Thursday, November 3, 2011

How are Physicians taking to Social Media?

2:58 PM Nrip Nihalani


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.

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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?

9:20 PM Nrip Nihalani

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.

1. ESET NOD32
Information: http://www.eset.com/

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

3. BIT DEFENDER
Information: http://www.bitdefender.com/

4. QUICK HEAL
Information: http://www.quickheal.com/

5. NORTON INTERNET SECURITY
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

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

3. AVIRA
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.


References:

Difference Between Medical Billing Software and EMR

12:37 PM Nrip Nihalani

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.

References:

Saturday, September 17, 2011

Cloud Computing in Healthcare

5:16 PM Nrip Nihalani

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.

References: