per clinic rather than a one-click button, because moving a live clinical record is a clinical-safety exercise as much as a technical one.

Status and roadmap

Lumen is in active development and in private pilot with a small group of Australian ophthalmology practices. The clinical core and the ophthalmology-specific workflows are in use; billing and the integrations are at the stages shown above; and the government conformance applications (Services Australia, ADHA My Health Record, the HI Service, Medical Objects and NASH PKI) are progressing in parallel with the build.

The honest summary is that the parts a clinic touches every day are real and in use, the Australian plumbing is partly shipping and partly in conformance queues, and the finished product is the union of everything on this page. Timelines depend in part on those external approvals, so this documentation describes scope and direction rather than dates.

Joining the pilot

Lumen is live for pilot clinics at lumen.trenthos.com. If you run an Australian ophthalmology practice and would like to follow the build or join the next pilot cohort, we would be glad to hear from you.

Write to hello@trenthos.com, or use the contact form and choose "Pilots & onboarding". For the thinking behind the product, the Trenthos Research writing covers the clinical and regulatory realities Lumen is built around.