Tuesday, December 20, 2011

Top 10 mistakes that Doctors make in choosing medical software

Choosing which program to buy to run your medical practice has never been easy. Earlier , it was because there were very few programs available. Today, ironically, it is because there are too many !  Doctors are very confused as to which program they should buy – sometimes, too much choice can be as bad as too little !

Doctors have some special character traits which software producers need to be aware of !

a. To be able to treat a patient and be confident that your decision is right requires tremendous self confidence, which means doctors often have a big ego. Many take the approach that they are always right - even in a field like computer technology !
b. Doctors have a tremendous thirst to learn. Years of med school training allows you to pick up knowledge quickly and most doctors who want to buy software are quite knowledgeable about computers. However, sometimes a little knowledge can be dangerous , and often what doctors know about computers and software leaves a lot to be desired
c.     Doctors are pressed for time, and hence their decisions are based on the fact that “anything that does not gel with me is going to hamper me”. Rather than try to improve their workflow with the help of computers, they’d rather stick to their old dysfunctional habits, even if this hampers their efficiency.

Doctors who wish to enhance their practice and provide better care and service to their patients by using technology are on the right track. Unfortunately, they don’t always go about it the right way.  Some of the important mistakes doctors make are highlighted below.

1. Wanting too many bells and whistles:
Some doctors want their software to do everything for them - even pay their taxes (Just joking ! ). Sometimes putting too many things in your software tends to delay its deployment and make it too complicated to use . Often, some doctors will end up not buying any program at all, because it does not have everything which they want – which means they deprive themselves of a great opportunity of improving their efficiency in 80% of their practice. For example , some doctors want the entire drug database of 15000 drugs in their software! Now you know you will never use even 1/100th of these. There are enough online resources to give you these details when you do require this esoteric information. Why load this redundant data in your software and make it slow by cramming it with stuff you will never use ? It’s much more sensible to have a small efficient intelligent drug database which you can grow over time. That’s what we recommend at Technical Dr. Stick to the basics - your aim is to improve your practice - not to solve the world healthcare crises.

2. Trying to save a penny:
It’s a simple fact of life that investment reaps rich rewards. Why haggle over a few dollars and try to find the cheapest option ?  Negotiating is great, but choosing quality, support and peace of mind is far more important than trying a save a few bucks. It’s easy to get a local company to make a simple, unsupported database for you to manage your patient’s addresses. However, in the long run it makes more sense to invest a little more in good software – preferably from a company which is completely focused on the healthcare space. Medical practice is a complex domain , and an software engineer who doesn’t spend time understanding this cannot make a good product. This is why the early successful packages were created by doctors because they did have the right idea. However, they did not have the savvy to remain uptodate with the latest technology. Please stop acting like a miser in choosing a package. Every doctor I know earns enough to invest in a good package which will enhance his practice. Choose your vendor carefully – after all, you want them to be your partners for life, and for this, they need to make enough profit ?.

3. Thinking someone else understand your business:
A lot of doctors tend to put too much trust in what their software vendor is doing for them. They feel he is the computer expert, and know what he is doing ! If a custom built package is being made, unless you provide the vendor with adequate knowledge on your processes, templates , wants and need, the program will never do what you want it to. Garbage In, Garbage Out. I know doctors who just give a brief outline of what they want and leave it at that. Now the vendor is left scratching his head because he does not really understand what is required of him . He muddles through – but what he produces is not what the doctor wanted, which means a lot of time, money and energy is wasted – and the cycle needs to be repeated again. If you want a custom built solution, you need to be very closely involved. You cannot delegate this. You need to provide all the information required personally. More importantly , you need to review and ask for updates from time to time. Often, the project gets needlessly delayed because the doctor realizes  that this was not what he wanted only after the complete package is delivered to him.

4. Losing sight of the basics – KISS :
Your primary aim is to improve your productivity, and you should always keep this in mind! Anything else should come later. For example, we have clients who request Accounts integration in their software.. But delaying an order or cancelling an order based on just this one feature is unjustified. Nice to have is not the same as “essential” – and adding too many features just results in “bloatware”. It is a mistake to want your software to do too many things right from the start. Get what is essential, and build from there.

5. Waiting for something better:
Doctors often keep on waiting for something better to come along. Unless you don’t jump in the water, you aren’t going to learn how to swim ! Some of the best run private hospitals have been early adopters of technology. Today they might still be using legacy systems , but they are much better run than non IT friendly setups. It’s true that software will evolve over time, but you cannot wait for perfection. At Technical Dr, we study and add new items to our list daily – after all, software is always a work in progress, which gets improved and polished incrementally. However, just because you want a Mercedes does not mean you should continue driving a cycle to work ! It is a mistake to wait when you can always upgrade if you want to later on !

6. Thinking your staff shares your vision:
Many good doctors buy the perfect software and then find that it does not help them manage their practice at all . Often  they blame the software for being unfriendly or useless . Most  doctors fail to understand that their staff is one of the key stake holders in this process. Unless the staff uses the software, it is bound to fail. The software may be the best in the world, but if it is not used properly  , it isn’t living upto its potential. Doctors need to be firm and to share their vision for the software with their staff. It is a mistake to assume that software will be easily adopted by support staff, nurses and fellow doctors. Provide lots of training – and if some members refuse to use this, you need to take them to task.

7. Not nurturing innovation:
The biggest stake holders in this industry are the doctors. It is important for them to nurture innovation. Sometimes it is valuable to take a risk or allow a software company to go that extra mile in providing a feature which will change the process flow of your clinic. Doctors who refuse to try out products which provide extra features or new age ideas because they do not understand its utility are closing the door on innovation. A doctor who asks me to block some modules to save money because he feels he will not use them is basically closing his own mind to the potential of using new processes to improve his practise . Do not buy the module in the beginning, but keep an open mind.  Even when doctors do not ask for the SMS or Email Plug-in , we still leave it on the User Interface, because just seeing that button there will make them wish it was active when they want to send out a report or reading instantly. Once they see the value, they can always buy the module later on.

8. Underestimating the complexity of your needs:
Running a clinic is like running a small business. It’s a complex enterprise, and often doctors overerestimate their ability to do a good job. Ideally, you should be focused on taking care of your patients, so your staff can run the clinic. If you find you are spending time on routine administrative tasks, this means you are wasting your time and money. There are only 24 hours is your day – learn to use them sensibly. A good software program will help you to improve your productivity and that of your staff, if you use it to its fullest extent. An integrated program will allow you to do all the tasks needed to ensure your clinic runs smoothly - manage appointments, accounts, inventory, medical records and referrals. Don’t get stuck buying a cheap program which was designed for a small shop – you will end up being unhappy and dissatisfied.

