Tuesday, September 13, 2011

How Does Email Help You As A Doctor?

6:30 AM Nrip Nihalani

Email or electronic mailing has revolutionized business communication. The incentivization of technology in the healthcare industry coupled with its growing inclination towards consumerism and strong patient-doctor relationships has made it necessary for doctors and healthcare professionals to utilize this channel of communication to improve the quality and reach of their practice. However, even though a majority of doctors do own personal email accounts, not many are comfortable using the email for regular, professional correspondence.

Why Should Doctors Use Email?

Doctors are busy people. Email is fast, easy to manage and allows for instant response. As emails can be read on PCs, tablets, smartphones and practically any device with web access in your clinic, home or while commuting, incorporating email communication in your daily practice will help you stay connected with patients and other healthcare professionals wherever you are. 

Email not only improves your accessibility (especially in situations where instant responses are needed for critical correspondence) but also helps you shorten your workday by eliminating those piled up stacks of paper mail that welcome you to your clinic every morning! 
Managing your email is very easy and most free email services are built on simple, user-friendly models. You can send, receive and store all your correspondence instantly, without having to use paper, fax machines or courier services. You can prioritize your mails and respond to them based on the immediacy required. You can use the email to schedule visits, send appointment reminders, prescription refills, lab reports, scans, pre and post surgery care instructions, medication advice and billing details to patients. You can network with media, other doctors and medical professionals in the industry. You can also use it to educate patients by sending useful links and important online study material that could help them understand and work on their condition better.

One of the biggest advantages of using the email is quick and organized storage of all your communication which may include records and other documentation. Your files, scanned paper work, pictures, reports, graphs, numbers and other medical data which have been sent or received via email can be saved and stored online. These files can be neatly organized under appropriate tags for quick and easy retrieval whenever you wish to view them. Adding to that, convenient email search options save you hours of otherwise looking through paper files to find that one elusive paper that just won’t show up!

Using the email to communicate with your patients has a number of advantages. However, you cannot aim to completely replace telephone calls, personal visits and other forms of patient communication with it. One cannot communicate critical medical data requiring the doctor’s personal presence and support using this rather impersonal communication device. Doctors must identify the correspondence that will show positively on productivity and patient satisfaction if exchanged over email and only model those functions and areas under its purview on a regular basis.

Popular Email Services

There are many popular free email services that will help you send, receive, store and manage your correspondence. Gmail, Yahoo, Windows Live and AOL are widely used web email services. MS Outlook or Zimbra can be used to configure your email on your computer and is also a popular choice. Another email service that specifically complies with HIPAA rules is MD email.net (Medical Email). It is a medical industry secure HIPAA email for medical professionals and has over 395,000 doctor-users spanning over 65 medical specialties.

How To Set Up An Email Account?

To set up an email account, key in the URL address of the provider of your choice, click on the usually prominent “Sign up” button, fill a form and you’re ready to get started.
For example, if you wish to set up an account with Gmail, 

2. Click on “Create an account”
3. Fill in the registration form. 
Here is a video which shows you how.


What’s Keeping the Doctors Away?

The medical industry is historically known to be a conservative one characterized by sluggish and rather cynical adoption of technology. Studies indicate that while 90% patients would like their doctors to be accessible over email, doctors continue to elude this space.
One reason for doctors shying away from using the email could be that email correspondence is not reimbursed by insurance providers. Also, most doctors still prefer to operate under traditional models of communication simply because they have been using them for all these years and are too comfortable to venture out and try newer, faster and more productive ways of reaching out to their patients. 
Security and compliance issues are also responsible for doctors being weary about using email communication in their practice. Medical data is always sensitive and like any other form of communication, email too has its medical-legal implications. The AMA lays down guidelines for doctor-patient electronic communication that can be read at http://www.ama-assn.org/ama/pub/about-ama/our-people/member-groups-sections/young-physicians-section/advocacy-resources/guidelines-physician-patient-electronic-communications.page
Along with following these guidelines, doctors must ensure that they operate on a secure and reliable internet connection. Computers must be well-protected against spam, virus and other bugs. As a rule of thumb, unknown emails should not be opened. Your password must be unbreachable, kept confidential and regularly changed. Keeping these security guidelines in mind, doctors can safely utilize the benefits of email to improve the productivity and accessibility of their practice.

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Thursday, September 8, 2011

How Technology Can Improve The Work Life Balance For A Physician

12:50 AM Nrip Nihalani

Doctors and healthcare professionals are not strangers to poor work life balance. A very strong culture surrounds this industry that perceives a doctor wishing to lead a healthy personal life as a sign of weakness. 

It is not uncommon to see doctors resign to the demands of the job and the medical culture system, leading to unhealthy suppression of their personal goals and requirements. No doubt that for some medical professionals, the passion for work overrides the stress and the burning out, but for others, constantly trying to cope with the unwritten but powerful psychological contract of “if you cannot work 18 hours a day and seven days a week, you don’t belong here” can be very overwhelming.

