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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Making Digital Connections with Patients between Visits

Making Digital Connections with Patients between Visits | Online Reputation Management for Doctors | Scoop.it

The traditional care model, through which primary-care physicians check in with patients in the office during regularly scheduled visits, is "not going to work anymore."

That's according to Danny Sands, chief medical officer at Conversa Health, Inc., who co-presented a session with Philip Marshall, MD, chief product officer at the health IT company, during the Healthcare Information and Management Systems Society (HIMSS) Conference in Chicago.


During their session, "Staying Connected with Patient-Generated Health Data," Sands and Marshall said it's time for physicians to "bridge the gap" with patients between visits. 


Sands said the shift toward value-based payment, the need to reduce healthcare spending, the growing elderly population, and a looming physician shortage are all factors driving the push for more interaction and health information feedback from remote patients. "We have got to figure out how to scale our healthcare system," he said.  


Another factor driving the push, he said, is the increasing number of patients with multiple chronic conditions. "If we are dealing with an epidemic of chronic conditions ... we need a new model for healthcare," said Sands. "What we are doing is not working. It's expensive, we are not getting the quality we want; we are not getting the engagement we want."


So how can physicians better engage with, and receive more health information from, remote patients?


Sands said it's time to "space out" visits a bit more, improve health literacy, and have frequent "light touches" with relevant patient populations between visits to monitor progress, blood pressure, pain, medication adherence, and so on.


Frequent check-ins  


When attempting to acquire patient-generated health data (PGHD) from remote patients, Sands said it is critical to consider work flow. The information received from patients should be automated, simple for patients to provide, and it should not overwhelm the physician. Too much information is not a good idea, he said, but if you can help create information from the data then that is going to be useful.


While remote health monitoring devices such as those that track patients' steps or calorie intake are popular among patients, they don't necessarily provide the type of information that physicians need to receive from patients on a daily basis, said Marshall. During their presentation, Sands and Marshall pointed to a pilot PGHD study that Conversa partnered with in which an adult primary-care practice explored how it could receive health information from 1,300 chronic disease patients.  The patient population they decided to start engaging with more outside the office, was a


They practice started by analyzing the EHR data of that patient population, and pulling it through the system so that they could profile each patient and target a "set of rules" on what to ask them when checking in with them remotely, and how often they should reach out to these patients.


They then arranged for the patients to receive a digital alert indicating it was time to answer the questions related to their condition and/or share biometric data through "digital check-ups." Once patients completed the questions, the data then went straight back into the EHR.


"Seamlessly integrating into the EHR was absolutely a kind of critical requirement for us, the practice would not have had it any way and frankly we wouldn't have either," said Marshall.


The practice then used the data to determine if a clinical intervention was necessary, and if they should be checking in with patients more or less often.


The results:


• About 73 percent of the patients in the pilot completed one or more digital check up, and 81 percent stayed engaged after the first check up.

• Twenty-nine percent of the patients had a clinical intervention during the pilot in order to get them back on track, said Marshall, adding that many of these issues had to do with medication adherence and most of them could be fixed by a quick call.

• Seventy-two percent of the patients stayed on track or improved during the pilot.

".. As we push for value-based care and increased provider capacity, we have to more efficiently manage this gap and bridge patients and providers," said Marshall. "It is possible to automate this process, by knowing the patient, knowing their profile, knowing which rules will be triggered in what situations."


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DrChrono helps small medical practices use iPads for patient records

DrChrono helps small medical practices use iPads for patient records | Online Reputation Management for Doctors | Scoop.it

Michael Nusimow and Daniel Kivatinos were college friends at SUNY Stony Brook on Long Island. Then Michael went to work at Bloomberg, while Daniel studied further before joining New York startups. When Michael took his father to hospitals and doctors, he was frustrated by how inefficiently patient data was handled. In some cases, paper forms needed to be filled out repeatedly. At another site, a doctor had a terminal, but he was so busy typing he hardly had time to look at the patient. Despite recent improvements to document interchange standards, sharing data between different medical institutions can be difficult given incompatible systems, complicated workflows and privacy concerns.

So Michael and Daniel decided that doctors could perform much more effectively with a web-based system. Initially, they started by automating patient communications. Their system would remind people of appointments with text and email messages. Then they added billing and interfaces to existing financial systems, learning requirements as they visited small ambulatory doctors' practices. They launched DrChrono in 2009.
 
According to Black Book Rankings, in 2008, only 12% of office practices had even the most basic electronic health record (EHR) systems. By 2014, 51% of office-based practices were using a fully functional EHR systems, and 82% had basic electronic medical records.

In 2010, the iPad was launched. A tablet enables a doctor to face a patient while taking notes. Also in 2010, the government was moving to make Electronic Health Record (EHR) systems more open. So DrChrono decided to build an EHR system from scratch that would work on iPads. They launched their new system in 2010 at a Health 2.0 conference in Florida. It was an exciting time. Instead of struggling to sell a web-based system, Michael and Daniel closed deals at the conference as doctors enthusiastically saw the iPad's potential.

