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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Online Reputation Protection for Physicians

Online Reputation Protection for Physicians | Online Reputation Management for Doctors | Scoop.it

The first thing to realize is that online physician reviews are written predominately by patients who are either delighted or disgusted by their most recent experience with your practice. As a result, a practice that provides good service most of the time, but occasionally keeps a patient or two waiting for an hour, can easily find itself with a relatively large number of scathing reviews.

 

But even if your practice has been hit by some negative reviews, keep in mind that new patients know that no practice is perfect. The best way to deal with a few negative reviews is to understand what's driving them, to try to anticipate and correct problems, and to build up positive reviews from happy patients to create a more realistic picture.

 

Here are some of our easiest-to-implement tips to improve your reviews:

 

1. Monitor rating sites

Healthgrades, Vitals, and Yelp are good places to start. A tech-savvy person with good judgment can take this on for your practice as "social media lead" — it may only take a few minutes per day to stay on top of reviews and respond as necessary (always encouraging the patient to call and never sharing personal health information online). This can be a great opportunity for a motivated staffer to branch out, improve his skills, and show off what he can do.

 

This person should report back to your whole office on what he finds. Reviews can be a wonderful resource to understand how patients see your practice. Applaud everyone's efforts to understand the strengths and weaknesses of your practice as it's presented online. Make sure to register as the practice owner on sites that allow you to respond to complaints. It's critical to respond quickly, emphasize privacy, and let the patient know how important it is to speak by phone or in person about the issue.

 

2. Don't forget payer directories

I can't tell you why so many payer directories are out of date, but inaccurate ones send many patients to physicians who are out of network; which results in unhappy patients hit with additional expenses they weren't expecting. This task might only take an hour or two every few months, but it might just save you a nasty review.

 

3. Resolve to communicate well with patients

Starting at check-in, simply keeping patients abreast of what to expect next and when to expect it can make all the difference — a patient told that the doctor is running 15 minutes late will be a lot happier than a patient who waits 15 minutes wondering if they'll be waiting an hour. While a doctor shouldn't be kept waiting for a patient to be roomed, it's important that a patient not be roomed long before they are expected to be seen by the physician — time can pass frustratingly slowly stuck in a white room with a poor selection of magazines. Your whole team should be vigilant about keeping patients informed.

 

4. Help patients understand payment responsibility

Many patients end up confused and angry at the practice when hit with unexpected costs, and they often turn online to voice their displeasure. It's in everyone's interest to be clear about what the patient will be expected to pay at their visit — and of course, it's important for your bottom line that your staff is comfortable collecting in a professional manner.

 

5. Check-in at check-out

If you have staff dedicated to checking patients out, they can play a hugely beneficial role by simply and sincerely asking each patient how their visit went. When the practice messes up (and nobody's perfect), having somebody listening to the complaint can make a huge difference. If the patient is really upset, the administrator can personally offer a heartfelt apology.

 

6. Aim to delight

It's amazing to see what a truly service-oriented staff can do. When patients are greeted uniformly by staff who are personally committed to caring for the comfort of each patient, your practice can stand apart from the typical practice where staff seem disinterested and/or too busy to bother. A side benefit of the high-attention-to-patients practice — it's much more pleasant to work at too.

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Newscenter - Online reputation management for physicians

Newscenter - Online reputation management for physicians | Online Reputation Management for Doctors | Scoop.it

As more patients go online to find information about physicians, your reputation is being built and managed on the Internet. And like it or not, your online reputation plays a role in acquiring new patients and maintaining trust with existing patients and colleagues. It is imperative for physicians to have a plan and focus on online reputation management.


Online reputation management is the process of preventing and repairing threats to your online reputation. It is done by tracking what is written about you and using techniques to address or moderate the information on search engine result pages or in social media. The goal is to promote positive or neutral content while suppressing negative content.


For physicians, online reputation management involves addressing information in three areas:


  1. information found on search engine results pages (Google);
  2. information found in social media (LinkedIn, FaceBook, blogs); and
  3. information on rating sites, such as Vitals, HealthGrades, Rate MDs, Yelp, and Angie’s List.


Recently, a physician received an email from a company offering online reputation management services to help him mitigate negative online reviews on sites such as Yelp, Google, and health care review sites such as Vitals.


There are hundreds of companies out there offering these services. However, physicians are urged to use extreme caution when choosing a reputation management company. Some companies engage in questionable techniques that could lead to disciplinary action by the Texas Medical Board (TMB).


Specifically, the company that emailed this physician said they “will post reviews for our clients to over 40 social media web sites . . . We post up to 25 reviews per month.”


