Prescribing eHealth for Your Patients

I recently attended the mHealth Summit in Washington D.C. and it was yet another example that physicians are still missing from key conversations. Last week it was New York eHealth Collaborative Conference, previously Connected Health Symposium in Boston … Health 2.0 in San Francisco. Why aren’t physicians attending these conferences?

The techies and start-up health company founders were discussing their plans for pilot programs where physicians become active prescribers of eHealth resources and mobile health applications for their patients. Why is that an important discussion physicians should be part of?

Think about the countless hours patients spend on managing their conditions outside of the doctors’ offices. In diabetes for example, we’re talking about an average of almost 8,000 hours that physicians can’t account for! Can doctors make an impact on what happens during that time? Yes. Some examples:

• Prescribe your website or blog where you write answers to most common questions that you repeat 20-30 times a day. The time savings alone justify having your own website. How many doctors have their own website?
• Prescribe online patient communities that you yourself reviewed and approve of. Patients will be spending hundreds if not thousands of hours online looking up their conditions, other patients’ experiences and advice on how to improve their quality of life. Why not become a trusted filter and help your patients find great information … rather than misinformation.
• Prescribe Mobile Health Applications for your patients. iPhone and Android applications are being created by the hundreds. You’re able to account for every adverse effect, every time a patient might not be feeling their best, and even accurately record ECG in real time via the iPhone that can be seemlessly transferred directly into the EHR. Do you treat migraines? What if you had the opportunity to monitor effects of treatment plans at the patient’s home, something that is never recorded in real time but rather at the next patient visit. Think of all the critical clinical data that is lost when it is not recorded and forgotten.

With so much stress on accountability, treatment compliance, cost-effectiveness and keeping patients healthy, physicians’ voices have never been more important than right now.

Start planning for 2012 to attend conferences and meetings on innovations in the medical practice. There are many conferences being planned that will not only unveil ways to keep your practice successful, but will earn you CME credits, uncover business opportunities, and earn you recognition for being an innovator when you bring your success stories to the panels.

Two upcoming conferences:

• February 19-21 Physician Strategies Summit
• March 29-30th in New York City – NextGenHealth - plug in code “simon12″ at checkout for a discount.

I’ll update this list of conferences for physicians as soon as I review what’s coming up. There are also conferences planned in each major specialty. Check in with your specialty’s association for details.

Hot Dog Buns and Health Records

The next time you’re at Costco ogling flat screens and buying a pallet of paper towels, you may also be surprised to learn that Costco members are now eligible to receive incentive pricing on a Costco-branded cloud-based electronic medical record. During my maiden voyage to Costco after arriving in the Bay Area,  I saw a promotion for a Costco-branded EMR, billed as a “Service of the Month.” I was so baffled that I almost crashed into the guy with the cart brimming with hot dog buns. Fortunately, he was more amused than annoyed with me. (When I asked him to pose for this photo, he thought I was crazy.)

I’m not sure if posting marketing materials in Costco’s exit lane is an effective way to target a potential audience of EMR purchasers. However, it demonstrates that EMR marketers will take just about any approach to find a customer.

I picked up the promotional materials on the way out of the store and conducted some research after getting home. I was also surprised to learn that the Costco/EMR partnership was not a first for big-box retailers. Sam’s Club and Dell had a brief affair with another EMR company, eClinicalWorks in 2009, but soon dissolved its partnership due to lack of interest among members.

Given the failed relationship between Dell, Walmart and eClinicalWorks, why is Costco now selling a cloud-based EMR? I asked myself this question. Then I asked this question on Quora and am beginning to collect responses. What’s yours?

Stick Out Your Tongue!

