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.

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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.

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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.

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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.

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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)

References:

http://missourihealthconnect.org/FAQRetrieve.aspx?ID=45267

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

http://www.emrandehr.com/2010/08/30/meaningful-use-resource/

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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.

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