9. Delaying a decisions:
The single biggest mistake a doctor makes in buying software is when he delays his decisions – whether it is thinking about his needs; talking to the vendor; spelling out his requirement; installing the program ; or getting training for his staff. As a result, the vendor is frustrated; the doctor is confused ; the staff is anxious ; and patients continue to remain unhappy. Start small – but start today !

10. Disregarding the hardware:
Hardware always complements your software. As much as the software vendor may try to make his solution lithe (for example, Technical DR products can run on any Windows and Unix system, and even an AMD netbook processor) , if you want the best results, invest in good hardware. Do not be afraid to upgrade your hardware to help enhance the productivity of your medical software – PCs have become very inexpensive these days !

11. Not providing enough time for training.
While doctors understand that learning a new medical procedure can take time, unfortunately, they are not willing to invest the same time in training their staff – and themselves – in learning how to use the software properly.  This can cause a lot of frustration and when this happens, many doctors just give up on the idea of using any software at all, because they feel their staff is too stupid.

Tweaks to make your PC experience better as a Doctor

Today a lot of Doctors are waking up to using the computer, maybe to surf the net, or they own a website or better still have an EMR solution. Below are some tips to help you make your time spent on the PC better.  These include some mundane ideas and thoughts and also some personal insights in what works best. So make your PC experience a good one, because it’s going to last you a life time.

a. Use the Internet: Today almost every PC is bought with the thought of going online. However for those who are hesitant, it is important to remember the usage and experience far outweighs the ghost of virus attacks and vulgar content. From the EMR software point of view, maximum benefit can be derived from our packages by those who have the Internet to send SMSes, Emails or get support directly online.

b. LAN connection in a clinic: For any clinic which is not a single doctor no receptionist, it is ideal to get a LAN connection with another PC to help manage the work. The efficiency of handling patients and workload multiples manifold by the simple move. Creating a LAN is simple enough and your local computer guy will be able to have it running within minutes. Wiring may take some time if it is elaborate or you can go the wireless way. Our EMR solution works best when used with a LAN connection, clearly dividing the workflows for doctors and receptionists/nurses who can handle the non clinical transactions.

c. Syncplicity/Dropbox: These softwares are simply fantastic. Most of us have nightmare about viruses and PCs crashing and losing all our information! Now with auto backup softwares that can never happen. Select which folders, drives and PCs you would like to back-up, it automatically syncs it to a virtual representation of your folders online. These can now be downloaded or accessed with a password by you anytime. The whole solution is secure and does not need a huge bandwidth.

d. Virtual memory:  Most computers use not just the RAM but also some part of the hard disk space as memory to run applications. This is called virtual memory as it is an extension of the RAM space into the hard disk. Lot of times your PC may appear slow despite having a decent RAM or gives a pop up saying Virtual Memory Low.  For application that use caching, paging and other virtualization techniques they require adequate virtual memory space.  Ideally your Virtual Memory should be set to 1.5*RAM.

The following procedure is based on Windows XP Professional.
1.    Go to right-click My Computer and choose Properties.
2.    In the System Properties dialog box, go to Advanced tab.
3.    Click Settings button that is from the Performance frame.
4.    Once the Performance Options shows up on the screen, go to Advanced tab.
5.    Under the Advanced tab, click the Change button from the Virtual Memory frame to access to the Virtual Memory setting.

Then the Virtual Memory dialog box appears on the screen. In there, you are able to check how much the Virtual Memory you set. If you would like to modify the size of Virtual Memory, follow the procedure that is shown below.
1.    In there, select the drive letter that is used to install the Operating System.
2.    Choose the option that says, "Custom Size:"

Once you choose that option, the setting for Initial Size and Maximum Size become available for you to set. Initial Size (MB) means the actual size of Virtual Memory, and Maximum Size (MB) means the maximum size of Virtual Memory that is allowed to use.

e. Clean Up the Temp Folder: A large section of your hard disk gets blocked over time by the Temp Folder where, partially downloaded files, applications in progress, copy pasted data is stored in parallel.
C:\Documents and Settings\{NAME OF USER ACCOUNT}\Local Settings\Temp, clear this Folder out from time to time.  A similar exercise can be carried out with the Temporary Internet Files located in the Windows Folder.

f. System Restore – Another handy little service that can get your computer back up and running sometimes, but again takes up a lot of extra space that is not needed is System Restore. But System Restore only recovers Windows files, not any of your data. So having System Restore enabled on any other drive other than your C drive (where Windows is installed) is completely useless. Hence keep it turned off.

To fix this one, right click on My Computer and choose Properties. Click on the System Restore tab, you will see all the drives on the computer, if you have a C and a D drive, turn it off for D drive. For system restore, a value between 2% to 4% will be fine in terms of space. The default 12% wastes loads and loads of space!

g. Use a Local Mail Option: Use a local mail option like Outlook, Outlook Express, Thunderbird, Eudora to sync your mails offline from multiple sources so you access them at any time. Even Google Mail provides this option now. Just go to the Offline Tab in your settings and read up about it.

h. Clean with CCleaner:
CCleaner is a tool used to clean your PC. IT description on its site is given below – “CCleaner is a freeware system optimization, privacy and cleaning tool. It removes unused files from your system - allowing Windows to run faster and freeing up valuable hard disk space. It also cleans traces of your online activities such as your Internet history. Additionally it contains a fully featured registry cleaner. But the best part is that it's fast (normally taking less than a second to run) and contains NO Spyware or Adware!” So download it today and get your PC cleaned for free.

i. Out with the toolbars: Usually most people end up having numerous toolbars on their application windows. This is most common in browsers, but also tends to happen in Office applications where all the various tools are now on an ever descending bar. The user experience is diminished if half your seeable and workable space is cluttered with objects which take up your attention and are not even used. So my suggestion, for browsers uncheck all the external toolbars from Yahoo, Google and what not, these not only take space but also cause pop-ups and headaches. In case of MS Word or MS Excel, stick to the basic tools on the window, remove the unnecessary, they can be accessed any time anyway. These extra toolbars also cause delays in loading the software or browser.

j. A Free Desktop: Keep a neat clean desktop. It slows down start up and makes you and your PC sluggish to have uncountable number of items on your desktop. My suggestion is create a folder called Desktop items in your documents and create a shortcut on the desktop and dump everything in that. This is if the habit it too hard to shake off.  I find it much easier and quicker to work if the Desktop is clean or at least cleaned once in a week to make it fast and simple.

k. Use Bookmarks: Use bookmarks, stars, favorites and other such little programs to make your life on the net simpler. Why run around to search for the pages already found or remember the long URL which you never will. Just a single click to bookmark them and they are stored forever.

