Online Reputation Management for Doctors
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Online Reputation Management for Doctors
Curated and Written Articles to help Physicians and Other Healthcare Providers manage reputation online. Tips on Social media, SEO, Online Review Managements and Medical Websites
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FDA’s Mobile Medical Apps Guidelines “Surprising”

FDA’s Mobile Medical Apps Guidelines “Surprising” | Online Reputation Management for Doctors | Scoop.it
News Feature | November 15, 2013
FDA's Mobile Medical Apps Guidelines "Surprising"

By Katie Wike, contributing writer

The FDA’s mobile medical app guidelines allow a surprising amount of freedom and room for innovation

According to Government Health IT, the FDA probably had no idea the release of its mobile medical app guidelines would be seen as either sparking or killing innovation. “This is a really big deal for garage entrepreneurs, or whatever you would call them - people working in health institutions and even academics,” said Robert Jarrin, senior director of government affairs, Qualcomm. Morgan Reed, executive director and mHIMSS legal/policy task force chair for the Association for Competitive Technology, adds that for the first time in a long, long while, FDA “recognized that they aren’t going to tell us how to innovate.”

Whatever intent the FDA had in issuing its guidelines, they weren’t exactly what was expected. Jarrin and Reed recently outlined some of the more surprising parts in a virtual HIMSS briefing.

  • Labeling will play a big part in whether or not a product is intended as a medical device. “It comes down to the intent of the person responsible for labeling the devices,” Jarrin said. He uses an analogy of an ink pen. If it is not stamped with any medical terms, it is clearly not a medical device. If somewhere in fine print, however, it is labeled as “sterile,” this implies the pen could be used for medical purposes.
  • Footnote 27. Another interesting revelation in the guidance is found in footnote 27, regarding medication reminders. FDA gave a “very clear impression” it won’t be enforcing medication reminders on a platform or an app.
  • Most apps, in fact, don’t even need regulation. “Many mobile apps are not mobile devices,” Jarrin added. “This is important.”  Even though some will meet the definition of mobile devices, they pose a low risk to the public, and the FDA won’t even regulate them. The FDA will only look at products that function as mobile medical devices and could pose a risk if they don't work as intended.

“There are issues that remain to be clarified by the FDA, including some on clinical decision software,” Jarrin said. “But overall, the guidance is chock full of anecdotes that provided better clarity.”

And when it comes to apps that fall in a gray area that appears undefined by the FDA, Reed said, “I think it’s really critical we understand that the regulatory discretion the FDA is providing here resembles an `I need to see progress’ and then we’ll make a decision down the road. But it’s also really important that we don’t treat this as a total free-for-all.”



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Nurse Informaticists Increasingly Popular

Nurse Informaticists Increasingly Popular | Online Reputation Management for Doctors | Scoop.it
Nurse Informaticists Increasingly Popular

By Katie Wike, contributing writer

The need for analyzing raw data and creating reports that can be easily interpreted has spurred a demand for nurse informaticists across the nation

According to HIMSS, nursing informatics (NI) is “a specialty that integrates nursing science, computer science, and information science to manage and communicate data, information, knowledge, and wisdom in nursing practice. NI supports consumers, patients, nurses, and other providers in their decision making in all roles and settings. This support is accomplished through the use of information structures, information processes, and information technology.”

Because of the clinical experience gained working on the hospital floor, nurses have proven to be valuable additions to hospital IT staffs. The most recent HIMSS report, HIMSS 2011 Nursing Informatics Workforce Survey, notes the average nurse informaticist has been working in the nursing field for sixteen years and therefore has the ability to meld clinical and technological knowledge.

The report concludes, “Based on this survey and compared to the surveys conducted in 2004 and 2007, the healthcare industry is recognizing the value of nursing informatics. One metric in particular speaks volumes to the importance of nurse informaticists in the healthcare industry: base salary. The level of base compensation this year is significantly more than the data generated in the past two surveys, with an average salary of nearly $100,000 (and even higher in consulting and in vendor settings), which is impressive considering the current economic landscape. Compared to the average salary in 2004 ($69,500) and in 2007 ($83,675), the average salaries reported in 2011 are almost 17 percent higher than in 2007 and 42 percent higher than in 2004. Future surveys will determine whether the base compensation ceiling has been reached.”

