Thursday, September 1, 2011

Using Skype To Help Your Practice

What is Skype?

Skype is a software program that allows its users to make voice and video calls between computers (including tablets, smartphones with web access) and voice calls from computers to regular telephones that are not connected to the internet, anywhere in the world. Some of their services are free to use while some are available for a fee. 

What makes Skype such a valuable asset to medical practice is its videoconferencing tool. Gaining widespread adoption in the healthcare industry, this tool has the potential to transform the process and practice of medicine for physicians as well as patients.

Skype in Healthcare
 Practitioners have identified a number of functional areas where Skype can help improve the quality of care by raising the level of accessibility, reach and convenience for both patients and doctors.

While Skype calls and videoconferencing may not serve to replace personal visits and interactions, many physicians are turning to it for pre-appointment screening and post-appointment follow-ups and monitoring. Some doctors use Skype to effectively educate new patients prior to their first consultation to get them familiar and comfortable with typically intimidating medical environments. In remote areas with inadequate medical care facilities, Skype video calling allows patients to connect with their doctors and other medical providers for virtual consultations and evaluations, saving on a good amount of travel and other medical expenses. 

Skype is also gaining popularity in helping patients keep in touch with their loved ones in medical facilities like children’s hospitals (Skype works with UCSF Children’s Hospital and UCSF Medical Center), birthing suites and skilled nursing units.

One subspecialty that has greatly benefited from Skype’s video communication is Psychiatry. As America’s baby boomers age (over 50% of the 85+ age group deals with dementia), healthcare costs are positioned to rise. In such a situation, Skype offers an affordable and effective alternative for patients to interact with their doctors and be regularly monitored without having to spend time and money on travelling and office visits. It also enables doctors to access higher healthcare education via Skype-enabled virtual classrooms taught by global healthcare experts.

As Skype strengthens its focus on mobile users, medical professionals are presented with newer opportunities to leverage this trend for improving their practice as well as the relationship they share with their patients.

Getting Skype for your Practice
To make a Skype call, you will need the following:
- Desktop/Laptop/Tablet/Smartphone/Skype-enabled TV
- Internet access
- A microphone and headset
- Optional Web camera (even though most laptops have a built-in web cam, it is advisable that patients purchase a separate, detachable web cam that can be adjusted to focus on specific body parts that need virtual examination)
- Optional Skype Accessories like USB Phones, Bluetooth Headsets, Skype VoIP Adapters can also be used to enhance your Skype experience

Once, you have all the hardware and equipment in place, the next step is to download the program from their website. You can do so here: www.skype.com

After downloading Skype (ensure that you download the version that’s compatible with your particular device), you have to install it on your system. 

Both these steps are as easy as signing up for an email and are very well explained on their website. 

When you have finished the download and installation, you will log in with your Skype name and Password from your system.

On logging in, you will be able to add your patients to your list of Skype contacts (in case they have added you already, you may accept their request). You can make or receive voice and video calls to/from anyone in your contact list. 

If you still have doubts concerning the download and installation, this Slide Share presentation http://www.slideshare.net/hmartyn/skype-4069998 offers a simple Step-by-Step guide through the entire process.

Video Calling On Skype

You can use Skype to offer high quality virtual consultations, pre-appointment screenings, follow-ups and monitoring to your patients. However, for a clear, uninterrupted video call, you will need a fast internet connection, or in the case of smartphones, a mobile data plan or Wi-Fi. 

Watch this online tutorial to know exactly how you can make video calls using Skype: http://www.skype.com/intl/en/features/allfeatures/video-call/

Skype Features For Your Practice

- Platforms Supported by Skype
Skype is available on Windows, Mac, Linux, Android, iPhone, Symbian platforms. You can also make high quality video calls from Skype-enabled Panasonic, Samsung and Sony TVs as well as Blu-ray™ players from Panasonic and Sony.

- Free to Use Skype Services
Skype offers a number of services that you can use free of charge to connect with patients and other medical providers across the globe. Skype-to-Skype calls, One-to-one video calls, instant messaging and screen sharing are features that you can use for free. For practitioners using Skype for the first time, these features will more than serve your purpose, at least to begin with. Once you get comfortable using the software and are able to identify the features that will fulfill your specific communication needs, you can always upgrade to the paid and premium versions.