A Guide to Improving your Patient Interaction and Outreach

Technology enables, but man disables by not taking advantage of opportunities given to him. As a Physicians today, you have many key touch points to increase and consequently improve your interactions with patients. Some are simple methods, some require a little bit of work, but what is the end advantage of it all? For one thing it makes you popular amongst patients;  and the side effect could lead you to get more business.

Second it helps educate and provide information to patients and people who may read just what they need, thanks to you! A little help goes a long way in accumulating blessings.

Third, contributing to the general knowledge resource of the community improves the very community you are part off, it encourages others to follow suit.

So now what do you need to do?

1. Reach out to many in the general audience: Start writing, the internet lets you update and express views, either as 160 character bursts on twitter, or a long blog detailing your experience.

Twitter: On twitter you can start putting up bursts of interesting cases you see, new techniques you here about, information about your local medical network which may help people in your area! Go onto www.twitter.com, register yourself and type away.

Blogging: Doing a lot of research which you think people should here about, or have an opinion which potential patients should here about, blog about it. Many people will find it online as they search for an information panacea for their problem and be happy to come across your blog.

2. Create a mechanism such that people can contact you: For a start, get a practice website. It helps you disseminate information about your services for people looking for the same. It isn’t advertising, it’s a service, people today face many choices and are hampered by lack of information, improving their ability to find information quickly is beneficial to them.

On your website, don’t only talk about you, tell the patients more about what diseases and disabilities you treat, what are the latest treatments, generic advice and maybe even help them going to right person if you weren’t involved.

Use tools like interactive patient forms which can be filled before the patient arrives at the center, saving time and giving you a heads up on the patient’s needs. Use query forms on the website so that people can ask you about their problems, patients their doubts; this gives the feeling to your patients that you are available to them 24/7 without actually being there. Technical Doctor encourages doctors to have their own websites through their initiative http://www.technicaldr.com/tdr/websites-for-doctors. We also offer advice and consulting to help your website create the best impact on your patients and potential clients.

3. Using Software tools: Use softwares which improve communications. Invest in software which doesn’t just keep your records and accounts. The software should come with communications tools integrated and can be used with ease. Emailing of schedules and reports to patients is a must.

The software should also allow using SMSes to send reminders, alerts, prescription reminders etc. This is a new level of service, and patients will be thrilled to know there is always an alert to give them confidence in their moments of doubt.

Online Medical records allow patients to access their records remotely, insist on looking at software which promotes this feature if not today, but at least is compatible with this extension in the future. Technical Doctor provides EMR software products which come coupled with email, SMS and online EMRs. We encourage doctors to use these services to improve their service quality. You can see our products on http://www.technicaldr.com

4. Accessing data and messages on your phone: Today you may be using you phone to send SMSs, read emails and play games online. Why stop there, use it to drive business wherever you are. Neat and simple apps provide you fingertip information, coupled with your own website, or software they can become powerful tools in your hands to handle patients remotely.

Access patient alerts via the phone or your actual software to pull up data remotely. Technical Doctor already has a suite of products and apps which can run on phone browsers.

5. Contribute to journals and medical website online: Numerous sources are present where doctors submit their stories, research and experiences. The medical and patient community will be greatly benefited by your inputs, a little effort online will show you exactly where you should be adding your data.

6. Using new cool online tools to make education interesting: Nowadays making a presentation, cartoon strip or a cartoon movie to help educate your patients or interested clients is easy. Many tools are available online which let you render very interesting collaterals that can help ease patient doubts and also make it fun. Tools like www.bitstrips.com which we use to make cartoons helps in creating awareness in an educational yet informal way. Putting these up on your clinic facebook page or on your website is the best option.

These are just some pointers on how technology can help you as a doctor to interact with patients and also general public looking for information in your areas of expertise. It’s time to exercise your power using technology, so see you out there soon.

Friday, November 18, 2011

Features in Practice Websites which increase Patient Satisfaction

An important part of managing a patient over a long period of time is communicating with the patient. Most follow up cases in medical practices have niche requirements and consequently patients have certain expectations from their physicians. Also a happy patient is a physician’s most powerful marketing asset. Practices should strive to provide for such patients by offering services which improve the quality of service they perceive, which in turn will increases their satisfaction.

A well planned and feature rich practice website allows physicians to assist patients in their day-to-day living by providing timely solutions for all their health queries even after a visit. For a patient, this continued access to expert medical advice via simple online tools is one of the most cherished features of any e-practice.

Despite best efforts, many patients make errors while following medical advice. Many times, follow-up patients have new queries they wish they could simply share with their physicians. A large number of patients also do not ask new questions just because they don’t want to look stupid in front of their physicians! These patients are often unsure of the importance of their queries and generally procrastinate visiting their physicians for answers. Sometimes new complaints crop up which may or may not affect the ongoing medical management. The internet, via a medical website, allows physicians to clarify many such small doubts these patients face while following medical advice. A timely word of advice can save these patients a whole lot of pain, literally and figuratively. Important issues which may arise during such advice can be solved by arranging for a new visit.

There are a number of ways medical websites and integrated web 2.0 tools can be used to help physicians improve patient-physician communications and thus decrease the morbidity among patients. Let’s look at five such applications:

Online Chats

Chatting on the internet is something most patients are comfortable with. Medical websites can have widgets which allow patients to directly chat with the physician or the physician’s representative. This is a common and simple to add functionality within any medical website. Patients can be given pre-decided timings (say, 9 p.m - 10 p.m on Mondays, Wednesdays and Fridays) when the physician shall be available for the chat. Such chat transcripts can then be appended to the electronic medical record of the concerned patient. More people can be added to chats so as to allow group discussions (e.g: Friday evening hour long chat session for all Pregnant women, in case of gynae practices).

