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 . 

Plus91 Technologies Pvt. Ltd.

http://www.plus91.in

http://www.plus91online.com

http://www.twitter.com/plus91

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.

-- 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.

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

Using IT to 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 in this series:

- Medical Information Sources

- Digital Identities for Providers and Provider Information Sources

- Patient Provider Communication

- Health Information Exchanges

- Online Health Communities

In the next Article we'll look at Using Medical Information Sources to build the foundations of a Digital Ecosystem in Healthcare, thus creating a useful paradigm for providing Information Therapy

- By Nrip Nihalani and Aditya Patkar

Plus91 Technologies Pvt. Ltd.

http://www.plus91.in

http://www.plus91online.com

http://www.twitter.com/plus91

Improving Patient Care through EMRs

EMRs-Electronic Medical Records are a modern revolution in the field of healthcare improving the standards of quality in healthcare and raising it to a higher level. With all the numerous benefits of EMRs to doctors, it eventually signifies the benefits to patients and thereby improves patient care.

Using EMR in medical practice can improve patient care in the following ways:

Safe and secure medical records: Electronic medical records are safely and securely maintained in a PC in contrast to the paper-based records let out in open leading to forgery, loss of records or damage due to natural factors. Records inside the PC cannot be damaged or lost and thus a patient is tension-free with respect to the security of his records.    

Make better decisions: A patient history well maintained helps you make better decisions in your treatment. EMR is a tool to maintain such patient histories and take decisions accordingly increasing patient care.

Less time in management and more relief to patients: Paper-based records and registers pile up and become difficult to manage. Moreover, it takes a lot of time for the receptionist to search the record and hand it over to the patient. Instead through EMRs, the doctor searches the records in a single click and reduces the time spent in searching them inside the clinic. This eventually gives a relief to the patients as their waiting time is curbed.

Email the reports to non-local patients: Mailing the reports is a great way to showcase care for patients. If they are paper-based, it becomes a tedious task to deliver it to the patients who are not in the same city, state or country. However, if the doctor uses EMR and mails the reports it saves time and improves patient care. 

Reduction in chaos, happy patients: A messy clinic with cluttered papers, chaos and mismanagement gives a bad impression of the doctor and the clinic. Instead resorting to EMR with no papers lying around, a clean clinic and proper management smoothens the practice giving a good impression to the patients. 

Say no to Memory-based treatments: A memory based treatment proves dangerous for both patient and the doctor. So no more risk of giving bad treatment to your patients with EMR having records of the diagnosis and treatment available within seconds. EMR based treatments have proved safer in contrast to the memory-based treatments improving patient care.

A specialists’ and colleagues’ opinion: EMR stored inside a PC is easy to share with your fellow colleagues and specialists to discuss a rare clinical case. Paper-records require a lot of time to share as compared to an electronic record. With a handy device and a sharing access, medical record distribution is a cost-effective solution.

Handwritten Prescription Risk: A hand-written prescription can prove highly dangerous for the patient. Drugs which are spelt similarly or having a difference of few alphabets/structure are more liable to be misunderstood by the pharmacist and handing over wrong medications. Resorting to a PC-based prescription along with the record neutralize the perils of handing over some other drug increasing patient care.

Quick response to emergencies: Digitized records on a centralized server ensure quicker response to emergency situations for patients. Entire patient history can be referred by the doctor in a short time and proceed with the treatment unlike the paper-based records where it requires a lot of time to search and refer patient history.

 

Adverse Drug Reactions: Side effects of drugs if not informed to the patient can lead to a patient’s health in danger. EMR software which records ADR definitely makes you inform the patient while prescribing the drug. Patient safety and patient care ensured.             

                                             

Patient’s access to records: Giving another dimension to EMRs; from a doctor’s accessibility to patient’s accessibility of medical records, EMR is a boon to patients as well. Not only does it eases access of records in faster and simpler manner but is helpful when a patient is at different locations. A medical record integrated with a doctor’s portal is accessible worldwide limiting it only to the doctor and the corresponding patient providing patient care.

Patient Consent: Smart EMRs with consents help patients make decisions about the choices available in the treatment they are about to undergo. Issues related to patient consent are reduced with EMRs that give you options of the treatment and lets the patient beware of the risks and benefits associated.

An in-depth medical knowledge may care and cure the patient but added services like EMR will retain patient care.