- Paid Features
Skype’s paid features include voice calls to regular phones and cell phones anywhere in the world at very low calling rates, SMS, call forwarding, voicemail, group video calling with three or more people in a single video call and live chat support. You can also get your own online Skype number for your patients to call and reach you wherever you are or you can sign up for a Skype To Go number to make low-cost international calls from your mobile or regular landline. These features are competitively priced, depending on the subscription package you opt for.

Skype Security for Healthcare – HIPAA Compliance

Despite Skype’s potential to combat rising healthcare costs, busy patient and physician schedules and healthcare accessibility issues, practitioners seem to be reluctant to adopt Skype in their practice due to the controversy surrounding its security and compliance protocols. 
However, Skype’s 256-bit-point-to-point encryption is in agreement with HIPAA’s privacy requirements. It is a secure videophone and any HIPAA requirements that apply to a regular telephone are applicable to Skype. Practitioners, however, must ensure that their systems are well-protected against spammers, bugs and malware as a precautionary and safety measure that holds not just for Skype but for any other web-related activity as well.

References:


Wednesday, August 24, 2011

What Is Telemedicine?

The American Telemedicine Association defines Telemedicine as "the use of medical information exchanged from one site to another via electronic communications to improve patients' health status."

The term "telehealth", "e-health" and "telemedicine" are often used interchangeably, the difference being that telemedicine involves using information technology primarily for the delivery of clinical services while telehealth and e-health also include the provision of non-clinical healthcare services like tele-education and tele-training for continuing medical education, practice management, research and administration.

Telemedicine is practiced when medical services like health consultations, diagnoses, procedures, patient report analysis, monitoring and so on, are electronically provided by practitioners to patients based in remote locations using telemedicine technology and equipment.

Types of Telemedicine

There are three primary types of telemedicine – Store and Forward, Remote Monitoring and Two-way Real-time Telemedicine.

Store and Forward Telemedicine includes healthcare services for non-emergency situations that can be provided offline, without requiring the presence of the provider and the patient at the same time. It involves the remote patient passing on his medical data like medical history, EMR, scans, reports, past diagnoses etc to the provider who assesses his health status based on the given information and reverts accordingly without carrying out a personal, real-time examination of the patient.

Remote Monitoring includes a telemedical facility actively monitoring patients over remote locations using telemedicine equipment and devices. It is an effective way of monitoring vital signs like ECGs, blood glucose levels, respiratory rates etc for volatile health issues like cardiovascular diseases, asthma and diabetes that require constant care and vigilance.

Two-way Real-time Telemedicine provides consultations, diagnosis and treatment over real-time videoconferencing, live transmission of diagnostic images/videos, phone conversations and other synchronous interactive telemedicine technology where the practitioner and patient remotely connect and interact with each other at a given time with a local doctor as an intermediary.

Besides these, some facilities also provide emergency telemedicine and disaster restoration tele-support services.

Benefits of Telemedicine

Telemedicine services aim to replace or at least equal traditional clinic visits, face-to-face consultations and visiting nurses, save costs and provide better care in locations where the quality of healthcare is not up to the mark. So far, around 50 medical subspecialties have adopted telemedicine with radiology turning out to be a heavy user. Teleradiology is widely used to electronically transmit x-rays, CT scans and other images to remote providers for evaluation and assessment.
Other branches that have resorted to telemedicine to improve their quality, reach and accessibility are dermatology, ophthalmology, psychiatry, cardiology and pathology.

Telemedicine technology allows patients to avail of quality consultations, monitoring, electronic housecalls, testing, diagnosis and treatments from remote locations that may lack the required medical services, connecting patients and practitioners via an integrated, global healthcare system. With telemedicine, practitioners can provide improved diagnoses and better treatments due to comprehensive digital data that is available to them offline and over the web. Follow-ups and monitoring patients becomes easier and more efficient owing to automated active monitoring devices that provide continual and constant connectivity between the two parties. As for patients in remote or under-served areas, telemedicine gives them access to world-class medical services without having to travel or shift base. This not only helps them gain valuable medical advice and treatment from top medical specialists but also saves on their travel expenses, unnecessary hospital visits and in many cases, cost of medicines and expensive health facilities.

Equipment and Facilities Required for Telemedicine

A successful telemedicine program requires specialized telemedicine equipment and facilities. For seamless and uninterrupted delivery of remote medical services, medical devices, peripherals and software solutions supported by expert telemedicine professionals, customer care personnel and training staff must be incorporated within a compatible system that functions according to an effective, tested workflow model.

