Archive for Learn This: Technology Answers

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Blockchain for Beginners

Do you know what blockchain is?

Everyone has heard of blockchain, but not many people understand what it really is – myself included. I went looking for an approachable introduction to the technology and found this excellent Wired video (posted below) that describes blockchain for five different levels of understanding:

  • Five Year Old
  • Pre-Teen
  • College Student
  • Grad Student
  • Expert (at about 10 minutes in if you want to skip ahead)

I found that listening to each segment helped me grasp the concept and increase my understanding as the levels progressed.

What does blockchain have to do with healthcare?

Although I found varying degrees of optimism about the blockchain’s ability to solve healthcare’s interoperability problem, I did find a wishlist on happiest minds blog that highlights some of the most promising uses for the technology.

Features of a “Health Wallet” Owned By Patients*

  1. Block Chain contains the complete health and billing history of the patient
  2. The transaction is updated into the Block Chain only when there is consensus between the parties involved, and there is no option to update a previously written record
  3. Patients permit the stakeholder to access the historical data, which is always in read-only mode; Patients will always know who had access to their data.

Benefits of a “Health Wallet” Owned by Patients*

  1. Comprehensive and trusted view of the Patient record
  2. Could avoid any new integration system to be created to communicate to different systems
  3. Administrative task and claims can be made easier

*Parents, Families, Caregivers, Guardians

Other possibilities suggested by posts on HealthITAnalytics:

Diagnosis Mistakes

“…The patient could be put in complete control of who accesses the record and who can make changes.  The patient could monitor the accuracy of edits such as new diagnoses, or even limit which providers are allowed to access sensitive information such as mental health data.”

Access to Sensitive Information

“Patients could receive automated notifications when a party asks permission to access a certain piece of data or requests a change, giving individuals more control over how, when, and for what purpose their data is shared.”

Universal Credentialing Relief

“Blockchain would allow a provider to make his or her current certificate of attestation of licensure available on the blockchain, where organizations can query for the data and ensure that it is trustworthy and up to date.”

Care Coordination

“…Chilmark Research envisions that blockchain could improve care coordination by connecting patient data across multiple providers, or simplify the process of revenue cycle management by strengthening bonds within provider networks, streamlining the eligibility verification process, and automating claims adjudication.”

Medication Mistakes and Prescription Fraud

“If one provider writes a prescription that is identical to the recommendations of another clinician, the blockchain could flag the duplication and prevent the patient from doubling up on the same medication.”

Posted in: Electronic Medical Records, Innovation, Learn This: Technology Answers

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Who’s Listening to Our EHR Issues?

Who You Gonna Call When Your EHR Sucks...the Life Out of You?

 

 

 

 

 

We hear more and more every day about EHR problems and physician dissatisfaction with performance and usability, and the way the federal government makes them use it. So, who should physicians complain to?

Of course you should complain to the vendor about usability, and complain in groups when possible. I’ve started several user groups in the past and have had success in communicating with vendors to improve their products. The key is keeping the User Group independent from the vendor, which takes committed volunteers.

In addition, you may want to complain to the Office of the National Coordinator (ONC) and hope that other physicians will do the same and there will be traction gained by many voices. The ONC has just launched an online complaint form for this purpose, but note, Coordinator Karen B. DeSalvo, MD only wants to hear about problems with certified EHRs.

Don’t know if your EHR is certified? Check here.

The American Medical Association (AMA) is also working on behalf of physicians with a campaign called “Break The Red Tape” which calls upon physicians to write about (or video) their EHR story. Even if you don’t plan to share your EHR story, be sure to click on the link and hear from real people.

Physicians (and their staffs) are overwhelmed with all the mandates. As a consultant, I no longer work with Meaningful Use, PQRS/VBM or PCMH. I refer practices to other consultants for these needs because I would rather work on what I think is meaningful in medical practice today – practice business models and strategies that bring more satisfaction to the physician and the patient.

Photo Credit: pixel pro photography south africa via Compfight cc

Posted in: Electronic Medical Records, Headlines, Learn This: Technology Answers

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Bringing Physicians and Patients Together Via Smartphone? Dr.Church Has An App For That!