I am lucky enough to share a co-working space with a woman who recently graduated from the American College of Traditional Chinese Medicine. As a result, I get to be the beneficiary of health advice that lies beyond the parameters of traditional Western approaches. Rather than the anatomic or organ systems approaches I’m accustomed to, TCM’s approach is based on “the ancient Chinese perception of humans as microcosms of the larger, surrounding universe—interconnected with nature and subject to its forces. The human body is regarded as an organic entity in which the various organs, tissues, and other parts have distinct functions but are all interdependent. Health and disease relate to balance of the functions.” Searching for an analogy when reading this translation of the Classic Chinese Medicine text Huángdì Nèijīng, I think of an interactive weather map of the body. Turns out that TCM practices also rely heavily on maps of one kind of another.

One of the diagnostic foundations of Traditional Chinese Medicine (TCM) is tongue evaluation. This practice assesses a patient’s general energetic condition. Because the tongue is positioned somewhere between the interior and exterior of the body, it is particularly well suited to detect imbalances. Different areas of a patient’s tongue correspond to the different channels of the body. The color, texture, shape, and regions of the tongue are mapped and provide clues to diagnosis and therapeutic approach and progress. In addition, the tongue is also particularly well suited for photography in a clinical environment, provided the patient is a willing participant. A series of chronological photographs of the patient’s tongue can also provide a vivid picture of their clinical course and the effectiveness of therapies.

Most Common Topographic Representations of the Tongue in Traditional Chinese Medicine

Once a diagnosis is made, TCM practitioners may use acupuncture to treat imbalances in the body. In acupuncture, small thin needles are placed in points along meridians of the body clear blockages and release “qi,” the body’s energy. Of the over 350 points along 12 major meridians of the body can also be best represented on a map of the human body. For an acupuncturist to track the points that they use in treatment, they typically record the point in a record by number. However, a visual map of a human body be a great addition to an acupuncture record and would likely be a more efficient means of recording and annotating these procedures.

A Model of Acupunture Points in the Human Body

TCM practice, along with a litany of other Western subspecialties can leverage files with annotation. This can be a valuable tool in developing a comprehensive and information-rich medical record. This can also be a valuable tool in the education of patients. DrChrono’s FreeDraw feature provides a seamless way to integrate images and annotate. But it’s up to the practitioner to find creative and efficient ways to use it.

Have you found a way to use FreeDraw that we should know about? Let us know.

Coal Miner’s Doctor?

Image courtesy of the U.S. National Library of Medicine

Occupational and Environmental Medicine is a specialty where physicians are responsible for the health of workers. While your average office cubicle dweller doesn’t usually think twice about workplace health hazards, those in mining, manufacturing, and the military have good reason to be concerned.

Typically an occupational health record and a medical record take two completely separate paths, and rarely does a practitioner get the benefit of being able to see both in the same system. As a patient’s work affects their health and vice-versa, this report proposes that an EMR also capture occupational health information. The Institute of Medicine, the Government’s most august body of academic physicians and policymakers just issued a report that examined the rationale and feasibility of incorporating occupational information in patients’ EHRs. Patient records and occupational health records typically exist in separate systems – probably because reimbursement systems differ. To unify these records would give a physician a full picture of the patients’ health, potentially making care more effective and lowering costs.

Though the most obvious place for an occupational health department is a health care setting, occupational health physicians can practice just about anywhere. Judging from a few recent listings on the American College of Occupational Medicine’s website, in addition to the usual suspects like large health systems, occupational health physicians are currently needed at the Harley Davidson Plant in Tomahawk WI, the Social Security Administration in Baltimore, MD, and SeaWorld. It seems that a physician who works at any of these atypical settings would benefit from an EMR that speaks specifically to the needs of these particular sets of patients. A diver at SeaWorld and a line worker at the Harley plant would benefit from a customized OnPatient experience when seeing an occupational health physician. Physicians who work in these environments also need to have their own set of efficiencies built into their workflow given the variety of environments they work in.

iPad makes the rounds with physicians

Apple released this great video showing off how the iPad can be used in a medical setting. The video features St. Louis Urgent Cares.

For more information, apple.com.

The video shows off how drchrono makes doctors mobile.