The following facilities and equipment are usually needed to provide telemedicine services:
- Tele-consultation rooms
- Patient engagement facilities like beds, scopes etc
- Desktops/ Laptops/ Tablet PCs
- Internet Connectivity and Broadband Devices, Routers
- Printer
- Film Scanner
- Digital Camera
- Video Conferencing Kit
- Specialized Tele medicine software for your subspecialty
- Non-invasive pulse and blood pressure unit
- Digital ECG
- Digital Microscope
- Glucometer and Haemogram analyzer
- Mobile vans (in case of mobile or emergency telemedicine centres and ambulatory care sites)

Telemedicine Delivery Channels

Telemedicine services can be provided over four main channels:

1. Point-to-point telemedicine where patients and providers (hospitals, clinics) are connected over private networks directly or through an independent practitioner as an intermediary.
2. Patient is connected to a specialty care provider through tele-videoconferencing for a real time consultation over a home connection.
3. Active tele-monitoring for housebound patients over specialized tele-monitoring systems.
4. Direct web-based telemedicine services and patient-care.

Telemedicine Support in the USA

Despite its numerous benefits, telemedicine has a long way to go before it finds a viable place in the country’s mainstream medical system. The government supports the adoption of telemedicine with a number of incentives and federal grants. The American Telemedicine Association provides more information on federal funding for telemedicine at http://www.americantelemed.org/


References:


Sunday, August 21, 2011

How Can A Smartphone Help You In Your Practice?


75% of American doctors own smartphones and over 95% of them use smartphone healthcare applications in their practice. As a growing number of medical schools and health facilities make it mandatory for students and practitioners to actively use smartphones in their practice, the wireless health market is positioned to grow exponentially in the coming years. Latest smartphone advances in technology and medical applications have provided doctors the opportunity to bring about improvements in almost every function of their practice.

Using Smartphones To Improve Your Practice
Using a smartphone in your practice can help improve its efficiency and productivity in ways more tangible than perceived. These ergonomic, portable devices provide wireless web access and ingenious medical applications that offer limitless possibilities in the hands of a skilled user. For starters, doctors can carry a whole world of medical research, updated real-time information and databases in their pockets, allowing for complete point of care accessibility. 

Apart from providing crucial medical information, smartphones perform a number of administrative and medical functions that can change the way medicine is practiced. On the administrative side, smartphones can be used to maintain calendars, appointments, patients schedules and these can be synchronized with multiple devices like  home and office laptops, tablets and other workstations, making all the information available to you as one simplified, integrated database. Smartphones can work with emails, can be used for emergency notes, memos and patient records, automated appointment and medication reminders, e-prescribing, drug management, billing and policy information and prescription drug references. They are intelligent devices that allow doctors to view and scrutinize medical images, ultrasound scans and ECG reports. Lab orders and results can also be reviewed wherever you are, using your smartphone. 

A growing number of practitioners are connecting with their patients using social media and other interactive web-based apps. These tools typically require a dynamic, on-the-go approach which is possible only via portable devices with inbuilt web access and smartphones fit the bill perfectly. Smartphones are also poised to be smart health monitors that use smart sensors and smart bandages to monitor patients, communicating the relevant data to practitioners through health monitoring apps. Patients and doctors can both receive indicators and warnings on their health dashboards based on the reports of this active monitoring model.
Smartphones can help healthcare professionals manage their day in the field to route patient calls, send instant patient reports and generate bills at the point of care. In fact, telemedicine is now using the NFC or near-field communication technology in smartphones to completely go wireless. This technology uses radio-frequency identification (RFID) that allows patients to pay for healthcare with a swipe of their smartphones.

Mobile Medicine - Smartphone Healthcare Applications
The main advantage that smartphones hold over regular mobile phones is the availability of useful and cutting edge healthcare applications. With over 17,000 medical apps available in the market, we put together a list of apps that are most popular with healthcare professionals of varied interests and specializations. Many of them are free to download (with paid premium versions available) and can be used on the iPhone, Blackberry, Windows, Palm and Android operating systems. Users must check the compatibility of the applications with their smartphone operating systems before downloading.