Fifty-six percent of respondents to the HIMSS survey reported having earned a postgraduate degree and 35 percent of those hold a master’s degree. Nursing experience is critical to the job, however not all respondents to the HIMSS survey still worked in hospitals. “Less than half of the survey respondents (48 percent) reported that their primary workplace is a hospital while an additional 20 percent reported that they work at the corporate offices of a healthcare system. Nine percent work in an academic setting and five percent work for a consulting firm or a vendor.”

Generally, nurses with clinical experience and an interest in healthcare IT are selected for this position. Surprisingly, “The majority of respondents in all the surveys indicated that they have no formal informatics/education training.”

“I’ve been a nurse for twenty-five years, specializing in critical care and cardiology,” Audrey Funt, RN, MSN, Clinical Informaticist, Burholme Campus of the Temple University Health System, told Health IT Analytics. “I took some courses in IT and project management when I went back for my master’s degree, and then I did an internship in informatics, and decided that I really liked that and it was a good fit for me.”

“We were getting ready to implement a new EHR for the emergency department, and they knew I had interest in that area,” Funt continued.  “So I went onto that build and did it from the ground up.  From there, we decided to do an EHR throughout the hospital so that seemed like a natural path to follow.  Then we did the CPOE build, and they decided what they had really wanted for a long time was a clinical informaticist that would have the pulse of all of the applications, because there are so many.  It just seemed like a natural progression.”

Data from the HIMSS report shows nurses who show the ability to balance clinical knowledge and informatics savvy are in high demand; especially with MU requirements and quality reporting a must. “You need someone who has clinical nursing experience and someone who also has the computer piece,” says Funt.  “It’s a little difficult to find both of those, so it really helps if you have a clinical person who can really talk the talk and walk the walk because they’ve been there.”



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Putting Social Media to Work: Channels That Deliver

Putting Social Media to Work: Channels That Deliver | Online Reputation Management for Doctors | Scoop.it

So many social media channels, so little time! Not only can the sheer number of options be overwhelming, but there are also plenty of pitfalls and rewards to consider. You want to respect privacy, avoid making inadvertent factual or grammatical errors (that become public), and of course reach the right audience. What to do? Where to go? Which channel is easier, faster, safer…better?


Here, I’ve compiled a list the social media channels I use and what benefits they bring me. Obviously, this represents my own, personal opinion, and reflects my individual experiences as a healthcare marketing manager. However, perhaps for some of you they can represent a launching point, help inform a decision, or – best of all – spark some discussion and note-comparing.


Twitter, Hootsuite, Vine, and Storify
Twitter is great for short bursts of information, and Vine – Twitter’s proprietary app for sharing photos and videos – has been a helpful recent addition (on that note, here’s an interesting post about a hospital using Vine in the OR for educational purposes). In all cases, hashtags can really help your tweets get the attention you want. You can see some great health ones here on symplur.


Twitter’s 140 character length limit means I try to shorten URLs when I can. For that – unless I’m tweeting from a site that has a ‘tweet this’ button – I usually use Hootsuite, which also helps me organize my content flow a bit better. Hootsuite is particularly well-constructed for following healthcare tweetchats and for live-tweeting at conventions, offering user-friendly message streams, and ways to search hashtags and twitter handles. The service also provides another convenience: It lets you have several Twitter accounts right on the same page (your practice and your personal one, for example). This can be a great time-saver, but a word of caution – use the correct account for the appropriate tweet.


 Storify is a great way of stringing tweets together to make a longer point or narrative. As such, it can be used for tweetchats or for summarizing a discussion or lecture at a health conference where a lot of people are live tweeting. Simply pull the tweets you want from a particular hashtag stream onto the app (an easy tutorial shows you how) and supplement with text, photos, links, and whatever else you want to create a story from the tweets. Then you can post the story, and all the people whose tweets you used to tell the story will be notified. Here’s an example of a Storify post taking from the #HIMSS12 Twitter stream: HIMSS12 Storified.


Facebook
Facebook is the most social of the social channels, and I find it to be an excellent gathering place for casual conversation and engagement, especially about wellness news. I think the Cleveland Clinic uses Facebook really well for their Health Hub page.


Be careful of photos you post on Facebook, though. When I am at a convention or an event, I love to post pictures, especially if it is a group gathering. But make sure you have everyone’s OK with being on Facebook. Many people don’t want to have their photos shared on the Internet at all, so always ask.


I won’t go into the privacy concerns about healthcare professionals posting on Facebook, as there are innumerable articles written on that topic already. I think the best thing to do for anyone (and that includes me) is to keep your personal FB page personal and your business FB page business.


