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What’s the biggest source of inefficiency in your office? Playing telephone tag with patients who have questions? Refilling prescriptions? Making sure your patients comply with treatment? If you have a typical medical practice it’s likely that a lot of time and energy goes into dealing with inefficient communication.
Take for instance, the way hard-copy messages get passed back and forth. Perhaps a nurse scribbles something on a sticky note and puts it in a file she places on the doctor’s desk. The doctor scribbles something on the note and puts it in another file. "Things get lost, they get dropped, and no one follows up," says Bob Elson, MD, MS, of iMcKesson Provider Solutions Group, an Internet-based technology company in Minneapolis. Almost any kind of message, including lab results, involves pulling the chart and refiling the chart. "That doesn’t even take into account the inefficiencies relating to messages between physicians and patients," Elson notes.
The Internet offers a opportunity for communication through e-mail, says Matthew Weingarten, MD, director of clinical programs for Mediconsult, a Tarrytown, NY, health care consulting firm. For instance, with structured e-mail, patients can go to a physician Web site, click on an e-mail box, and send an e-mail that allows them to cancel an appointment s, receive lab results, or ask for a medication refill. The system does not give patients the ability to add text, so there is no way that an emergency message would sit in a message box unnoticed.
The clinic Web site could be set up so that the patient has a user name and password for security purposes. The patient is notified by e-mail when the response is back and can go to the Web site and log in to get the answer. This system avoids one of the biggest worries of Internet communication — that confidential information will fall into the wrong hands, Weingarten says.
Internet-based compliance programs can offer supportive messages that are sent patients by e-mail at intervals specified by the doctor, Weingarten says. For instance, patients who are taking medicine for ulcers have a natural tendency to stop taking it as soon as they start feeling better. The system can automatically send e-mail message to patients at regular intervals, reminding them of treatment compliance.
An example: Day 5: You should be feeling (describe it). Day 10: If you have X side effects, contact your physician. Day 20: You may be feeling better and tempted to stop your medicine but here are the reasons you should not.
"Our project has been well-received. It offers a real opportunity to extend a physician’s reach in an area where both the payers and recipients of health care are expecting it to be extended," Weingarten says. Electronic patient provider interaction software offers a range of services for physicians and patients, Elson says. "It allows the clinic to tackle customer service issues and create a significant Web presence early on," Elson says.
His company offers software that allows the physician to create a personalized Web page for every patient who registers for it. Patients can automatically receive healthcare information from their doctor, request appointments, renew medications, and ask questions on-line.
"One clinic with a busy practice found that 1% of patients per month register for the service. This means that after a couple of years, 25% to 30% of patients will be active users. Physician practices can’t expect to get 100% but if they get 30% or more patients using the system, it takes a significant burden off the telephone lines," Elson says.
Among his company’s products are tools that manage laboratory test orders and results, allow on-line prescribing, access patient records, provide access to on-line patient data, and integrate clinical tasks.