This claim is alarming in the context of medical practice. How are they managing to post reviews from the patients of a particular physician? Are they making up reviews and then posting them? It is unethical and dishonest to post reviews on these sites that are not from actual patients. Physicians are held to a different standard than other businesses, and posting fake patient reviews is problematic. Doing so would also violate TMB advertising rules, as this type of advertising (and the TMB does consider this to be advertising) would be considered “misleading.”


Here are a few techniques for managing your own online reputation.

 Know what is being said. Conduct web searches on yourself and your practice regularly. Review the first 30 hits of the search. (Any hit past 30 is generally considered extraneous and not likely to be read.) (1) Among the top 30 hits, what are these sites saying about you? Continue to monitor these online discussions.


 Know what you can and cannot do about negative reviews.  Because of health care privacy laws, physicians cannot respond to online reviews. The fact that a patient’s identity is protected information directly hinders the physician’s ability to refute a complaint. Simply acknowledging publicly that the complaining party is a patient breaches confidentiality and violates HIPAA.


Physicians can consider giving patients more constructive ways to offer their feedback. Conducting a patient survey, for example, would be a good way for patients to express their dissatisfaction and feel empowered.


Another option is to talk to the patient directly if you can identify who made the comment. This should be done in person or over the phone. Begin by asking the patient why he or she is dissatisfied.


It is also a good idea to investigate the patient’s complaints. Is the complaint legitimate? Was the problem with a procedure, a staff member, or the patient's wait time? Can the problem be fixed?


 Optimize your site for search engines. Optimizing your site for search engines will ensure that anyone typing in your name or your practice name will see your web site at the top of the search list. Optimizing your site involves creating comprehensive and targeted meta tags and web site page titles that help search engines index your site. More sophisticated techniques include editing your site’s content, HTML, and associated coding; removing barriers to the indexing activities of search engines; increasing inbound links; or purchasing related web addresses.


Create your own blog. You cannot control what other people say about you online, but you can create your own story and your own content. Your blog could be as simple as one 300-word post per week. The content could be about services you are offering to patients, the importance of getting a flu shot, or any other health topic that is relevant to your patient base.


 Create a LinkedIn profile. Your LinkedIn profile is another aspect of your online presence that you create. Add information about where you went to school, your specialty, and your practice. Make your profile public so that patients and potential patients can learn about you in a way you can control.


Take advantage of that “thank you.” The next time you receive a thank you note or email from a patient or family member, ask that person to post their comments on your blog, on your LinkedIn profile, or on physician rating sites.


 Keep in mind that with the prevalence of smartphones and tablet PCs, patients can post a review of you — a positive or negative review — at anytime and from anywhere. Even from your waiting room. Don’t ignore what’s being said.

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Six Ways to Improve Patient Satisfaction Scores

Six Ways to Improve Patient Satisfaction Scores | Online Reputation Management for Doctors | Scoop.it

Large physician practices and hospitals already have a portion of their payments linked to patient satisfaction. Over the next few years, it will be an integral portion of physician payment, including penalties possibly dwarfing those under meaningful use. More about this program, known as the Clinician & Group Consumer Assessment of Health Providers and Systems (CG-CAHPS) can be found on the Agency for Healthcare Research and Quality's website.

Here's the government's hypothesis in a nutshell:


• Patients who like their doctors are more likely to be compliant patients;

• Compliant patients are healthier patients;

• Healthier patients are less expensive; so

• Physicians with satisfied patients should be paid more than physicians with dissatisfied patients.

The Affordable Care Act introduced a different set of quality metrics than used by the Institute of Medicine (IOM): quality, patient satisfaction, and payment. Quality is a key element with both programs, but there's an important difference with the reform law: your patients are the arbiters of quality. Quality more or less equals patient satisfaction.


What's being measured?


CG-CAHPS measures the patient experience, an expansive proxy for quality that takes into account the following:

• Timely appointments

• Timely care (refills, callbacks, etc.)

• Your communication skills

• What your patient thinks about you

• What your patient thinks about your staff

• Your office running on schedule

I have been in enough medical practices — both as a patient and as an administrator — to know there's a method to this madness. It's less about the care and more about the caring. Here's what I suggest for improving your quality measures via these proxies.


1. Hire sunshine.


I can train anyone* to do anything in our office, but I can't train sunshine.  Look to hire positive and happy people, particularly for roles with lots of patient interaction. Your patient satisfaction — and thus, your "quality" — will improve. You'll also find a cost-saving benefit to this hiring tactic: employee turnover will shrink.


2. Start on time.


CG-CAHPS asks patients whether they were seen within 15 minutes of their appointment times; it's even underlined for emphasis. Physicians who start on time are more likely to run on time, so have your feet set before you start running.