Pinterest
Pinterest is mainly a scrapbook; you just “pin” an article or post to your Pinterest page (note that there must be a photo on the page for the post to look like anything). I use Pinterest to post infographics, photos, and images of interesting gadgets. Nutrition and fitness content does well here, I’ve found. Also, keep in mind that it is currently visited mainly by a female audience, so it can be a great place for information relating to women’s health. Overall, Pinterest is a visual journey. You can browse through the site to see exactly what I mean.


LinkedIn
It’s been said before, if Facebook is the casual healthcare venue, LinkedIn is the office (complete with job search features). I see it as the most “serious” of the social sites. Create a profile on LinkedIn and, these days, it often becomes your resume. On the site, you can network with any number of people, join groups with special interests, and participate in discussions with other members. Within these groups, posts and comments are moderated, and participants typically need permission to join. LinkedIn represents a great networking opportunity and is wonderful for researching companies and individuals, reaching out, and “getting to know people” virtually. My company, HealthWorks Collective, has just started a LinkedIn HealthWorks Collective Group - check it out and please join if you are interested.


Google+
Google+ has good features for posting articles and photos, and it also offers the G+ “Hangout,” a live video streaming feature where a group of participants can get together to discuss a topic, brainstorm, or conduct a meeting. Later, users can upload a hangout to YouTube and post it and share it. Here’s a hangout on Google Glass that was uploaded to YouTube and then put in a post: Google Glass in Surgery.

G+ started out with a smaller, more tech-centric audience but it is more mainstream now and is very easy to use, with large numbers of communities available to browse or easily join (unlike LinkedIn, moderator approval isn’t necessary). I post a lot on G+, basing my choice for which health community to share through mostly on the topic I’m sharing information about.


Skype and YouTube
Video is a great way to vary the delivery of your message. A video embedded in a post gives your audience the option of watching, reading, or both. I tend to rely on Skype for video interviews of health start-up CEOs, doctors, and other thought leaders. The process is easy: Skype offers a built-in recorder, and users can then edit the result in iMovie and upload to YouTube. The quality is not the best, but it is easy and the only costs is the price of downloading the Skype recorder, which is nominal.

If you choose to make your YouTube video “public,” it can be seen by anyone, and can be embedded in a post easily. Here is a sample of a Skype interview edited in iMovie, uploaded to YouTube, and then embedded in a post: Acquapura.


Scoop.it
Scoop.it is a news board of posts and articles written on a variety of topics. Here, you can choose a topic to curate, and can then “publish” related posts on your own board. I use Scoop.it primarily as a fast and easy way to monitor and share what’s happening in healthcare around the web. Always check the dates on the news articles; I have come across some rather dated posts on Scoop.it.

There are many other social channels, certainly, but I have found the above to be the most useful for me. Try them out, see how you like them!


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Facebook Etiquette Rules for Doctors' Websites

Facebook Etiquette Rules for Doctors' Websites | Online Reputation Management for Doctors | Scoop.it

For some doctors social media is very new. If you’ve never experienced Facebook with a personal page before it may be difficult to navigate a business page without that point of reference. Even if Facebook doesn’t interest you in the private realm, it is a necessary part of any doctor’s online presence.


The name of the game is engagement, but there are a set of rules that businesses and practice must adhere to, even if unspoken.

Here are some quick and easy tips to keep in mind when expanding your social media presence.

  • Be Relevant: patients will view, and like your Facebook page for information—and while all your posts don’t need to be “strictly business,” try to your limit fuzzy kitten meme shares. Instead share information related to your practice and industry. Specials, tips, even jokes relevant to your audience will reinforce your position as an authority.
  • Be Engaging: Communicate with your followers. Even if you choose not to respond to each individually, if there is an overwhelming sentiment among your network, address it.
  • Be Professional: If you’d like to voice personal opinions create a personal page. Your practice’s page is no place to air personal gripes, carry on political or religious debates or call out competitors.
  • Be Present: Creating a page and never looking back doesn’t help your brand, and can actually hurt it. Create a schedule and post interesting content at least once a week. Many will consider your Facebook page an extension of your practice—you wouldn’t ignore a patient for weeks on end…

A Doctor learns how to use Facebook to his advantage

Now that you’ve created a Facebook business page and you know what to do, here are a few things not to do. Just like in life, a bad online reputation can follow you, and possibly hurt your brand.

