Free EMR Newsletter Want to receive the latest news on EMR, Meaningful Use, ARRA and Healthcare IT sent straight to your email? Join thousands of healthcare pros who subscribe to EMR and EHR for FREE!

Tech We Take for Granted in Healthcare

Posted on March 26, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Every once in a while I like to take a step back and think about all the tech that we take for granted. Yes, it’s easy to get stuck in the discussions of what’s missing from our tech life or ways in which tech could be implemented better in healthcare. However, there’s a whole series of technologies that we use all the time and barely give it a second thought.

Certainly there are some rural areas of the country where their internet connection isn’t very good, but for a large portion of healthcare a nice internet connection is just a feature. Most clinics don’t give their internet connection a second though. It just works. They go online and do what they need to do. Sure, you might have an outage here or there (and those are brutal), but most of the time the internet just works.

Related to this is Wifi. Unless you’re in a clinic where the wifi implementation isn’t very good (and there are still plenty of those), you roam around with your laptop, tablet or other wireless device and it just works. It’s amazing to watch my kids, because they really don’t have any idea on how it works. They just open up the iPad and watch movies as they wish. They literally have no idea what’s required to make that possible. Yep, they take it for granted because the tech has become so good.

We’re now starting to see the next level of ubiquitous internet with 4G speeds being nearly as good as Wifi for many applications. Soon we’ll be taking for granted that we can get good internet speeds almost everywhere we go. The same is true for cell phone connection. The only time I can remember looking at my phone to see how many bars I had was when I was deep in the heart of a National Park. Yes, there are a few places in the wilderness where phone coverage is not likely to hit. However, for 99% of most people’s activities the phone just works.

Another great example is email. I totally take for granted that email just works. If I send an email I assume it’s going to be delivered. Sure, there are times when your email service provider goes down and we have to deal with spam folders, but I don’t really give much thought to whether my email is going to work or not. I just do it all day every day and it just works.

Instant Messenger is another application I use that just works. I know some healthcare institutions that use it, but so far not for PHI. It’s amazing technology that I can see whenever someone is online and send them a message. They can reply almost instantly. The beauty is that most people have become really mature with the use of this technology. It’s a use as needed thing. I don’t greet every person that comes online, but it’s there if I need to get a hold of someone quickly.

Often related to IM is video chats. Unfortunately this hasn’t taken hold very much in healthcare and it’s unfortunate. Video is built into most IM platforms: Skype, Gchat, MSN Messenger (or whatever it’s called now). With video cameras built into so many laptops or desktop cameras available for as cheap as $30, doing a video chat with someone is almost trivial. Add in things like FaceTime on the iPad and the idea of doing a video chat with anyone anytime you want is almost here.

I’m sure there are a hundred other technologies that I could list. The reason I find this so fascinating is that I think we’re going to have the same thing happen with EMR. In the next 5 years, EMR is just going to be another technology that we use without really even thinking about it. We’re not there yet, but it will happen.

I look forward to the day when we start to take EHR for granted.

Virtual Doc Kiosks – A Giant Leap for Telehealth

Posted on October 3, 2011 I Written By

Priya Ramachandran is a Maryland based freelance writer. In a former life, she wrote software code and managed Sarbanes Oxley related audits for IT departments. She now enjoys writing about healthcare, science and technology.

Just a couple of weeks ago, I wrote about doctors who FaceTime or video Skype with their patients. I’ll freely admit that while I’m as addicted to my Smartphone as the next person, I generally feel as if these healthcare innovations will result in overworked doctors and demanding patients.

And now, here’s something else to think about. According to a recent article in Computerworld, pharmacy chain Rite Aid, in conjunction with healthcare provider OptumHealth, is rolling out online physician chat rooms. Patients can virtually chat face-to-face for 10 minutes with a physician for $45. Virtual chats with OptumHealth nurses are free.

Pros of this system:
Shorter Wait Times: No more Waiting Area blues, and no more wondering if the paper robes cover you adequately enough.
Doctor-Pharmacy Cross Referencing: If Rite Aid already has a patient’s pharmacy history, the provider/nurse can access it any time. No need to rely on a patient’s memory any more.
Electronic Capture of Medical Records: These can be communicated to the patient’s PCP in needed.
No more scheduling tag: Walk in for a chat when YOU are ready.