Contact Forms and Feedback Forms

Medical websites allow all registered members (i.e. follow-up cases) to access some parts of the website which are meant only for them. A simple form is embedded within this secure area through which a follow-up patient can ask a question. These questions are then directed to the physician’s email address. The physician can answer such questions securely via email or even ask the patient to book an appointment if required. Ideally, physicians should create an email id purely for answering queries of follow up cases. This will help in segmenting all electronic medical communications between physicians and patients. All such queries are also automatically added to electronic medical record of that patient.

Facebook Groups

After email, Facebook is the most commonly used online platform for communications. physicians can easily use this platform (by forming closed groups) for answering some of the common queries by their patients. All follow up patients who share their primary email id can be added to specific closed groups on Facebook. These patients can post their queries on the group wall (which is not public and viewable only by group members) or send it as a direct message. Answers which have general significance for all patients can be posted on the group wall (e.g.: I am taking Metoprolol XL 50 mg once daily for my hypertension. I am scheduled for a tooth extraction next week. What precautions should I take? ). Personal queries can be answered via direct messaging. Urgent and important issues can be simply escalated to a telephonic conversation. Over time, such a Facebook group shall mature into a powerful resource for all new members. 

Video Chat
Questions which require visual inputs (like appearance of rashes or swelling on hands and feet) can be handled by using Video chat within Facebook. Important advice can be reinforced by typing it into the chat area so as to create a transcript document of the encounter. There are medical social media guidelines published by many international organizations which can be followed for all such patient-physician communications on Facebook.

eVisits using Skype
Physicians can also use Skype and payment gateways like PayPal to organize revenue generating e-visits by follow-up cases who find it difficult to physically visit the clinic premises at regular intervals. This is especially the case with geriatric and physically challenged patients.

Wednesday, November 16, 2011

Medical Websites Help Small Practices Compete Against Large Hospitals

Practicing medicine in the private sector is a very tough proposition. It’s not enough simply to be a very good doctor; Its also imperative that one is known by most to be a very good doctor. It’s not enough to provide all the latest treatment options and services; Everyone must also know or be able to find out easily all the services provided at a practice/hospital.

Traditional Healthcare Communication Meant Word-Of-Mouth Publicity

Traditionally, physicians and medical practices have relied on word-of-mouth publicity to establish themselves. A patient who has undergone an event-free angiography at the local cardiac care center would then tell five others about his/her wonderful experience.And now five more people know about the latest angiography services at that cardiac center. Hopefully, this positive review would continue in a geometric progression and more and more people would visit the medical center. 

But is that enough? Also, what about the high tech cardiac catheterization and latest stenting services also available at that center? There would be hundreds of bits of positive details about your practice most patients would’nt even get to know of. Hoping that all visitors to a medical center realize all its plus points and then remember to pass these plus points to others is so optimistic, it’s foolish. Thus word-of-mouth publicity serves a very limited role in evangelizing any healthcare services.

Challenges In Healthcare Communication

Medical practices can no longer rely only on word-of-mouth to inform the world about their existence. But they also face a big handicap. They need to make themselves and their quality services known without resorting to overt advertising. Clinics and smaller hospitals face a specially forbidding challenge in breaking through this glass ceiling of ‘perceived quality’. Sheer size has allowed larger hospitals to carry an aura of quality, irrespective of the services they provide. In contrast, many clinics which provide top-of-the-line services are just not accorded due respect or simply remain unknown.

Medical Websites In Healthcare Communication

Despite providing the best services, many small practices are labeled ‘poor quality’ simply because of low visibility. Technology has broken down this artificial divide between small and larger medical practices. A high quality website has become the single most important way to establish your credibility, authority and niche online. Websites and social media channels provide an easy to access free platform for showcasing your expertise to any targeted/ segmented population.

A website becomes the way people remember and recall your clinic. A website creates a visual brand for your medical practice, allowing strong recall value even among people who may never have visited your clinic. With the help of a high quality medical website, a niche specialty clinic can achieve the same recognition as many large super-specialty hospitals.

Beyond branding, the practical utilities medical practices can provide the patients via their websites are plenty. Appointment scheduling and lab reports can easily be accessed via medical websites. Interactive patient communication widgets and electronic health records can add an entirely new dimension to the concept of medical websites.

Monday, November 14, 2011

Social Networking for Physicians – Tips and Options

With millions of patients seeking medical help and information on social media and the Internet, it has become imperative for physicians to connect with existing and potential patients as well as the medical community across the globe using social media and other means of electronic communication. A study by the online physician learning collaborative QuantiaMD in August 2011 indicates that nearly all physicians in the United States are social media users. However, the study also reveals that most physicians engage in social networking for personal purposes only, appearing rather reluctant to adopt it for enhancing professional interactivity and building a web presence for their medical brands.

Social Media Tips for Physicians

Social networking can help physicians manage their online reputation. Signing up for a static profile on Facebook or Twitter does not make for an active social media presence as it contributes zero value to doctor-patient relationships or the physician’s positioning in the medical and patient community. A good social media strategy must consolidate your presence and identity over a number of social media communities.

Here are some tips on how physicians can improve their social media presence to build a strong online medical brand for themselves.

Content Creation - Blogs and Social Media Sites

Social media websites give you access to a valuable network of prospective patients looking for credible medical information. Naturally, the best way to reach out and connect with them is to provide the information they need. Creating and publishing medical content like your medical experiences, breakthrough cases, innovative medical practices and other crucial medical information on your website, blog and also guest medical blogs can help you create a reputation of credibility and goodwill.

Posting links to such exclusive and valuable medical content on social media websites and other medical blogs will boost your visibility and reach. Over time, such consistent and organized social media linked blogging will make you a trusted name in the medical community, helping you position yourself as an influential thought leader in your specialization.

Informative Videos

Another effective way to engage patients is by posting informative and educational medical videos on You Tube and similar sites. Conversion rates from You Tube are found to be about 20% higher than search engines. A good social media strategy will include this tool to achieve greater reach, link building and visibility.

Social Media Attitude

Social media plays an important role in influencing opinions and perceptions. With so much information available on the Internet, patients often resort to online medical communities to conduct background checks, read patient reviews and testimonials before consulting a physician. Doctors must therefore maintain strict social media etiquette and decorum at all times. Upholding a positive attitude towards patients and other professionals in the network, willingness to help, answer questions, address concerns and being accessible can go a long way in building strong social media relationships as well as your medical brand and practice.