  • Don’t Over Post: While it is important to be present, there is a limit. Posting once an hour will dilute your followers’ interest, and eventually the attempt to be engaging and present will relegate you to blocked status.
  • Don’t Be a Salesperson: Even though a Facebook business page is there to reach out to existing and potential patients, don’t think of your status updates as ads. If everything you post is a thinly veiled sales pitch your followers will quickly diminish.
  • Don’t Be a Mass Messenger: If you’d like to reach a large part of your fan base do it via status updates, or create a group and invite those specific people. Mass messaging means every response will be sent to every person on the message—which becomes incredibly annoying very quickly.

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Specialists Struggle With MU Reporting

Specialists Struggle With MU Reporting | Online Reputation Management for Doctors | Scoop.it
Specialists Struggle With MU Reporting

By Katie Wike, contributing writer

A group of specialists is asking Congress to make an exception when it comes to MU reporting requirements

In order to receive payments from the EHR Incentive Program, providers must show certain qualifying reports. For specialists, this is often difficult as the requirements are “geared towards primary care, and requires information that specialists don’t routinely collect for many of their patient populations,” according to EHRIntelligence.

This has led a group of specialist organizations to ask Representative Diane Black (R-TN) “to allow reporting to a clinical data registry to satisfy the quality reporting clause.” Black is known for previous legislation to add exemptions for solo practitioners and specialists.

A letter addressed to Black reads in part, “The value of registry participation goes beyond simple quality measurement. With the evolution of health information technology, a new kind of clinical data registry is emerging that extracts data directly from the EHR for analysis and faster feedback to physicians on quality initiatives. Because clinical data registries collect data elements specific to a physician’s patient population, they improve electronic documentation, promote meaningful data exchange, and produce meaningful and actionable measures of patient care.”

The letter is signed by The American Academy of Ophthalmology, The American Association of Neurological Surgeons/Congress of Neurological Surgeons, The Society of Interventional Radiology, The American Society of Anesthesiologists, American College of Gastroenterology, American Society of Cataract and Refractive Surgery, North American Spine Society, American College of Rheumatology, and American Urological Association.

“The greatest tool we can give to physicians to drive quality improvement is relevant, timely, transparent, and actionable data about their patient populations. Clinical data registries have the potential to dramatically improve healthcare through meaningful quality measurement and timely feedback,” continues the letter.

If the recommendations in this letter are accepted, specialists would have the option meet the quality reporting measure through uploading data to specialty-specific registries. This is already in sync with MU requirements. “By definition, true participation in an EHR-based clinical registry also requires that physicians (1) capture relevant patient data, the ONC’s goal of stage 1 meaningful use, (2) exchange data with the registry and across settings, the goal of stage 2 meaningful use, and (3) engage in quality improvement activities, the goal of stage 3 meaningful use,” the letter explains. “Therefore, physicians who use their EHRs to participate in a qualified clinical data registry should be deemed by CMS as having satisfied the requirements of the meaningful use program.”

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Remote Patient Monitoring Through Telehealth

Remote Patient Monitoring Through Telehealth | Online Reputation Management for Doctors | Scoop.it
Remote Patient Monitoring Through Telehealth

By Wendy Grafius, contributing writer

Implementation of expanded telehealth services will allow clinicians to remotely monitor patients in any location

By Wendy Grafius, contributing writer

Mercy, the nation’s sixth largest Catholic health system, has collaborated with Royal Philips, a leader in cardiac care, acute care, and home healthcare, to expand telehealth services to Mercy’s medical and surgical hospital units. The implementation will allow clinicians to remotely monitor patients in any location, improving care and outcomes.

A rapidly growing care delivery model, telehealth supported by Philips has been in place at Mercy since 2006. Mercy SafeWatch is the largest electronic intensive care unit in the country, providing 24-hour monitoring of critically ill patients and managed with Philips eICU platform. And several Mercy emergency departments utilize the Philips Telestroke program. These telehealth implementations have resulted in improved metrics in length of stay, readmissions, and patient safety.

With patient acuity levels rising, medical and surgical care in hospitals continues to consume healthcare resources, prompting Mercy’s decision to extend telehealth to these areas. “We have never been more convinced of the power of telehealth to improve patient access and outcomes and reduce costs,” said Lynn Britton, CEO and president of Mercy. “Adding acute care telehealth services is a natural extension of our successful eICU and telestroke programs and will allow us to support our mission to provide quality care to patients in need, regardless of location.”