Text to Doctor

I am always excited when physicians design products for other physicians because they “get it.” Here’s the tale of a Midwest physician, Dr. Fred Church, who has developed  a free app  to communicate one-on-one with his patients via email or text.

Mary Pat: Dr. Church, tell me how you came to design e-Consult My Doctor, an app that lets physicians and patients communicate with the ease of email and text in a secure environment.
Dr. Church: I suppose the axiom of “necessity is the mother of all innovation/invention” applies here. I saw a growing need and had a growing entrepreneurial passion to solve the problem for more physician-patient interaction between scheduled visits. I believe we are at the precipice of still greater demand for mobile connectivity and services in America.
The premise of private communications to enhance doctor-patient relationships is not a novelty, but how to do it in a HIPAA-compliant manner that is also is simple and convenient is a significant challenge. We are delivering an elegant smartphone app that uniquely understands a busy doctor’s and patient’s lives and works to serve them. We have created a utility that enables any doctor to be a concierge-service doctor and every patient to be the beneficiary of that great personalized care – care that is direct from the doctors that know them and whom they trust.
Mary Pat: You describe e-Consult My Doctor as a tool to augment the physician-patient relationship, not replace the traditional office visit. Can you give some examples of this?

Dr. Church: In no way is our communication management tool intended to replace the face-to-face interaction and assessment between a physician and his established patient.  We have terms of service that users will explicitly understand and agree to prior to participation. Doctors will not have to worry about this being crystal clear to patients. Most reasonable people understand that emergency situations need to be dealt with in-person and this tool is not intended to deliver emergency communications.   Example Scenarios: 

  1. “Doctor, can you give me an evaluation of this mole as I think it has changed since you last saw me for my physical? You told me to watch it and document it myself on my phone… should I be seeing you now or wait until my next physical?”
  2. “Surgeon, I am three days post-op and it’s Sunday afternoon and I’m scheduled to see you tomorrow for follow-up.  Can you take a look at these two pictures of my wound to tell me if I need to go to the urgent care or ER tonight before tomorrow’s follow-up? I’m not alarmed but a little concerned at how it looks and I want to have your opinion before my scheduled follow-up.”
  3. “Doctor, one month ago I described to you during Betsy’s well-child visit the rare sounds and behavior changes I was hearing and seeing from my 3 month-old daughter and felt like I was having difficulty adequately explaining it to you. Guess what, I was able to capture it on this video with audio.  Can you listen to it and tell me your opinion if I should be concerned about it? Should I bring her back in after you view this so you can examine her again and/or do more lab workup?”
  4. “Doctor, we talked about considering certain omega 3 supplements and I want your opinion on this particular supplement (see picture of label) from XYZ that the pharmacist recommended. Do you think it’s a good one also?  I appreciate your opinion before my next follow up with you.”

Mary Pat: Foremost in everyone’s mind is the privacy and confidentiality of texting and emailing – how does e-Consult My Doctor achieve HIPAA compliance? 

Dr. Church: Our smartphone app technology uses best practice standards for data at rest and in transit using AES 256-bit encryption. Doctors and patients will have a secure login to their app so that if their phone is stolen or misplaced, the data is still encrypted and cannot be viewed without a user’s password. If a user’s account is somehow compromised, administratively we can suspend his account, his e-consulting relationships, and access to the information between those relationships.

Mary Pat: Do you see this product replacing the traditional function of a nurse triage in the medical practice?

Dr. Church: Absolutely not. In fact, it is intended to offload the burden that triage is often overwhelmed with. Traditional healthcare will always need people to properly triage communications at a doctor’s office.  Unfortunately, high volumes and increased costs mean that calls are not always responded to in a timely way. Doctors need communication tools that are portable and flexible and this describes e-Consult My Doctor.

Mary Pat: Your software has some interesting features, including a mini-EMR or PHR (Personal Health Record.) Can you describe the benefits of a mini-EMR available from a smartphone?