Social Networking Options for Physicians

Apart from general social media sites like Facebook, LinkedIn and Twitter, specialized physician communities are a great way to connect with other professionals in the industry. 

Some popular social media sites for physicians are DocGlobal, Sermo, Ozmosis, DoctorsHangout.com, MomMD, DoctorNetwork and StudentDoctor.net.

These medical networking circles help you interact with the international medical community. They are also a valuable resource for critical medical information and research.

Patient communities are also very effective in leveraging social media to encourage patient-doctor communication. Even though they are not very popular with physicians as compared to other social networking platforms, practitioners must use these forums to learn about their patients and inform themselves about patient concerns, needs and healthcare requirements and utilize these to improve the quality of care.

Sunday, November 6, 2011

How can Mobile Technology help Healthcare

An estimated 70% of physicians in the United States have either a smartphone or a tablet PC such as an iPad. They are adopting EHRs and are more techno savvy than ever before.  Mobile health provides ease of access and mobility to both physicians and patients and creates a coordinated care culture.  Let’s look at some of the examples available today of Mobile Technology driving Healthcare.

1. Mobile technology can help patients access care for themselves and others.  They can help with making physician appointments and getting alerts to be reminded of them.  Mobile also allow direct to patient alerts to increase adherence of physician instructions, specifically with regards diets, exercises and medications.

2. Mobile Technology helps in easing the delivery of care in the form of tools to better self monitor. Examples are the mobile apps capturing vital sign as also those which monitor various parameters like blood glucose, heart rate, cholesterol, etc.

3. Mobiles help improve the patient provider communications. Simple text messages and phone calls to verify or report a problem or symptom allow a more direct one to one relationship. While many physicians wonder how this helps them, this significantly adds trust in the eyes of a patient.

4. Mobile Technology also helps in easing the delivery of care by providing direct access to medical providers, ancillary services such as home nursing, insurance companies and the patient’s electronic health record portal. 

5. Mobile health Technologies can provide physicians and laboratories with data measured at much shorter intervals than those of typical in clinic patient visits.  This allows collation of data which can be meaningful analyzed for trends.  For e.g. a physician may increase surveillance of blood glucose levels to help manage diabetic patients.

6. Mobile technology allows the patient information, results, trends to be accessible anywhere.  A patients history can be pulled up on demand on a smartphone in the operating room; Patient charts can be viewed and updated on a tablet while walking in the hospital on rounds.

Saturday, November 5, 2011

What is Meaningful Use?

The purpose of the Healthcare IT incentive program is not static adoption of EHRs. The program has been devised in a manner that incentivizes only the “meaningful use” of your EHR system. Simply put, your practice will be eligible for the $44,000 incentive payment ONLY if it is able to actively utilize the EHR for improving the quality of care by satisfying certain federally set criteria. These criteria are called “Meaningful Use Objectives”.

Meaningful Use objectives have been defined in order to allow the progress of Healthcare IT and its impact on the National Healthcare System to be measured in terms of quality and quantity. It encourages the active adoption and implementation of health information technology by rewarding practices that are able to successfully incorporate the EMR in their daily workflow, using it to their full potential for delivering higher standards of healthcare.  

Meaningful Use is a phased program. It consists of three stages and the successful implementation of each stage is linked to incentive payments to be received for meeting the requirements of that stage.   

Stage 1: Data Capture (2011-2012)

This stage focuses on electronically capturing patient health information in a structured digital format using your EHR and utilizing this information for clinical purposes as well as communicating it for care coordination to other providers. If your first year of payment is 2011, you must satisfy the requirements of this stage in your first and second years of payment, i.e, 2011 and 2012, to receive the incentive payment.

This stage divides the objectives into two groups:

   1. Core group of 15 mandatory objectives
   2. Menu Set of 10 objectives from which physicians can choose any 5

Stage 2:  Data Aggregation and Exchange (HIE) (2013-2014)

This stage builds on the objectives of Stage 1 to focus on using health information technology to improve the quality of healthcare at the point of care. It also involves electronic and digital exchange of structured medical information among providers. This includes computerized physician order entry or CPOE and electronic transmission of diagnostic test results and other data required for clinical and medical support services.

Stage 3: Data Use to Improve Outcomes (2015)

Stage 3 focuses on utilizing the structured medical data made available in the earlier stages to improve healthcare quality and outcomes. This stage lays emphasis on the macro aspect of the healthcare system by encouraging support for national high priority conditions, emergency medical crises, self management tools for patients, access to patient medical databases and improvement in overall standards of healthcare delivery and population health.

Given below is a list of the Core and Menu Set Criteria required to be satisfied in Stage 1.

15 Core Criteria

[1] Objective: Use CPOE for medication orders directly entered by any licensed healthcare professional who can enter orders into the medical record per state, local and professional guidelines.
Measure: CPOE is used for more than 30% of all unique patients with at least one medication in their medication list seen by the Eligible Professional (EP) have at least one medication order entered using CPOE. (Exclusion: Any EP who writes fewer than 100 prescriptions during the EHR reporting period)

[2] Objective: Implement drug-drug and drug-allergy interaction checks.
Measure: The EP has enabled this functionality for the entire EHR reporting period.

[3] Objective: Maintain an up-to-date problem list of current and active diagnoses.
Measure: More than 80% of all unique patients seen by the EP have at least one entry or an indication that no problems are known for the patient recorded as structured data.

[4] Objective: Generate and transmit permissible prescriptions electronically (eRx).
Measure: More than 40% of all permissible prescriptions written by the EP are transmitted electronically using certified EHR technology.

[5] Objective: Maintain active medication list.
Measure: More than 80% of all unique patients seen by the EP have at least one entry (or an indication that the patient is not currently prescribed any medication) recorded as structured data.

[6] Objective: Maintain active medication allergy list.
Measure: More than 80% of all unique patients seen by the EP have at least one entry (or an indication that the patient has no known medication allergies) recorded as structured data.

[7] Objective:  Record the following demographics: preferred language, gender, race, ethnicity, date of birth. 
Measure: More than 50% of all unique patients seen by the EP have demographics recorded as structured data.