The acute care telehealth program is expected to be in place by April 2014. Audio and video bi-directional access will complement Mercy’s home care technology with plans for the Mercy virtual care center to be staffed by hundreds of healthcare providers. By 2017, Mercy hopes to provide its eAcute program to 1500 acute care beds within the Mercy system as well as to other partner hospitals via telehealth technology. “With the right leadership, people and processes in place, Mercy has become a model for how to roll out a coordinated telehealth strategy that truly changes the way patients receive care,” said Brian Rosenfeld, M.D., VP and CMO of Philips Healthcare Hospital to Home. “Our acute care program builds on the success we’ve had in the ICU, Emergency Department, and the home, and we will continue to partner with leading health systems like Mercy to expand telehealth programs across the country.”

With a long history tracing back to 1827 in Dublin, Ireland, the Sisters of Mercy Health System was formed in 1986, transitioning in 2011 to one name – Mercy. With 32 acute care, specialty care, and critical access hospitals serving more than 3 million people in Arkansas, Kansas, Missouri, and Oklahoma, the nonprofit system also has outreach ministries in Louisiana, Missouri, and Texas. The Mercy Clinic is a team of 1700 primary and specialty care physicians and 600 advanced practitioners delivering care out of 300 locations. Named one of Hospital & Health Network’s “Most Wired” organizations ten times, Mercy was an early adopter of electronic health records and was the nation’s first Epic user to implement EHR-automated care paths. The health system also ranks among the top 10 healthcare supply chains.



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The physician will text you now: Follow ups from the doctor in your mobile phone

The physician will text you now: Follow ups from the doctor in your mobile phone | Online Reputation Management for Doctors | Scoop.it

The doctor will text you now. Social media has finally developed a post-emergency room (ER) follow-up that works. Diabetic patients treated in the emergency department who were enrolled in a program in which they received automated daily text messages improved their level of control over their diabetes and their medication adherence, according to a study published online today in the Annals of Emergency Medicine. You can check out the study or its abstract, "Trial to Examine Test Message Based mHealth in Emergency Department Patients with Diabetes (TExT-MED): A Randomized Controlled Trial."


In the past decade, many doctors also have used email to send the results of physical exams and blood tests to patients by posting the results on a website that can be accessed only by patient and doctor. Now, social media and mobile phones are so widespread in the population, that doctors are texting patients for their follow ups that follow them up for six months.


Doctors can use social media to remind patients to be more self-sufficient when it comes to taking responsibility to be healthier instead of thinking, "I'll let the doctor take care of my problem." Or like the TV advertisement for certain drugs said, "I'll do my job and let my doctor do his." When the doctors text patients for six months, it keeps patients reminded of how to manage their health better, or at least reminds them of what they're supposed to do when managing a health problem such as type 2 diabetes.


"Our results were especially pronounced for Latinos, who are twice as likely as non-Latinos to develop diabetes," explains the lead study author Sanjay Arora, MD, of the Keck School of Medicine at the University of Southern California in Los Angeles, according to the November 11, 2013 news release, The doctor will text you now: Post-ER follow-up that works. "These patients, when followed up by text messages for 6 months, improved enough to reduce their dependence on the emergency department for care of their diabetes. Text messaging is effective, low-cost and widely available for our patients who often have no other source of medical care."


Patients received text messages for half a year

Adult patients with poorly controlled diabetes who visited an urban, public emergency department for care received two daily text messages for 6 months. For patients who received the text messages, blood glucose levels decreased by 1.05 percent and self-reported medication adherence improved from 4.5 to 5.4 (on an eight-point scale). Effects were even larger among Spanish speakers for both medication adherence and blood glucose levels.


The proportion of patients who visited the emergency department was lower in the text messaging group (35.9 percent) than in the control group (51.6 percent). Almost all (93.6 percent) patients enrolled in the program reported enjoying it and 100 percent reported that they would recommend it to family and friends.


The text messaging program is called TExT-MED

The text messaging program, called TExT-MED, included daily motivational messages such as "Having diabetes can lead to a heart attack or stroke – but it doesn't have to" and "Eat more fruits, vegetables, beans and whole grains and less salt and fat." In addition, it provided three medication reminders per week, two healthy living challenges per week and two trivia questions per week, designed to build diabetes awareness (sample: "Trivia" Eating too much sugar and other sweet foods is a cause of diabetes. A. True. B. False.").