 By Pooja Raval

Technoclinics- Upcoming scenario in India

Medical industry in India is proud to have adopted the latest medical equipments in every specialization and has achieved tremendous results in terms of rapid and effective treatment. The benefits that the Indian IT sector has made in the global village the past 15 years, are now being extended to the Indian Healthcare industry too! 

Taking advantage of these  some clinics are transforming into “technoclinics” by smartly using technology and software in their practice. Dr. Ankit Khanna (MDS) at Pune, who uses a Blackberry to track his online appointments says, “Advances in technology have definitely changed today’s scenario in the dental practice. Earlier for root canal treatments, X-rays taken were on a thin film which gave information only about pathology and cavity. But with the Digital X-ray, it is now possible to know the bone density, height, thickness along with the conventional pathological details and cavity of the teeth.”

Moreover, the paper-based records are now shaping into Electronic Medical Records storing all the patient details along with the medical history and previous visits. Searching a patient record barely takes seconds and all the information is available at fingertips. Dr. Khanna cites out the benefits of EMR, “With EMR, the medical records are a proof which reduces the conflicts between doctor and patient. If a patient visits two dentists for treatment, with the software now it is easy to show the patient which treatment he came for to avoid the confusion.” Dr. Khanna confides in software stating that he can now provide warranty with the treatment as he successfully manages and tracks the patient records strengthening the patient-doctor relationship.

Most of the clinics are still maintaining the paper based records which eventually lead to frustration and chaos. There are some clinics where the doctors prescribe medicines on a follow up visit memorising the patient history which proves dangerous for the patient as well as the doctor! Imagine how much better it would be if the doctor knew the patient history and accordingly prescribed the medicines? That’s where the software plays the role and reduces the risks of memory-based treatment.

The doctors of “technoclinics” are enjoying their practice because they only have to concentrate on proper diagnosis and treatment whereas the entire clinic administration is managed by the software. Within the coming years, its predicted that the majority of clinics will resort to software, thus improving their practice,  benefit in terms of hassle-free practice, improved profits, time and money savings and also building stronger patient relationships. This revolution is what awaits the healthcare sector in India.

by Pooja Raval and Nrip Nihalani

Patient Safety

Few Sundays ago we were privileged enough to be invited by Dr. Nikhil Datar, a pre-eminent gynecologist and medico-legal expert to witness his premier talk on Patient Safety. It was hosted by IMA Dombivali and had a strong audience of over 40 doctors waiting to hear Dr. Datar’s talk. Dr. Datar had recently returned from UK where he attended a program organized by WHO on Patient Safety. Plus91 Technologies believes in making patient centric solutions which don’t just automate the clinic or hospital but also improve quality and service. Keeping this in mind, the presentation was interesting not just for the doctors but also for us.

The doctors were interested in the talk, intrigued by what new information can they hear. It started slowly but filled with practical examples the doctors soon were eager to know more. More than that they realized in their own practice they need to reflect and close loopholes so that they ensure patient safety. The doctors really got involved with questions, interactive cases and videos. We think they all walked out little bit wiser. As a software company involved in Healthcare, we think patient safety becomes a vital cog in what we are doing and it works at multiple levels. 1. Creating solutions which ensure and promote safety, 2. using the patient safety angle to promote such solutions which benefit the doctor in many more ways, but they finally see it as useful when something hard hitting as this is spoken about and 3. Increasing patient interaction and service allowing patients to feel safer and learn on how they should protect themselves too.

So what all does patient safety entail? It covers a lot of ground from something simple like washing your hands before a physical examination to something complicated as giving instructions during a high pressure surgery. They key learning was awareness that things can go wrong and improving communications and processes to prevent minor errors from becoming major issues. Simple techniques like reading medicine names allowed, using color coding on various instruments, storing patient records in a neat and systematic manner help provide better quality care to the patient. We think from hearing his talk, the biggest initiative one can take in improving patient safety is increasing ones awareness in their surroundings. Being aware of the possibility and the effects of your actions goes a long way in preventing mishaps that can happen. Some major inferences were: Out of the 3.7% cases, only 1% could be called as negligent, 50% of these are preventable and most notable – majority of them were not individual failures but the system failures.