[8] Objective: Record and chart changes in vital signs: height, weight, blood pressure, calculate and display body mass, plot and display growth charts for children 2-20 years, including BMI.
Measure: For more than 50% of all unique patients age 2 and over seen by the EP, height, weight, blood pressure are recorded as structured data. (Exclusion: Any EP who either see no patients 2 years or older, or who believes that all three vital signs of height, weight and blood pressure have not relevance to their scope of practice.)

[9] Objective: Record smoking status for patients 13 years old or older.
Measure: More than 50% all unique patients 13 years old or older seen by the EP have “smoking status” recorded as structured data. (Exclusion: Any EP who sees no patients 13 years or older)

[10] Objective: Report ambulatory quality measures to CMS or the states.
Measure: Successfully report to CMS (or States) ambulatory clinical quality measures selected by CMS in the manner specified by CMS (or States).

[11] Objective: Implement one clinical decision support rule relevant to specialty or high clinical priority along with the ability to track compliance with that rule.
Measure: Implement one clinical decision support rule.

[12] Objective: Provide patients with an electronic copy of their health information (including diagnostic test results, problem list, medication lists, and allergies) upon request.
Measure: More than 50% of all patients who request an electronic copy of their health information are provided it within three business days. (Exclusion: Any EP that has no requests from patients or their agents for an electronic copy of the patient health information during the EHR reporting period.)

[13] Objective: Provide clinical summaries to patients for each office visit.
Measure: Clinical summaries provided to patients for more than 50% of all office visits within three business days. (Exclusion: Any EP who has no office visits during the EHR reporting period)

[14] Objective: Capability to exchange key clinical information (for example, problem list, medication list, allergies and diagnostic test results), among providers of care and patient authorized entities electronically.
Measure: Performed at least one test of certified EHR technology's capacity to electronically exchange key clinical information.

[15] Objective: Protect electronic health information created or maintained by the certified EHR technology through the implementation of appropriate technical capabilities.
Measure: Conduct or review a security risk analysis in accordance with the requirements under 45 CFR 164.308 (a)(1) and implement security updates as necessary and correct identified security deficiencies as part of its risk management process.

Menu Set Criteria
Given below is the Menu Set of 10 objectives from which physicians can choose any 5. One of the 5 must be either Objective 9 or 10.

[1] Objective: Implement drug formulary checks.
 Measure: The EP has enabled this functionality and has access to at least one internal or external formulary for the entire EHR reporting period.

[2] Objective: Incorporate clinical lab-test results into EHR as structured data. Measure:  More than 40 percent of all clinical lab tests results ordered by the EP during the EHR reporting period whose results are either in a positive/negative or numerical format are incorporated in certified E HR technology as structured data. (Exclusion: An EP who orders no lab tests whose results are either in a positive/negative or numeric format during the EHR reporting period.

[3] Objective: Generate lists of patients by specific conditions to use for quality improvement, reduction of disparities, research, or outreach.
Measure: Generate at least one report listing patients of the EP with a specific condition.

[4] Objective: Send reminders to patients per patient preference for preventive/follow-up care.
Measure: More than 20 percent of all patients 65 years or older or 5 years old or younger were sent an appropriate reminder during the EHR reporting period.  (Exclusion: An EP who has no patients 65 years old or older or 5 years old or younger with records maintained using certified EHR technology.

[5] Objective: Provide patients with timely electronic access to their health information (including lab results, problem list, medication lists, and allergies) within 4 business days of the information being available to the EP.
Measure: At least 10 percent of all unique patients seen by the EP are provided timely (available to the patient within four business days of being updated in the certified EHR technology) electronic access to their health information subject to the EP’s discretion to withhold certain information.  (Exclusion: Any EP that neither orders nor creates any of the information listed during the EHR reporting period.)

[6] Objective: Use certified E HR technology to identify patient-specific education resources and provide those resources to the patient if appropriate.
Measure: More than 10 percent of all unique patients seen by the EP are provided patient specific education resources.

[7] Objective: The EP who receives a patient from another setting of care or provider of care or believes an encounter is relevant should perform medication reconciliation.
Measure: The EP performs medication reconciliation for more than 50 percent of transitions of care in which the patient is transitioned into the care of the EP.  (Exclusion: An EP who was not the recipient of any transitions of care during the E HR reporting period.)

[8] Objective: The EP who transitions his/her patient to another setting of care or provider of care or refers his/her patient to another provider of care should provide summary care record for each transition of care or referral.
Measure:  The EP who transitions or refers his/her patient to another setting of care or provider of care provides a summary of care record for more than 50 percent of transitions of care and referrals.  (Exclusion: An EP who neither transfers a patient to another setting nor refers a patient to another provider during the EHR reporting period.)

[9] Objective: Capability to submit electronic data to immunization registries or immunization information systems and actual submission according to applicable law and practice.
Measure: Performed at least one test of certified EHR technology’s capacity to submit electronic data to immunization registries and follow up submission if the test is successful (unless none of the immunization registries to which the EP submits such information has the capacity to receive the information electronically). (Exclusion: An EP who administers no immunizations during the EHR reporting period or where no immunization registry has the capacity to receive the information electronically.)

[10] Objective: Capability to submit electronic syndromic surveillance data to public health agencies and actual submission according to applicable law and practice.
Measure: Performed at least one test of certified EHR technology’s capacity to provide electronic syndromic surveillance data to public health agencies and follow-up submission if the test is successful (unless none of the public health agencies to which an EP submits such information has the capacity to receive the information electronically). (Exclusion: An EP who does not collect any reportable syndromic information on their patients during the EHR reporting period or does not submit such information to any public health agency that has the capacity to receive the information electronically.

(Source: http://www.osteopathic.org/inside-aoa/advocacy/regulatory-issues/Documents/meaningful-use-objectives.pdf)





Thursday, November 3, 2011

How are Physicians taking to Social Media?

Social Media is no more just an in-thing. It has quickly become an integral part of our days and provided an excellent online extension to our lives. And it is now being used to keep track of sport scores, understanding stock market trends, ordering dinner etc. Social Media has also started making its in presence felt in various aspects of healthcare.

In an online survey carried out over apprx. 4,000 doctors with regards their involvement and interest in different types of social media, 87 % of the physicians claimed to be active on at least one social media site for personal use, while 67 % had used social media sites professionally too.

This is remarkable, given that a year back, predicting such numbers would have been preposterous. What is even more remarkable is that 66 % of the respondents described themselves as either “positive” or “very positive” with regard to the impact online patient communities are having on patients.

