Posts Tagged virtual office visit

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The Medical Office of Today or Tomorrow

I’ve been thinking about the medical office of the future.  How would you design a building today that is meant to take you into the future?  Here are my thoughts.

One of the hallmarks of a well-designed office, today or tomorrow, is flexibility.  You want as much functionality as you can possibly get out of each space and use each space for as many purposes as possible.

For instance, a large room with lots of voice and data jacks or wireless and electrical outlets might be used for:

  1. Physician meetings, staff meetings or parties
  2. Group patient visits
  3. In-house health fair
  4. Staff or patient training
  5. Public meetings
  6. War room for disaster management or ad hoc project (medical record scanning prior to an EMR go-live)
  7. Conversion to workstations for a merger with another group
  8. Place to do group sports or college physicals, flu shot clinics, DOT physicals

I see reception and waiting areas getting smaller as patients have less time and are less willing to wait.  Patients may not have to wait at all if you are sending them a text message or Twitter when the doctor is ready to see them.  Some practices will not have waiting areas as patients will be escorted directly into exam rooms where the entire visit, from soup to nuts, will take place.  Instead of going to the lab, the lab might go to the patient.

Registration may be replaced by check-in kiosks that totally automate the process, including a vitals booth which takes the patient’s weight, blood pressure, oxygen levels and temperature.  Patients and their demographic and insurance information may be identified by fingerprints or iris scans. You may have a receptionist avatar greeting patients.

Fixtures are movable – storage cabinets are on wheels and not permanently attached to walls.  Any room can be an exam room, a treatment room, a test room, a procedure room, simply by moving the cabinet with the needed items and the machines, which will be handheld.  See an example here.

Providers’ phones are their everything.  Their mail, patient records, test results, journals, phone calls, and their family pictures are on their phone, so no need for an “office.”

As always, non revenue-producing space is minimized and revenue-producing space is maximized.

The need for storage of paper (records, forms, etc.) is minimized because everything is digitized and stored on the cloud.  The need for staff workstations is minimized because many staff work for the practice from home.

Medical records are not viewed on computer screens, they are projected onto walls in any room, at any time.  See the TED Talk on the Sixth Sense technology here.

Many patients are seen at home or in the nursing home, with the provider in the office using telemedicine technology or virtual office visits.

Medication samples will not be given at the physician office – they will be distributed at the pharmacy.  All medications will be samples (no cost) until it is established that it is the effective medication for that patient’s problem.

Here’s a neat video from Microsoft about healthcare of the future.  It will get your mind racing about the possibilities.

Microsoft Health – Future Vision from Microsoft Feed on Vimeo.

It’s frightening and exciting – might there be no need at all for brick and mortar physician offices?  I think it’s very likely.

What are your ideas about the medical office of the future?

Posted in: Innovation

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Talking With Steve Malik of Medfusion: What Has Your Website Done For You Lately?

I recently had the pleasure of speaking with Steve Malik, the CEO and Founder of Medfusion.  Medfusion offers an array of products to the healthcare industry including physician websites and patient/provider portals.  With a background in healthcare billing and eligibility, Steve has been in a unique position to guide his company to solutions that make good sense financially and efficiency-wise for physician practices.  Steve predicts that Medfusion will be serving more than 40,000 physicians by the end of 2009 and says that “patients are used to the world of self-service, and physician offices want to offer that option.”  He sees practices ultimately offering completely automated check-in (including collecting payments) prior to the office visit similar to airline kiosks.

Based in Cary, North Carolina, Medfusion enjoys the distinction of being named the leader in patient portals by KLAS, a company which independently monitors and ranks healthcare technology vendor performance.  The HIPAA-compliant patient portal developed by Medfusion allows patients and providers to communicate and share protected health information and private identifiers such as social security and credit card numbers via a secure portal.  Medfusion’s secure portal empowers patients and practices in a number of ways including:

  • Secure online bill pay.
  • Appointment reminders and lab results messages.
  • Patient registration, demographic and health history completion online.
  • Completion of a history of present illness prior to the visit.
  • eVisits or Virtual Office Visits for established patients. Patients may pay out-of-pocket for the visit or pay a co-pay and the practice can file for the balance of the reimbursement (note: payers, most notably BC/BS, are starting to pay for virtual visits.)
  • Shared patient communication between practices.  Practices that refer patients to a specialty practice can make that referral electronically and can follow-up on the patient’s progress via the portal.
  • “Chat with a Biller” function.
  • Appointment requests and requests for prescription refills.
  • Credit card payments without the use of a credit card machine; online payment plans that automatically drafts the patient’s credit or debit card monthly.
  • Patient refunds via the web portal.

Medfusion has strategic relationships with the American Academy of Family Physicians (AAFP) and the Medical Group Management Association (MGMA) to provide website services to their member practices.  Steve is an active speaker and presenter on technology in healthcare , and is widely quoted in industry publications. The company also has a relationship with Allscripts and Origin Healthcare Solutions and provides connectivity to those products to import information from the patient portal into the practice management system.

Recently Medfusion enhanced its existing Symptom Assessment and Virtual Office Visit solutions to include H1N1 Influenza (Swine Flu) screening.  Medfusion’s press release from May 2009 states:

Without having to come into the office, the patient can log into the practice’s secure HIPAA-compliant patient portal, select either Symptom Assessment or Virtual Office Visit, and type in Swine flu when they are prompted for a condition. The patient then responds to a series of interactive clinical questions relative to their symptoms so that the doctor can provide a secure online consultation, prescribe the appropriate anti-viral drug, if necessary, or determine if the patient needs an in-office visit.

Additionally, physician practices have been able to use Medfusion’s Secure Patient Messaging solution to mass broadcast the availability of H1N1 influenza online screening and to keep patients informed about the latest news regarding this outbreak or any other dire health issues. ‘We immediately launched Webinar training session’s specific to Swine flu patient messaging and Virtual Office Visits, and the response from the practices was overwhelming,’ said Crystal Upson, Vice President of Client Services. Medfusion continues to hold these training sessions regularly. Also, physician practices that have a website powered by Medfusion have complete control over their content management, which means they are able to post and change messaging at any given time about their services and the latest health issue developments.

After all the excitement of the products described above, it seems a little anti-climatic to discuss Medfusion’s website design and hosting offerings, but it is well-worth mentioning as the products above can be integrated into a custom-designed website by Medfusion, or an existing website.  Medfusion will take the look and feel of a practice’s current website and replicate it so the patient always feels that they are “inside” the practice’s site.

What doesn’t Medfusion do?  I recently saw the Medfusion product line again and was a tad disappointed that the referral portal does not have the ability to use custom forms.  It would be ideal to refer a patient to another practice or a test facility and be able to complete the order electronically including an electronic signature.  Referrals are one of the most time-consuming functions of a physician’s practice (primary care practices particularly) and can significantly impact patient care and reimbursement when done incorrectly.

What’s in Medfusion’s future? It was recently announced that Medfusion purchased Medem and their iHealth personal electronic record.  As personal health record capability  is included in definitions of “meaningful use” of an electronic health record eligible for the ARRA stimulus money, it looks like Medfusion will be well-positioned to help its strategic partners meet that definition.

By the way, I have used Medfusion at three different practices in the past and am evaluating it again for my current employer.  I’ve not received any consideration for this article.

Posted in: Innovation

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