We think a lot of good work is now being done in this field by numerous players. The ones which Plus91 Technologies is directly involved with include Dr. Nikhil Datar an epxert in the field, PIET (Patient Information and Education Trust) and NGO, PEAS (Patient Education and Awareness Series) who make wonderful videos and content driven education material, HELP (Healthcare Education Library for People) which have seminars weekly apart from the actual library initiative and Dr. Malpani who is organizing a conference in October in Mumbai exclusively dealing with Patient Safety. As technology pervades healthcare, we can already envision so many places where Plus91 can actively help improve patient safety standards. The possibilities are exciting not only in their scope and challenge but also because this is probably one place we can actually be able to claim we saved a life and that thought gives us a tremendous boost.

Improved Patient Safety Using Software

Patient Safety is a vital aspect of healthcare. With a fairly large number of indirect deaths and also potentially life threatening situations resulting directly from lack patient safety it becomes a vital cog in the healthcare machinery. Software products are introduced in any setup to increase efficiency and accuracy, both important factors when trying to improve safety. I am going to highlight some basic examples how inherently as well by actual design patient safety measures can be improved through normal Electronic Medical Records or Practice Management Software.

1. Prescriptions and Medications: The most common errors are seen when doctors write prescriptions on paper and the patient or the chemist misread the prescription. This is a common occurrence and a printed prescription generated from software with already present Drug Data is the safest bet against such a mishap. Other errors which can be prevented include, mistakes made by doctors in writing the dosage or strength, which in software can be fixed to prevent wrong entries, also a check on concomitant medications interfering the drug can be done. These features are already present in the Plus91 clinic package Clinkare. Ensures no errors happen due to differing writing styles or hand writing.
Another neat feature is sending reminders to the patients/nurses to take the appropriate medication at the correct time via SMS. This ensures no missed dosage which could have lead to problems. This feature is available in ClinION the hospital management solution from Plus91 Technologies.

2. Patient History: Doctors in a hurry, if patient comes without papers can prescribe the wrong treatment in case the data is not properly documented. It is vital to know previous visit experiences which can help the doctor make a better decision. Almost all softwares allow storing overall patient and current complaint history which helps doctors make better and more accurate decisions thus ensuring patient safety. This feature ensures that reliance on memory is less!
In the new age software patient history can also be coupled with Clinical Decision Support systems to help the doctor make his or her decisions in a better and more accurate manner.

3. Patient Data Entry: This is an exclusively software based point. Accurate entry in the system can be ensured by various validation measures and checks. This may slow down the process but a good process ensures the software protects the basic problems that can happen. Some key examples are: a. Validated fields which take only certain values and anything outside throws an error, b. Every time a new page is opened or traversed the patient name is popped up to double check the correct patient data is being filled in, c. Two person check entries at very vital and critical data entry points (used often in clinical trial data management), d. SMS or Email alerts in case of a vital sign going outside normal range at the ICU

4. Consent Checks: A patient must know what procedure they are undergoing, the risks and also most importantly dos and don’ts. A software can for all the procedures ensure that the consents are filled using a reminder / validation system to ensure the patients have been given the once over either by the doctor as a series of questions and answers which are entered in the system or using a video/presentation format with a consent thumbprint or electronic signature taken at the end. This is vital so that the patient does not make mistakes because of not knowing he or she had to come empty stomach for a procedure.
Plus91 softwares automatically allow you to link vital consent forms to various tests, procedures and consultations and remind you to get them filled.

5. Check lists: The Indian Born adviser to the American President on Healthcare issues is Dr. Gawande just released his new book “The Checklist Manifesto”. A checklist is the doctor and hospital staffs most trusted friend. Often negligence cases leading to patient safety mishaps happen because proper procedure was not followed. Many types of software come with check lists which need to be marked as complete before the next screen of tasks can be accessed. This ensures that all important steps are carried out and in order.
Checklists can be determinate that is fixed in nature like an inventory for a particular type of surgery. Some check lists can be flexible, like an in house patient prescription check list or schedule followed for an entire ward. Using software both can be checked and managed without a fuss.

6. Improved analysis: Software allow us to collate all sorts of medical data, this data can now also be analyzed to make future decisions better. Knowing what kind of patients react to which medication, or which months cause more complaints of a particular type of disease or maybe information on which doctors have better recuperation rates vis-à-vis their treatment methods all allow the healthcare system to better prepared for future patients.