Monday, October 17, 2011

Website Features Which Increase The Patient Satisfaction Index

A large part of managing a patient over a long period of time is communicating with the patient. All old (follow up) cases in medical practices have niche requirements and expectations from their doctors. A satisfied patient is a doctor’s most powerful marketing asset. Healthcare professionals should strive to provide all old (follow up) cases with special features to improve quality of service, which in turn will increase the Patient Satisfaction Index.

A well 'endowed' medical website allows doctors to assist patients in their day-to-day living by providing timely solutions for all their health queries even after a visit. For a patient, this continued access to expert medical advice via simple online tools is one of the most cherished features of any e-practice.

Despite best efforts, many patients make errors while following medical advice. Many times, follow-up patients have new queries they wish they could simply share with their doctors. A large number of patients also do not ask new questions just because they don’t want to look stupid in front of their doctors! These patients are often unsure of the importance of their queries and generally procrastinate visiting their doctors for answers. Sometimes new complaints crop up which may or may not affect the ongoing medical management. The internet, via a medical website, allows doctors to clarify many such small doubts these patients face while following medical advice. A timely word of advice can save these patients a whole lot of pain, literally and figuratively. Important issues which may arise during such advice can be solved by arranging for a new visit.

There are a number of ways medical websites and integrated web 2.0 tools can be used to help doctors improve patient-doctor communications and thus decrease the morbidity among patients. Let’s look at three such applications:




The Embedded Form:
Medical websites allow all registered members (i.e. follow-up cases) to access some parts of the website which are meant only for them. A simple form is embedded within this secure area through which a follow-up patient can ask a question. These questions are then directed to the doctor’s email address. The doctor can answer such questions securely via email or even ask the patient to book an appointment if required. Ideally, doctors should create an email id purely for answering queries of follow up cases. This will help in segmenting all electronic medical communications between doctors and patients. All such queries are also automatically added to electronic medical record of that patient.



Chat Widgets:
Chatting on the internet is something most patients are comfortable with. Medical websites can have widgets which allow patients to directly chat with the doctor or the doctor’s representative. This is a common and simple to add functionality within any medical website. Patients can be given pre-decided timings (say, 9 p.m - 10 p.m on Mondays, Wednesdays and Fridays) when the doctor shall be available for the chat. Such chat transcripts can then be appended to the electronic medical record of the concerned patient. More people can be added to chats so as to allow group discussions (e.g: Friday evening hour long chat session for all Pregnant women, in case of gynae practices).



Facebook Groups and Video Chat:
After email, Facebook is the most commonly used online platform for communications. Doctors can easily use this platform (by forming closed groups) for answering some of the common queries by their patients. All follow up patients who share their primary email id can be added to specific closed groups on Facebook. These patients can post their queries on the group wall (which is not public and viewable only by group members) or send it as a direct message. Answers which have general significance for all patients can be posted on the group wall (e.g.: I am taking Metoprolol XL 50 mg once daily for my hypertension. I am scheduled for a tooth extraction next week. What precautions should I take? ). Personal queries can be answered via direct messaging. Urgent and important issues can be simply escalated to a telephonic conversation. Over time, such a Facebook group shall mature into a powerful resource for all new members. Questions which require visual inputs (like appearance of rashes or swelling on hands and feet) can be handled by using Video chat within Facebook. Important advice can be reinforced by typing it into the chat area so as to create a transcript document of the encounter. There are medical social media guidelines published by many international organizations which can be followed for all such patient-doctor communications on Facebook.

Doctors can also use Skype and payment gateways like PayPal to organize revenue generating e-visits by follow-up cases who find it difficult to physically visit the clinic premises at regular intervals. This is especially the case with geriatric and physically challenged patients. For more such innovative medical uses of the internet, kindly write to a.patkar@plus91.in or visit www.websitesfordoctors.in





Thursday, October 13, 2011

How IT can facilitate Information Therapy?

The end customer in the business of Medicine needs information. Everyday technology adds new ways in which we store and share this information for many to use, reuse, improve and share some more.

In this day and age of the Internet, Mobile Phones and Social Media; Patients are empowered with the possibility of Real Time Communication, 24/7 Access to Information and Live Community Feedback. 

Today’s patients have been exposed to numerous possibilities besides the ones which our forefathers would know of. This exposure has empowered this generation of patients to ask for better care, better facilities, cheaper alternatives, and more useful ways of using technology to provide healthcare as well as healthcare information. However, in spite of large amounts of information available today, a big problem that exists today is that the information is not necessarily usable when it is most needed.