While Physicians were found to favor the social biggies, Facebook and LinkedIn over Twitter, 28 % said they were also using Physician Specific Online Communities. This is an interesting result and shows the scope for targeted and richer social networks directed at physicians. Sermo, DoctorsHangout, DocGlobal are 3 popular networks, and we’re sure that in 2012, a number of smaller more focused networks will also emerge.


While all seems to point to increased usage of Social media amongst Physicians, there are some aspects which will need addressing. Most surveyed physicians expressed concerns about privacy and legal ramifications. There is a great post by Dave Ekrem, on “7 tips to avoid HIPAA violations in social media” at kevinmd.com for the interested. 

Besides these, it seems to be a concern to Physicians that there was no way to get paid for interacting with patients online. As more physicians jump on the Social media bandwagon, more concerns are bound to be raised. But each problem offers a potential business case. Some innovative EMR providers like have already demonstrated smart integrations with Social Services like Twitter and Facebook to help create a more robust patient record.

Also, social networks will start emerging which let patients discuss their problems and offer doctors the chance to help them. From a marketing perspective, this will help physicians create more trust amongst patients leading to more referrals.

13 % have participated in public online discussion forums with other physicians, while 2% have participated in public online discussions with patients; and 5 % have engaged in online chat with other physicians, while 2 % have engaged in online chat with their patients.

Another common concern amongst social media savvy physicians was that the technology was too new for them. This will get addressed over time as physicians get more acquainted with latest in technology. The more they use technology, the faster they will be able to adapt to newer technologies.

Use of Social Media is sure to grow amongst physicians. Since it involves both involvement as well as content, Social Media used effectively can help both in promotions as well as a medium for education.

Sunday, September 18, 2011

How Can Computer Viruses Affect Your Medical Practice?

As healthcare becomes increasingly dependent on information technology, system breakdowns due to viruses, worms and other malware can potentially stall the entire working of your practice. This article aims to discuss how practitioners can protect their computers against viruses to ensure the safety and confidentiality of their data systems.

What are Computer Viruses?

A virus is simply a software program or a piece of code that is developed to spread and break into computer systems to consume available memory, corrupt or erase data and eventually cause the system to stop working. 

There are many types of malware and computer viruses and they vary in characteristics, disguises and potency to breach security and spread across networks. 

Computer viruses are nowadays commonly spread by attachments in emails or IM messages. They can also be disguised as attractive images, lucrative discount deals, lottery announcements and other audio-visual files that are likely to arouse user-curiosity and consequent click or download response. Computer viruses and malware are easily spread using free Internet downloads and pirated or illegal programs and files. 

A computer virus infection can be detected from typical symptoms like lowered system speed, frequent hanging or freezing, unprecedented restarts, improper or sluggish functioning of applications, inaccessibility of disk or drives, unusual error messages, missing programs etc.
Even though these indicators may hint at other hardware or software problems, the safest option in such a situation is to run an anti-virus check and contact your data security provider.

How Can Computer Viruses Affect Your Practice?

EMRs and other electronic healthcare data systems hold confidential patient information and practitioners are responsible for their privacy, safety and security. Data theft, loss and system breakdowns due to virus attacks can be very detrimental to a practice and can even put people’s lives in danger.

While effective backup systems and regularly updated anti-virus software can help you avert these debacles, medical professionals must be informed about the repercussions and penalties that HIPAA mandates in case they fail to protect medical information. The federal law treats medical data security as a legal requirement and any compromise on this front is a punishable offense. HIPAA has also released guidelines to assist practitioners and data security professionals in building unbreachable data systems that protect electronic medical data in EMR and other software.

What Can You Do To Prevent Virus Attacks?

A comprehensive data security plan involves regularly updated system security, frequent data backups, employee education and effective administrative policies that regulate the use and accessibility of medical IT systems.

Antivirus Software

When implementing your EMR, ensure that your server and workstations are adequately protected against malware. There are many effective virus protection software programs that help shield your system from viruses, malware and spyware. Ideally, these virus protection programs must be installed and regularly updated as soon as you get your IT infrastructure in place, with or without the EMR. Some antivirus programs are freely available for download online (with paid premium versions) while others can be purchased for a fee. 

We list some of the most effective virus protection software programs that are popular for medical IT security.

Information: http://www.eset.com/

Information: http://www.kaspersky.com/

Information: http://www.bitdefender.com/

Information: http://www.quickheal.com/

Information: http://us.norton.com/

In the free to download segment, the most popular antivirus software programs are,

1. AVG
Information: http://www.freeavg.com/?lng=in-en&cmpid=corp

Information: http://www.avast.com/index

Information: http://www.avira.com/
You may also ask your local computer vendor or EMR provider to guide you on the most appropriate protection program for your practice. Many reputable EMR vendors include antivirus and security programs in their services at no additional fee or cost of resources.

Data Backup Systems

Regular backups are an absolute must in order to prevent the loss of crucial medical information to disruptive computer viruses. All data must be backed up on remote servers that are professionally managed by data security experts. With a backup system in place, even if your local server were to get infected and your data were to get erased or corrupted, you would still have all your information secure and intact on this remote server.

Along with antivirus and data backup systems, practitioners and healthcare staff must adopt the following practices in order to build the practice’s defense against unprecedented virus attacks. 
1. Routers and wireless internet connections must be protected with strong, unbreachable password keys.
2. Install firewalls and always keep them on.
3. Do not download attachments or click links from unknown email messages, IMs and social media sites unless you are expecting them. 
4. Do not respond to unusual virus attack warnings from unrecognized sources or download rogue programs that offer to heal the virus. More often than not, they are viruses disguised a antivirus software. 
5. Do not be lured into downloading malware hidden in funny images and unknown audio/video files. Only download from trusted sources and websites.
6. Regularly install updates for all your software. Subscribe to automatic updates if available. 
7. Passwords should be strong and kept confidential. They should ideally include a combination of letters, numbers and symbols and be at least 14 characters long. Staff should be advised to memorize them instead of noting them down somewhere. Also, each application should have a unique password that is not repeated elsewhere in another application, website or program. 
8. Be cautious while using flash drives. Ensure that they are virus-free before running them on your system.


Difference Between Medical Billing Software and EMR

Medical billing and EMR software systems are often designed to have overlapping features that improve the functionality and usability of the systems in order to make them a “one-stop-solution” for a practice’s medical IT needs. As a result, medical billing software and EMRs end up being interchangeably used discounting the primary objectives of each of the systems.