"Diabetes is emerging as a public health epidemic, particularly in low-income, underserved inner city and minority populations who depend on safety-net systems for medical care," says Dr Arora in the news release, The doctor will text you now: Post-ER follow-up that works. "Our goal is to transition our patients from crisis management to long-term diabetes management. In the absence of other health care options, reaching our patients by text message makes us partners in handling their disease and improves their quality of life."


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Providers wade warily into online patient groups, hope for benefits

Providers wade warily into online patient groups, hope for benefits | Online Reputation Management for Doctors | Scoop.it

Online patient groups -- where, for example, people with diabetes meet to support each other's efforts to maintain their proper insulin levels and overall health, or patients with similar behavioral health diagnoses offer one other encouragement and share successful coping strategies -- come in many flavors, but they come at a price.

The current model of care just doesn't allow us to focus on what really seems to be changing the cost dynamic -- behavior change.

Jason Cunningham,medical director, West County Health Centers

Some are sponsored by pharmaceutical companies or other profit-motivated vendors, who may drop marketing materials into the feed. Some independent groups, such as PatientsLikeMe, offer social network-like user experiences, but they can be a little more public-facing than some patients wish. And sometimes they share data with pharmas, too, as per its user agreement and general mission to affect new clinical treatments via crowd-sourcing of symptom data more nimbly than traditional clinical trials.

Another problem is there aren't any outcomes research on the effectiveness of these online wellness communities, Jeff Benabio, M.D., Kaiser Permanente dermatologist and physician director of health innovation told SearchHealthIT. He argued against the online groups in a debate session during Partners HealthCare Connected Health Symposium 2012.

"There's significant harm that's harbored within these communities in misformation -- well-meaning, but misinformation, and conflicts of interest," Benabio said. "So there's no protection for the patients ... no one's watching the store; we can't endorse them."

New model: Provider-hosted online wellness groupsA new model of online patient groups is emerging, however; one that hopes to counter the patient protection argument. In this model, the group is hosted by an outside vendor and moderated by a patient's care provider, which can set the agenda, exclude advertising and sketchy health information, as well as lock down privacy and security for HIPAA compliance. Patients can appear as anonymous (or pseudonymous) to their group peers, but the provider knows who's who in the back end for treatment purposes, and for documenting education material a patient consumes and course completion.

These groups aren't free, however. The provider must pay for them, since commercial sponsors don't. Because they're in their infancy, the outcomes still aren't well-known. But one resource-strapped federally qualified health center (FQHC), the West County Health Centers network of Guerneville, Calif., is wagering some of its chips on online patient groups.

The idea is that the groups, hosted by vendor WellFX, will work as a de facto population health management tool by inspiring West County's patients with diabetes, substance abuse and obesity problems, and behavioral health diagnoses to check with each other. Greater communication and improved home care tactics might keep patients healthier between what the provider hopes ultimately will be less-frequent episodes of care. That could quickly translate to cost savings, considering 40% of the clinic group's 13,000 patients are either completely unfunded or underinsured.

"We are, like everybody else is, rethinking our care delivery model in a significant way," said Jason Cunningham, D.O., West County medical director, who is overseeing the rollout of the first WellFX groups. "The current model of reimbursement, the current model of care, just doesn't allow us to focus on what really seems to be changing the cost dynamic -- behavior change. In primary care, with diabetes and heart failure and addiction and depression and mental illness, the 15- or 20-minute visit where we're dictating the conversation ... it's just not the right model for patient care."

WellFX activity isn't yet connected to the provider's electronic health record (EHR) system, and Cunningham said it can't yet be directly used to document any particular accountable care organization (ACO) or meaningful use measure, yet. But he believes the investment will ultimately pay off in fewer unfunded visits and Medicaid claims by helping create an overall healthier patient base. The groups may also contribute to better outcomes in several Medicare and Medicaid medical home pilot projects in which West County is enrolled.

So far the health centers have created patient groups for diabetes, chronic pain, anxiety and overall wellness. They serve as online continuations of in-person groups at West County when those have concluded. For example, patients show up from 8 weeks to 10 weeks for addiction groups at the clinic in person, and continue it online afterwards in WellFX. Providers don't address patients within WellFX; West County so far has confined those communications to its online patient portal.

"A lot of groups where we recognize that the secret sauce is patients engaging with each other -- we do a little bit of educating, but the patients engage with each other very candidly about what they need to be doing and lessons learned," Cunningham said


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