Dr. Church: Because our solution is much less complex than an EHR (Electronic Health Record), a single adult patient user may keep and manage all of his dependents’ information on one app securely. Our well-designed smartphone app stores all related health event reminders, vaccine history, and PHR information. The PHR on our smartphone app is viewable/editable without the requirement of an internet connection, which is a clear advantage over EHR portals.  When patients participate in managing their information and updating their PHR data between visits, it makes it easier for intake nurses/staff during scheduled visits to make sure the EHR’s data is also reflecting recent changes that may be more current than EHR updates from various sources: other urgent cares/ERs, other specialty doctors, other health providers/doctors/sub-specialists (DDS, DC, DPM, etc.), hospitals etc. One of the main advantages of patients participating in their own PHR information is it will hopefully improve PHR accuracy, contribute to better patient compliance, and help serve both patients and doctors in traditional healthcare delivery.

Mary Pat: How does the documentation of the communication between the physician and the patient get back into the practice EMR?

Dr. Church: The app will allow for exporting content via PDF and both doctors and patients will have their own copy of e-consultation data on their apps. Doctors may elect to attach the PDF of the e-consultation interaction to their respective EHR if they believe it is important enough and pertinent to a patient’s long-term record. For example, several EHRs do not have the ability to import pictures, audio, and video content which this app will easily store for minimal convenience fees.  Additionally, a doctor can simply summarize the exchange in her next scheduled office visit’s documentation if she feels the content is important enough. This will vary on an individual case-by-case basis and will be up to the doctor’s judgment.

Mary Pat: Between the secure communication and the mini-EMR, e-Consult My Doctor sounds very much like a patient portal. Can your software replace a patient portal for a medical practice?

Dr. Church: The mission of our software is to deliver a different and simpler solution for convenient communication and to augment the functionality of an EHR’s patient portal. An EHR patient portal is valuable for a singular patient to see what his doctor’s EHR documents as his current information including labs, vitals, etc.  The e-Consult My Doctor app will allow direct one-to-one communication any time and anywhere the doctor and patient are willing to participate.  One of the foundational premises of our product is that a doctor’s extra time and effort should be rewarded directly by the beneficiary… like having pay-as-you-go access to their mobile phone or email for enhanced, personalized care between scheduled visits.

Mary Pat: You have essentially designed a product that allows physicians to be reimbursed for care that they have been previously providing for free. Some patients will appreciate the convenience and be willing to pay for the personal attention and others will think it is akin to the airlines charging for luggage! How do you answer those who think healthcare is already too expensive without any additional fees? 

Dr. Church: I’m amazed how many people are willing to pay for the $1,000 – $2000 per patient per year for 24/7/365 access that they may only utilize a few times a year. I personally know concierge doctors who are eagerly looking forward to our HIPAA-compliant solution that will help them achieve better work-family life balance with our communication management tool.  We believe our smartphone app will bring a revolutionary solution that allows every doctor and every patient to participate in a concierge e-consulting relationship at a potentially lower price point. Our solution eliminates the middleman with a convenient and simple solution at a very affordable price and payment is directly and immediately received by the doctor.

Mary Pat: When will this product be available on the market and what will it cost physicians to purchase?

Dr. Church: The anticipated market delivery date is November 30, 2013. The app will be free and the basic subscription level will also be free. Users will be given a limited amount of secure storage space and may upgrade to larger amounts based on their individual needs. We will also offer a premium subscription level that will afford a larger secure space allotment and additional valuable service offerings. Our app will offer a pay-as-you-go, transactional model for the basic subscription level and a fixed-price price point for the value-minded user who wants more. Fred Church

Mary Pat: How can readers get in line to try your app?

Dr. Church: They can go to  http://e-ConsultMyDoctor.com and sign up for pre-launch information and be the first to try it out.  We invite physicians who want to be beta-testers!

Posted in: Amazing Customer Service, Electronic Medical Records, Innovation, Learn This: Technology Answers, Practice Marketing, Social Media

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Googling For Managers: Small Changes for Big Results

Google Search BoxI had a very illuminating conversation with my son Abraham the other day. It happens a lot. It’s one of the reasons we went into business together – we illuminate each other!

Abe said “Googling is such an underrated skill.”

I thought about how easy Googling* is. Google Search boxes are in most browsers and mobile device home screens, plus products like Apple’s Siri enable fast and successful voice searches. The act of Googling itself is easier than ever. But how good are you are taking advantage of this access? If you need to know something quickly, do you know how to find it the fastest? What about something more arcane – a very specific document or file for a nice task? How about the number of milliliters in a cup, or the definition of “tomography”? How well can you “get the goods” from Google?