To effectively facilitate Information Therapy, Information Technology must bring about a marriage of ideas with utility; IT has to ensure all actors in this ecosystem come together to improve information management for the benefit of the patient, the staff and decision-makers throughout the healthcare sector.  Only then can Information Therapy  be provided to various participants of the health care ecosystem through the different stages of an illness:
  • Diagnosis and information gathering
  • Finding a Provider
  • Soliciting Second Opinion
  • Accepting a diagnosis
  • Participation in research
  • Being an champion or advocate
For Technology to be successful at this there should be sustained focus on different avenues of Information Therapy.
We explore 5 avenues with roadmaps below:

Avenue 1: Medical Information Sources
IT vendors must work at creating Healthcare and Medical Information Knowledge Bases. This can be about medicines, diagnostics, decision trees, side effects, precautions, etc.
Technology should evolve to allow for more effective ways for Updating Information in such Knowledge Bases. These could be based on curation, criticism, collaboration to ensure that it is self adjusting, effective and patient-centered.

Advancements in Social Technology will provide new ways for spreading this information.
 
Innovation in Delivery mechanisms will provide easier ways for others to consume this information
This will help
-- Create Informed Patients

-- Create Valued Sources

-- Ensure poor sources are filtered and rejected


Avenue 2: Digital Identities for Providers and Provider Information Sources

The logical first step to creating rich Databanks of Provider Information is to create identities for Providers in the electronic world. The simplest way to do this is to Create Websites for Doctors, Clinics and Hospitals. This may not necessarily be individual websites for practices which don’t want to invest in one, but even simpler informative single web pages to fulfill the purpose of creating an identity for them.
 
Such websites can be optimized to convey Services, Location and Contact Information, Medical Notes, Special Cases treated. Such optimization will help in disseminating useful provider information to people looking for the same. This isn’t advertising, it’s a service: people today face many choices and are hampered by lack of information, improving their ability to find information quickly is beneficial to them.
For those practices and Practioneers who decide to engage IT to create digital identities (web sites), the following guidelines must be provided:

-- On your website, don’t only talk about you, tell the patients more about what diseases and disabilities you treat, what are the latest treatments, generic advice and maybe even help them going to right person if you weren’t involved.

-- Use tools like interactive patient forms which can be filled before the patient arrives at the center

-- Use query forms on the website so that patients can ask you about their problems and doubts; this gives the feeling to your patients that you are available to them 24/7 without actually being there

As was the case with Medical Information Sources, Advancements in Social Technology will provide new ways for sharing Provider Information.

Technology Vendors must provide easier ways for Provider information to be located and searched and which is available of different types of media.

-- Create Directories of Providers based on Provider Information

-- The Directories allow for Feedback on providers in a controlled environment

Avenue 3: Patient Provider Communication

True engagement comes about through two-way, mutually beneficial 
conversations.

Technology must look to create multiple ways to facilitate both formal and informal Patient- Provider Communication. The telephone made a huge impact on the way we communicate, and so did email. Newer technologies must be used to offer ease of use, larger acceptance and lower costs. Many providers today communicate with their patients using skype, google chat and even facebook. Technologies must build on such success stories.
Provider –Patient Communication will also benefit if vendors Link Communication mechanisms to Provider Information Sources and Health Information Exchanges

-- Provide integrations of these mechanisms with clinical and diagnostic software (EMR's, EHR's , etc)

-- Emailing of schedules and reports to patients is a must.

-- Using SMS to send Medical alerts, reminders, and schedules

-- Go the extra distance and use Social Media to provide alerts and reminders to patients via Facebook Messages, Twitter DM's, etc.

Avenue 4:  Health Information Exchanges
 
Technology Vendors must work together to create Health Information Exchanges(HIE’s) based on interlinking of Electronic Medical Records, Electronic Health Records, Laboratory Data and Patient Health Records across Providers and Patients.

They help by providing Patients with the option to switch providers easily, allowing doctors to easily refer patients to other doctors for multiple opinions, providing direct access to laboratory data for physicians along with a number of potential benefits which are expected in the future due to the creation of a huge data bank of Medical Data including Symptoms, Diagnostics and Prescriptions.

HIE’s must be designed with Programming Interfaces and sufficient freedom to allow Technology Enthusiasts and Innovators to be able to create novel ways of using and sharing the vast volume of data within HIE’s as long as patient and provider confidentiality is not compromised.

Avenue 5:  Online Health Communities
For years, patients have liked to work in groups, to support each other, to help themselves cope with illnesses which their near and dear ones don’t understand, to seek advice from others who have similar ailments. Bringing people together in collaborative dialogue to explore social conditions that are the major influences of health and illness generates deeper collective awareness and community-driven action.