Medical Billing Software vs. EMR

Many EMR companies are going the whole way to provide doctors with a single, comprehensive solution that will help them achieve Meaningful Use by incorporating crucial features like clinical notes, patient information and history, medication/prescription/drug allergies, diagnosis/treatments/procedures, patient scheduling, appointment reminders, e-prescribing, electronically available results, scans and reports, patient education resources, clinical decision support as well as full-fledged medical billing programs.

Specialized medical billing software on the other hand, is particularly programmed to maintain and keep detailed records of tests, procedures, examinations, diagnoses and treatments conducted on patients. It combines this medical information with the patient’s policy details to formulate a complete medical record that is used to generate bills. 

The software electronically submits these bills to the patient as well as the health insurance company for payment. Before a bill can be submitted to the policy provider, it has to be coded based on Current Procedural Terminology (CPT) and International Classification of Diseases (ICD-9/ICD-10) protocols. Medical billing software systems are programmed to automatically assign these codes based on the patient’s medical record. After reviewing the bill, the insurance company sends the appropriate payment (or notice of denial) notifying the patient and practitioner via an Explanation of Benefits (EOB) letter which is added to the patient’s medical billing record by the software. In case of a dispute, rectification of bills with errors or missing information and follow up on claims, the software will update the patient’s medical record and billing details with the revised information. 

Medical billing and coding software is thus equipped to seamlessly and accurately handle all complex processes and correspondence involved in medical billing.

A typical base package of medical billing software would contain features that are restricted to medical billing and accounting functions like patient recordkeeping, claims processing, electronic claims submission, receivables management, patient billing and accounting integration. However, many software providers extend their scope to include features like practice management, scheduling and other administrative and clinical functions that are generally a part of EMR software systems.

Therefore, the difference between medical billing software and an EMR is that of core functionality. While medical billing software focuses on a practice’s medical billing procedures and billing-related administrative and financial processes, features of an EMR are primarily concentrated on clinical functions, records and outcomes

Medical billing software may serve clinical EMR functions in addition to electronic billing and coding for greater versatility. The same is true for EMR systems that incorporate specialized medical billing and coding program features to supplement their clinical applications.


Saturday, September 17, 2011

Cloud Computing in Healthcare

This article aims to discuss aspects of cloud computing that are relevant to the healthcare industry and can be applied by doctors to improve their practice.

What Should Doctors Know About Cloud Computing?

There is a sea of information available on the internet about cloud computing and how it works. As a doctor with limited interest in information technology, understanding all that jargon (most of which may not even be directly related to your work and computing requirements) can be quite intimidating and time consuming.

Simply put, the cloud is a set of hardware, networks, storage, services and interfaces that are equipped to provide computing power, infrastructure, applications, software, business processes and storage – in short, all your computing needs, as a service wherever and whenever you need it.

Migrating to the cloud 'can' help you reduce cost, space, time and power that would otherwise be utilized for traditional IT services performing the same functions. This is possible because the cloud puts together a large pool of computing resources available to be used as an assured service by anyone who wishes to use it, anywhere in the world. Traditional IT environments on the other hand, have a limited set of resources that are independently managed and delivered to a limited number of people confined to a certain geographic location, thus pushing cost, time, space and power factors.

Using Cloud Computing To Improve Your Practice

Cloud computing can transform the way healthcare is practiced by empowering professionals to deliver better care at lower costs. Cloud computing allows doctors, researchers and scientists across the globe to collaborate and form a centralized, integrated and regularly updated medical database that can be seamlessly accessed by healthcare professionals without having to invest in over-the-top infrastructure or software. Doctors can use the cloud for viewing reports, scans, EMRs, prescriptions and information required to solve complex medical problems anywhere in the world.

Patients’ health data and EMRs can be combined to form a single, comprehensive health record that can be instantly accessed from one single source. The cloud also brings together patient information like insurance claims, prescription and drug details, lab reports, patient history and progress in cases of chronic illnesses and other details and consolidates them to be available at the point of care whenever required.

This not only helps improve the level of accuracy with which care is delivered but also reduces the time and cost of treatment for physicians and patients alike. As all data is sourced from a single, homogenous center, it also brings down the possibility of conflicting treatments, prescriptions and medical data miscommunication in cases where multiple physicians and providers are involved.

Cloud computing is typically subscription based. In many cases, it works on a metered billing model of payment where you pay only for what you use. It also allows for flexible self-service by which you can enable and disable the provision of required services depending on your usage and needs.

Cloud computing users need not invest in heavy capital expenditure on hardware, software, and services. As resources can be unsubscribed whenever required, the risk of investment is considerably reduced. The cloud also addresses increased data storage needs of physicians without having them spend on expensive personal storage devices. Software updates and innovation are centrally managed by cloud service providers, helping doctors focus the best part of their day on patient care.

Cloud computing can thus help physicians meet meaningful use criteria as it demonstrates better quality of care, lower costs and higher insurance/government reimbursements.

Popular Cloud Services

Most of us have “been on the cloud” without even knowing about it (eg: Facebook is an example of a public cloud). Depending on the visibility of data there are three types of cloud platforms: Public, private and hybrid (a combination of public and private).

A more popular classification is based on the services offered:

1. Infrastructure as a service (IaaS) offers hardware related services like disk storage, database or virtual servers. Amazon Web Services (AWS),Rackspace Cloud Servers and Flexiscale are popular IaaS providers.

2. Platform as a Service (PaaS) offers development platforms. Google’s Application Engine, Microsofts Azure, Salesforce.com’s force.com are well-knows in this category.

3. Software as service (SaaS) involves software services on the cloud like web based software applications, email services and so on. Popular examples of SaaS services are Salesforce.com (CRM), Google’s Gmail, Google Apps, Dropbox, Zoho, QuickBooks, Piwik, Microsoft Hotmail and their online version of office called BPOS (Business Productivity Online Standard Suite).

A good read on top cloud platforms at http://www.liventerprise.com/news/3608/.

Cloud Security

Cloud security and data ownership is a major concern for users and new adopters of cloud computing. As there is very little regulation currently pertaining to cloud computing, there are many data privacy and security issues to be dealt with. New users must be informed about details on who owns the data, third parties that may gain access to the data and the jurisdiction of the contract. We will look at Cloud Security in detail via a separate article.