Cons:
Steep price: $45 for a 10 minute chat is a tad high in my book. But when you look at it in terms of what the uninsured have to do to get any medical attention at all (either pay the high consultation rates, or negotiate with a kind-hearted doc for lower fees, or wait till their conditions become full-blown emergencies), it doesn’t look as pricey. I would also be really interested in seeing how insurance companies will react to telehealth initiatives like these. Will they, for example, reduce co-pays for such visits?
Revolving cast of physicians: The advantage of this system is you get to see a medical professional; you’ll probably not be able to ask to be connected to that incredibly insightful Dr. Smith you saw last time. Also if this takes off in a big way, maybe it’ll be a Dr. Reddy located in Hyderabad, India (though I should go on record at this point – I have absolutely no problem in being seen virtually by a Dr. Reddy or Dr. Khan in Pakistan, or anywhere else in the world)
Unclear logistics: Say, you have an abcess that you have to get checked on your er… backside. Are the kiosks private enough for truly comfortable patient-doctor interaction? Is there anyone else just offscreen at the doctor’s office, watching the video chat?

Definitely things to think about. I want to leave you with anecdotes from a different field – education. A few years ago, tutoring companies in the US figured out that American kids could really benefit from one-on-one tutoring from teachers. VOIP technology became cheap, even international video calls via Skype were free or for pennies a minute. I heard about this phenomenon when I enquired about a teacher at my high school in India. Many teachers at my school had quit to join such companies, and the school was making do with either substandard teachers or filling teaching gaps with part-timers on an ad-hoc basis.

It’s too soon to know what route these TeleHealth initiatives will take, but the scenario I described is not impossible with medicine too. While I’m excited about the convenience of these kiosks, I also think it would be a sad day if all/majority of our interaction with our providers is done online.

EMR in the Age of Skype

Posted on September 12, 2011 I Written By

Priya Ramachandran is a Maryland based freelance writer. In a former life, she wrote software code and managed Sarbanes Oxley related audits for IT departments. She now enjoys writing about healthcare, science and technology.

The physician community has something of a split persona. Doctors are probably the only community still dedicated to using pagers to communicate with their offices. And yet, it’s no secret that the medical establishment is among the fastest growing segment among smartphone and tablet users. A widely quoted statistic from Manhattan Research stated that 81 percent of doctors would own a smartphone. Manhattan now states that the 81 percent rate has already been reached in 2011, while average America is at 40 percent adoption, according to Nielsen.

So, the medical establishment is clearly ahead of the curve in some ways.

But you just have to juxtapose pagers and smartphones against each other to understand the real advantages of the smartphone. If you have an iPhone and your doctor has one too, you’re going to probably take it to the next level, right? Yeah, FaceTime. (Surprisingly enough, that’s not what the statistics show. A full 78 percent of respondents said they didn’t want to chat or IM with their doctors, according to this recent article on Technology Review.)

For this kind of face to face interaction to work, it really depends on how good a rapport you have with your doctor, but if there’s a good doctor-patient relationship, you might just consider making the move. Let’s be clear, doctors are not taking to video-conferencing via Skype or Face-Time in droves (or rather, there are no published statistics from the bean-counting firms about the trend), but there are some anecdotal stories on blogs like Dr. Brian Goldman’s on CBC.ca. But it’s interesting to think ahead to how video consultations might change EMR.

The Pros:
Direct connection with your doctor, in an instant: Great for the patient, furthers doctor-patient relationship but could be something of a double-edged sword.
Show, don’t tell: For those times, when you don’t know whether a symptom needs an in-office visit, or when you’re not in town and some conference magic and ePrescribing can save the day.
No more Lost in Translation: The paging process has that additional office staff layer in between, who convey your message to the doctor. It’s tempting to think that you can axe the middleman with Skype.

The Cons:
Direct connection with your doctor, in an instant: How long before patients are calling at all hours of the night demanding FaceTime? Blackberries and iPhones might simply be another way to tether yourself to your business (Next time you see 24-7 IT support, know that there is a person dreading the Blackberry ping somewhere in the world)
Too many interruptions spoil the day: Pagers let the doc put off calling till she’s done with the task at hand, not when the patient demands.
Privacy issues: From an EMR perspective, this is the big kahuna. There are several nuances to consider. The doctor-patient line has to be securely done, with HIPAA in mind. For CYA purposes, video-cons will probably need to be recorded.

Microsoft’s main intent behind its purchase of Skype might be its conferencing features for business, but wouldn’t it be awesome if Skype also showed up in HealthVault (which only has image saving capabilities so far, according to this Q&A on MSDN forums)? Or if any advice dispensed via Skype could be saved into your doc’s EMR system and become part of your health profile. There are several possibilities out there when you throw video into the mix, and they seem quite interesting.