DrChrono applied to join Y Combinator's funding program, which Michael describe as being like "a startup's coming out ball". The program requires three months intense work in Silicon Valley. So Michael thought he would come to Silicon Valley for about six months. However, the experience was so transformative, that he started raising money and hiring employees in Mountain View. The company is currently based near 101 and Rengstorff.

DrChrono focuses on making small medical practices more efficient. The system manages forms securely, submits insurance claims, schedules patients, enables email correspondence, helps doctors manage inventory, transcribes medical notes, checks for drug interactions and handles prescriptions. The doctor can share diagnostic images, from X-rays, for example on an iPad with a patient.

Patients can download an app, On Patient, to track their health and share information with their doctor. It works on both Apple or Android platforms and is only useful if your doctor has the iPad DrChrono system. On iOS8 devices it works with Apple's HealthKit, that integrates information from other health-related apps and displays them using Apple's Health app. If you have a newer iPhone or iPad you might want to check that your fitness and health apps are set to share information with Apple Health.

The company is constantly looking for technologies that can help doctors and tried offering Google Glass. The display in the glasses was useful for certain types of doctors like surgeons, who need hands free information. In general, most doctors found tablets more useful. Wearable devices to track heart rates, exercise and more will transform the doctor/patient relationship as their output is fed into doctors' systems. Michael quoted Vinod Khosla who notes on his blog that over time 80% of what a doctor does can be replaced by smart hardware, software and testing, with technology also improving a doctor's ability to perform.

The Electronic Health Records space is crowded and fragmented. DrChrono started by bootstrapping and has been extraordinarily capital efficient, compared with San Francisco's Practice Fusion, which has raised $134M from investors that include Kleiner Perkins and other big name firms. With major companies like GE, McKesson and Quest Diagnostics in the market, and many fast growing startups chasing for market share, DrChrono is racing to hire software engineers and customer relations staff so it can keep ahead of the game.


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ICD-10 Testing Tips for Small Physician Practices

ICD-10 Testing Tips for Small Physician Practices | Online Reputation Management for Doctors | Scoop.it

Small physician practices of one to five doctors may find ICD-10 testing more challenging than bigger medical facilities. Luckily, the Workgroup for Electronic Data Interchange (WEDI) released a white paper last week that offers a comprehensive plan for small physician practices looking to begin ICD-10 testing.

The publication targets external testing with payers. Starting in October, payers will incorporate ICD-10 codes in payment decisions and coverage. By performing ICD-10 testing, medical offices will be ensuring that their claims will be appropriately processed once the new coding system is in place across the country.2014-10-02-WEDI

The white paper goes into detail about some of the risks that ICD-10 testing will minimize. The risks include:

1) Claim denials and claim delays associated with ICD-10 coding errors

2) Cash flow disruption

3) EHR and other software applications’ inability to produce ICD-10 claims

Small physician practices may be experiencing a number of challenges with regard to ICD-10 testing such as few testing opportunities with payers or clearinghouses due to limited number of testing spots, inadequate ICD-10 training available for staff, and scarce provider resources available on ICD-10 testing.

To overcome some of these common challenges, the white paper covers key steps a small physician practice will need to take. First, it is important to speak with your EHR vendor and confirm that all software products and applications are ICD-10 compliant.

Then, identify the payers that process the highest percentage of your claims and be sure to test ICD-10 readiness with your top payers. Work with your clearinghouse or billing service to see how they can assist with ICD-10 testing.

Be aware that some payers are creating web-based, self-service testing opportunities for small medical practices. After speaking with your clearinghouse, the next step to take is to seek more resources through payer ICD-10 websites and provider newsletters.

Confirm that what you need to test aligns with what your payer is testing so that every base is covered. While there is still time, be sure to contact Medicare Administrative Contractors (MACs) and the Centers for Medicare & Medicaid Services (CMS) to register for ICD-10 testing during the remaining testing weeks.

For those wondering the best time to test, be sure to set aside plenty of time before the October 1 implementation date to complete your ICD-10 testing. Before you begin testing, determine if your team and needed resources are ready. Additionally, it’s vital to confirm that all payers and other partners are also ready to start ICD-10 testing. Contact clearinghouses and billing services to find out when their testing sessions take place.

CMS, for instance, offers end-to-end testing on April 27 through May 1 and July 20 through July 24. For the July testing session, providers have until March 13 to sign up. Creating a timeline for your ICD-10 preparations would also be a worthy goal.

Once you’re ready to begin ICD-10 testing, follow the instructions received from the payer or billing service end. When incorporating the new codes, it is important to pay attention to qualifiers, headers, and other key format items.

After you have completed ICD-10 testing, be sure to review the results and compare the actual data to predicted information. Analyze both the successes and failures of your submissions. Additionally, work with your payers to understand any errors that may have occurred and develop strategies to prevent the issues from taking place in the near future.

If you are a small physician practice, follow these ICD-10 testing tips to minimize any risks after the implementation deadline.


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