It’s usually only a matter of time until physicians begin to deal with ill health, depression, reduced efficiency and quality of work, lack of focus, fatigue-related medical errors, struggling personal and professional relationships and severe job dissatisfaction to the extent that many end up reconsidering their decision of being in the medical profession submitting to “maybe I’m not wired for this!”

Yes, there are caps on the number of duty hours for doctors. However, the increasing influence of consumerism on the national healthcare system and the growing demands of federal policies call in for greater accountability, increased bureaucracy and a ton of paperwork and administrative chores left to be performed by physicians themselves. This corporatization of work structure compels them to digress from their primary job of providing healthcare to completing clerical and managerial work that now ends up taking the best of their time and productivity, defeating the very idea of Meaningful Work.

In such a situation and keeping in mind the perfectionists that doctors are, one way for them to strike a healthy work life balance without compromising on their productivity or performance would be to focus the best part of their energy and work day on their actual job – that of being good clinicians and reduce the amount of time, effort and personal attention they put into peripherals like paperwork, clinic management and other administrative functions. 

This article aims to suggest help on how physicians may save time on these subordinate activities by using technological tools that will enable them to complete the same tasks quickly and efficiently, leaving them more personal time and a better organized work day.

7 Must-Use Technological Tools for Physicians

1.) Email
Physicians must leverage the power of this simple tool to reach out and connect to their patients without having to extend their workday. Communicating via email can be less intrusive and time consuming as opposed to personal telephone calls as it allows for multitasking, automation, bulk mailing and standardization of regularly used content.

Appointment reminders, medication alarms, direction maps and instructions can be sent out to patients through an automated, pre-programmed system that monitors all your email communication.

2.) Medical Website

In a world where people turn to the Internet for nearly everything, having a web presence not only helps you reach out to a global audience but is also a time saver for functions like briefing new patients about your practice, answering FAQs, providing critical information, clinic details, directions and patient support. For physicians looking to set up a website, a good place to begin would be http://www.websitesordoctors.in

3.) Spreadsheet programs like Microsoft Excel

If you haven’t already discovered the treasures of Ms Excel and still go the old pen and paper way to record your administrative activities, insurance, tax, bank and financial details, stocks, inventories and everything that makes up your practice, you are missing out on a tool that can transform your work day and save you a ton of time and trouble. Ms Excel is simple to learn, easy to use and will spoil you for convenience once you’re in the habit of using it. For free online training in Ms Excel, visit http://office.microsoft.com/en-us/excel-help/CH010369467.aspx.

4.) PDAs and Smartphones 

A personal digital or data assistant (PDA) can be used to save all your information paperlessly, in one single place. This information is portable and can be made available on your laptop, phone and other devices. PDAs can be used to store patient contacts, records, medical and other information, drug databases, crucial spontaneous notes, treatment information etc. E-books, medical databases, research and information can also be stored and accessed. You can use them to schedule your day, post reminders for important tasks and have all the information you need in the palm of your hand whenever you need it.

5.) Medical Software such as an Electronic Medical Record(EMR)

EMRs collect and consolidate all patient information into a single integrated system that can be accessed at the click of a mouse. Without having to look through heaps of paper files, EMRs allow for quick and convenient access to the patient's medical history, list of medications, drug allergies, test results and information, helping physicians make faster, accurate and more informed medical decisions, diagnoses and treatments. They also enable instant and simultaneous EMR sharing with other care providers, saving on a whole lot of time that would otherwise be spent in viewing, reviewing and communicating results with other practitioners.

6.) Smartphones/Tablet PCs 

Smartphones are poised to be the next big thing in Healthcare IT. The power of portable information and being connected on the go is sure to lend physicians greater autonomy and flexibility of work schedules. Smartphones and tablets can be synchronized with your office and home computers, PDAs etc and can be used to access this and other medical information from any place in the world. You can effectively use them to do your day’s reading or wrap up pending documentation and record work while commuting or even at home. A good article on using smartphones to improve your practice can be read at http://emrmeaningfuluse.blogspot.com/2011/08/how-can-smartphone-help-you-in-your.html

7.) Videoconferencing and Tele-consultations

Physicians can use videoconferencing tools like Skype to provide tele-consultations to patients based in remote locations. They can also carry out pre-appointment screenings, post-appointment follow ups and monitoring from home, saving themselves and their patients commuting time and making for a shorter work day. To learn more about videoconferencing and Skype, visit http://emrmeaningfuluse.blogspot.com/2011/09/using-skype-to-help-your-practice.html

These technological tools can be used to reduce the time and effort spent on administrative functions (and certain clinical functions too!). If a routine break up of your day is say 70% of seeing patients and 30% of filing paperwork and records, you can use these tools to work on bringing down the 30% average or even taking it home (easier for solo practitioners) as all the information is digitally available to you, wherever (and whenever) you choose to use it. 

Yes, taking work home is a debatable idea for many families but for physicians, it is really a case of being home at a good hour at least physically vs not being there at all. The trick here is to not get into a habit of “staying connected” all the time, using technology to only accomplish what is required for the day and switch off once you’re done.

References:


Thursday, September 1, 2011

Using Skype To Help Your Practice

1:16 PM Nrip Nihalani

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?

3:12 AM Nrip Nihalani

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/


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