Application
Features
Platforms Supported
PubMed On Tap

Gives you access to the National Library of Medicine and MEDLINE® citations.
iPhone
ePocrates
Information on drugs and drug interactions, helps you identify pills using pictures and descriptions, features a well-received medical calculator called MedMath.
iPhone, Android, Blackberry, Palm 
DynaMed
A clinical reference database containing more than 3,200 evidence-based clinical summaries that are updated daily and intended for use primarily at the point-of-care. 
iPhone, Android, Blackberry, Palm, Windows 
UpToDate
A clinical decision support system that includes access to over 8,500 topics in 17 specialties. Combines detailed medical information, expert opinions and recommendations.
iPhone, Blackberry
Skyskape’s RxDrugs
Provides updated dosing guidelines on medications, contains weight-based drug dosing calculators and informative monographs.
iPhone, Android, Blackberry
Taber’s Medical Dictionary
Contains over 60,000 terms, 1,000 photos, and more than 600 Patient Care Statements, in-depth definitions, nutrition and alternative therapy coverage, medical abbreviations, symbols and units of measurement, immunization schedules, nursing diagnoses, links to pronunciations.
iPhone, Blackberry, Android, Windows
Clinical Consult
Diagnosis, treatment, medications, follow-up of most common medical conditions. Drug therapy information, alternative medicines and evidence-based drug information provided.
iPhone, Android, Blackberry, Palm, Windows 
First Consult
Gives you evidence-based answers to clinical questions.
iPhone
Diagnosauras
Helps in differential diagnosis with access to over 1,000 diagnoses by organ system, symptom and disease.

iPhone
Netter’s Anatomy
Provides anatomical illustrations from Netter’s bestselling Atlas of Human Anatomy .
iPhone
MedCalc
Gives you easy access to complicated medical formulas, scores, scales and classifications.
iPhone
mobileMicromedex
Information on drugs, interactions, diseases, lab, alternative medicines, toxicology, news and alerts, convenient calculators.
Windows, Palm
Blackberry, iPhone (not on standard download)
Brain Tutor
Contains information on functions and structure of parts of the brain for students and medical professionals. It allows you to explore 3D models of the head and brain in real-time.
iPhone
Medscape
Includes drug reference, interaction checker, disease/condition reference and treatment guide, procedures reference, tables and protocols reference, daily medical news and alerts, continuing medical education activities, physician-pharmacy-hospital directories, offline access to clinical reference.
iPhone, Android, Blackberry
Wikipedia Mobile
Helps you view Wikipedia articles on your smartphone.
iPhone, Android, Blackberry, Palm, Windows 


Smartphones mean that you’re carrying large volumes of crucial confidential information in a fragile device. Hence, the FDA has stepped in to regulate the information that you can upload and transmit over certain apps for data security and safety purposes. Hence, users must keep informed about FDA regulations that apply to medical smartphone applications.

References
  1. http://cid.oxfordjournals.org/content/47/1/117.full
  2. http://drottematic.wordpress.com/2009/11/12/using-smartphones-in-medicine-practical-examples/
  3. http://www.firstwordplus.com/FWD0430510.do
  4. http://www.pcworld.com/article/236011/fda_plans_to_regulate_smartphone_apps.html
  5. http://www.theglobeandmail.com/news/technology/tech-for-tomorrow/health-care-eyes-smart-phones-to-heal-ills/article1288140/
  6. http://www.blackberrypartnersfund.com/blogs/bbfundblog/smartphonesandhealthcare
  7. http://hitexchangemedia.com/articles/mayjune-2011/smartphones-could-become-mobile-nurses-and-labs-in-the-future/
  8. http://digital-medicine.posterous.com/doctors-leaning-towards-e-detailing-and-table
  9. http://www.bluelinerny.com/blog/world/smartphones-future-of-medicine.php
  10. http://www.ncbi.nlm.nih.gov/pubmed/20690190
  11. http://blogs.ubc.ca/dean/2011/02/smartphones-in-medicine-let-me-count-the-ways/
  12. http://digital-medicine.posterous.com/using-smartphones-to-share-ecgs-with-your-doc
  13. http://news.wustl.edu/news/Pages/14109.aspx
  14. http://www.medschool.vcu.edu/technology/ed_tech/smartphones.html
  15. http://www.softwareadvice.com/articles/medical/smartphone-survey-results-1073009/#ixzz1VPd7ILCW
  16. http://www.ebscohost.com/dynamed/what.php
  17. http://itunes.apple.com
  18. http://www.uptodate.com/home/about/toc.html
  19. http://www.skyscape.com/estore/productdetail.aspx?productid=1093
  20. http://thinkanatomy.com/2008/10/netters-anatomy-iphone-app/