Since Individuals don’t see their lives partitioned into an online and offline world, Online communities should be given as much value as offline ones. A variety of Online Communities must come up for connecting patients quickly and privately with others who share similar health experiences.

Technology today exists not only in the form of created online communities but also online community frameworks which allow just about anyone with an idea of a community to set up an online one, full with video and audio chats, whiteboarding, discussion forums and groups and all the other good stuff.

This allows the creation for integrated digital ecosystem which simultaneously addresses both individual and social dimensions of health.

-- Allow Patients to engage with each other

-- Allow Providers to engage with this medium


 Case Studies showcasing IT providing effective Information Therapy using the avenues discussed above:

 - A Hospital Website provides emergency response numbers which earlier would only be found in a book. Today the website acts like an instant phone book for someone looking for these numbers during an emergency. Hence the Website becomes a good medium to share information about the medical entity for someone to access on the go. Taking emergency medicine up a notch by providing real time information through e-health channels

 - A Gynaecologist’s website allows a patient to calculate her schedule for check-ups and ultrasound visits and set reminders for the same. Whereas earlier, she would have to get it written down by the Doctor, and sure enough in all that stress call the Doctor each time to confirm, how all she needs to go is go on her trusted Doctor’s website and check the dates herself. E-Health, helping people plan their healthcare long term through tools that promote and help understand what they need to do

 - A Cancer patient after each chemo session feels low and unhappy, and is tired of the emotional stress involved. Being a shy person, he never talks to anyone and shies away from contact. Now online, he has a new lease of life, being able to interact and get support from patients just like him. Moreover he can do this anonymously learning how to cope with the pressure and the pain. Learning simple remedies and tried tricks from people who know and feel what he is going through. The power of e-health through patient forums, support groups and medical help portals online, allowing information flow where there was none physically

 - A patient in a remote village in South India suffering from acute pain in the abdomen has to make do with the local village doctor’s prescription.  A year later, a telemedicine pilot allows this same patient to get a second opinion using a remote video link and also by sharing X-rays of the abdomen using this equipment.  He also is able to identify what’s happening to him via the printouts he gets from the telemedicine center and realizes that he must work at improving his diet.

This is the 6th and final Article in a series of Articles on Using IT to facilitate Information Therapy by Nrip Nihalani and Aditya Patkar . These articles form the basis of the chapter "IT for IT" by the authors which they contributed to the book "Using Information Therapy to Put Patients First"





Tuesday, October 4, 2011

Online Health Communities : Using IT to facilitate Information Therapy

For years, patients have liked to work in groups, to support each other, to help themselves cope with illnesses which their near and dear ones don’t understand, to seek advice from others who have similar ailments. 

Bringing people together in collaborative dialogue to explore social conditions that are the major influences of health and illness generates deeper collective awareness and community-driven action.

Since Individuals don’t see their lives partitioned into an online and offline world, Online communities should be given as much value as offline ones. A variety of Online Communities must come up for connecting patients quickly and privately with others who share similar health experiences. A fantastic example of one such community is Patients Like Me

Technology today exists not only in the form of created online communities but also online community frameworks; These allow just about anyone with an idea for a group or community to set up an online network, full with video and audio chats, whiteboarding, discussion forums and groups and all the other good stuff.

This helps create an integrated digital ecosystem which simultaneously addresses both individual and social dimensions of health. In effect this
-- Allows Patients to engage with each other

-- Allows Providers to engage with this medium

This is the 5th Article in a series of Articles on Using IT to facilitate Information Therapy by Nrip Nihalani and Aditya Patkar 







Monday, October 3, 2011

Patient Provider Communication : Using IT to facilitate Information Therapy

True engagement comes about through two-way, mutually beneficial conversations.

Technology must look to create multiple ways to facilitate both formal and informal Patient- Doctor Communication. The telephone made a huge impact on the way we communicate, and so did email. Newer technologies must be used to offer ease of use, increase reach and lower costs. Many providers today communicate with their patients using skype, google chat and even facebook. Technologies must build on such success stories. 

Doctor–Patient Communication will also benefit if technology vendors link Communication mechanisms to Provider Information Sources and Health Information Exchanges

-- Provide integrations of these mechanisms with clinical and diagnostic software (EMR's, EHR's , etc)

-- Emailing of schedules and reports to patients is a must.


-- Go the extra distance and use Social Media to provide alerts and reminders to patients via Facebook Messages, Twitter DM's, etc.

This is the 4th Article in a series of Articles on Using IT to facilitate Information Therapy by Nrip Nihalani and Aditya Patkar