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Posted in: Day-to-Day Operations, Learn This: Technology Answers

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Designing Consumer Health IT: A Guide for Developers and Systems Designers

New AHRQ Guide Identifies Successful Design Methods for Development of Consumer Health IT

Mobile Health Information Technology for Consumers

At Manage My Practice, we get lots of calls from people with ideas for healthcare products. They want to tell us their ideas and get our feedback. We love to hear about their ideas and strive to help them understand how healthcare works. Now we can also refer them to a new guide from the Agency for Healthcare Research and Quality (AHRQ.)

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Posted in: Innovation, Learn This: Technology Answers

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Why Healthcare Loves the iPad

iPad in Healthcare

Since first hitting the market in January 2010, the iPad and its successors have been somewhat of an anomaly in healthcare technology. Outside of cutting edge clinical treatments, the healthcare industry normally lags behind other sectors in adopting new technology. Not so with the iPad, which has become a favorite of healthcare providers in both private practice and in hospital settings. Why, you ask? Because the iPad bypasses a lot of the usual frustrations providers have with technology. The iPad is small, lightweight, fast to start, easy to use, smaller than a patient chart, can fit into some whitecoat pockets, affordable, tactile, and has thousands of healthcare-related apps available.

At the time the first iPad was introduced, John Halamka, HIT rock star and CIO for Beth Israel Deaconess Medical Center said “My general impression is that it’s not perfect for healthcare, but it is closer than other devices I’ve tried. It will definitely be worth a pilot.”

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Posted in: Electronic Medical Records, Innovation, Learn This: Technology Answers

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2.0 Tuesday: HealthCamp RDU Approaches, Cloud Updates in Healthcare, A New King of the Web Browsers

visualizing large amounts of binary data

As managers, providers and employees, we always have to be looking ahead at how the technology on our horizon will affect how our organizations administer health care. In the spirit of looking forward to the future, we present “2.0 Tuesday”, a feature on Manage My Practice about how technology is impacting our practices, and our patient and population outcomes.

We hope you enjoy looking ahead with us, and share your ideas, reactions and comments below!

HealthCamp RDU and Health Innovation Week DC Bring Stakeholders Together for Conversations on the Future of Healthcare

Over the next two weeks two separate events will give stakeholders from all ends of the healthcare spectrum a chance to be a part of an open-ended conversation about the future of care. HealthCamp RDU on Wednesday May 23rd in Raleigh, North Carolina, and Health Innovation Week, beginning June 2nd in Washington D.C. will be fantastic gatherings for providers, patients, advocates, managers, and vendors to come together, engage in conversation, and share their own experiences and visions for the future. With the large-scale changes taking place in healthcare today, more than ever it is critical to share your point of view, and events that bring together such a wide range of attendees offer fantastic opportunities to do just that. Check out their sites for more information on these great events!

(via The Health Care Blog , Triangle Business Journal)

Overheard in the Healthcare Cloud

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Posted in: 2.0 Tuesday, Innovation, Learn This: Technology Answers

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What Can We Learn About HIPAA From Phoenix Cardiac Surgery?

Phoenix Cardiac Surgery probably never thought they would be a poster child for HIPAA safeguards, but this 5-physician cardiothoracic practice in Prescott, Arizona has become famous for something no medical practice wants to be famous for – not protecting their patient information.

Today’s HHS Press Release reads as follows:

HHS settles case with Phoenix Cardiac Surgery for lack of HIPAA safeguards

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Posted in: Compliance, Headlines, Learn This: Technology Answers, Medicare & Reimbursement

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Recorded Interview on EHRs on the Cloud

Listen to the recording here.

 

MU Live! is a 30 minute talk radio style web and audio cast hosted by the folks at HITECH Answers. Experts discuss breaking news and issues on meaningful use as well as other health IT topics.

From HITECH Answers:

February 28, 2 pm EST:  Our guest this week is leading practice management consultant and Health IT blogger of the year Mary Pat Whaley.  We’ll discuss cloud-based EHRs and other practice implementation strategies with Mary Pat, a former practice administrator with lots of experience managing EHR  implementations.

 

Posted in: Electronic Medical Records, Learn This: Technology Answers

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