3. Set patient expectations.


It's helpful to share with patients the FAQs about your practice so that they know what to do for refills, after-hour needs, appointment scheduling, etc. By making these answers available on your website, on your patient portal, and in your print materials, you'll better align patient expectations with patient experiences and thereby score better on quality surveys.


Some patients gauge quality by whether or not they get the antibiotic they think they need. It's helpful for primary-care physicians to include education on antibiotic overuse in their patient education materials.

Along these lines, it is important for your patient to know what to expect after their visit in terms of test results, follow-up visits, etc. I receive more complaints about the back end of our patients' experiences than anything else. Make sure you and your staff do not drop the ball as you near the goal line.


4. Listen with your eyes.


Nothing says "I don't care" like having your physician focus on a computer screen rather than on the patient. This is particularly true in the first couple of minutes of each visit, and especially important with new patients. One virtue of using medical scribes is that you can listen with your eyes a whole lot more.


5. Put your staff in their place.


Your staff has an important bearing on the patient experience. I'm a big fan of letting them know their actions influence quality. It's pretty cool, for me as a mere bureaucrat, to know that I can improve quality simply by being friendly and helpful to our patients. Make sure your staff knows that making a patient's day is a beautiful act.


6. Monkey see, monkey do.


Staff will follow your lead. If your thoughts and actions emphasize running on schedule, being kind to patients and their families, and not dropping balls, they'll be stronger teammates for you.


Patient satisfaction has always been a gauge of quality, just as patient referrals remain the lifeblood of most practices. Treat this next wave as an opportunity to show off the caring that has always been a big part of the medical care you offer your patients.

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HHS’ $30B Interoperability Mistake

HHS’ $30B Interoperability Mistake | Online Reputation Management for Doctors | Scoop.it

Sometimes things are so ill-advised, in hindsight, that you wonder what people were thinking. That includes HHS’ willingness to give out $30 billion to date in Meaningful Use incentives without demanding that vendors offer some kind of interoperability. A staggering amount of money has been paid out under HITECH to incentivize providers to make EMR progress, but we still have countless situations where one EMR can’t talk to another one right across town.


When you ponder the wasted opportunity, it’s truly painful. While the Meaningful Use program may have been a good idea, it failed to bring the interoperability hammer down on vendors, and now that ship has sailed. While HHS might have been able to force the issue back in the day, demanding that vendors step up or be ineligible for certification, I doubt vendors could backward-engineer the necessary communications formats into their current systems, even if there was a straightforward standard to implement — at least not at a price anyone’s willing to pay.


Now, don’t get me wrong, I realize that “interoperability” is an elastic concept, and that the feds couldn’t just demand that vendors bolt on some kind of module and be done with it. Without a doubt, making EMRs universally interoperable is a grand challenge, perhaps on the order of getting the first plane to fly.


But you can bet your last dollars that vendors, especially giants like Cerner and Epic, would have found their Wilbur and Orville Wright if that was what it took to fill their buckets with incentive money. It’s amazing how technical problems get solved when powerful executives decide that it will get done.


But now, as things stand, all the government can do is throw its hands up in the air and complain. At a Senate hearing held in March, speakers emphasized the crying need for interoperability between providers, but none of the experts seemed to have any methods in their hip pocket for fixing the problem. And being legislators, not IT execs, the Senators probably didn’t grasp half of the technical stuff.

As the speakers noted, what it comes down to is that vendors have every reason to create silos and keep customers locked into their product.  So unless Congress passes legislation making it illegal to create a walled garden — something that would be nearly impossible unless we had a consensus definition of interoperability — EMR vendors will continue to merrily make hay on closed systems.  It’s not a pretty picture.


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Collaborate or Compete With Retail-Based Clinics?

Collaborate or Compete With Retail-Based Clinics? | Online Reputation Management for Doctors | Scoop.it

We live in a culture of "now." We expect instant downloads and constant cellular connectivity. We are all so busy that it is difficult to wait and schedule services in advance. For many patients, this applies to medical care too.

Because most adults cannot get same-day appointments with their primary-care providers, this void has been readily filled by retail clinics and urgent care clinics. My area of northern Virginia is no exception, with seven retail clinics within 5 miles of my home (up from two clinics just a few years ago).


Retail clinics can be a good option for some patients, as most medical problems do not require an emergency room visit. And the majority of patients with minor problems have difficulty making daytime appointments that cause them to miss work or school. Very few medical practices are open before 9 a.m. or after 5 p.m. Personally, I think that making medical care available when a patient needs it is a good idea. However, as a medical practice owner, I know that retail clinics are in direct competition for my patients. Every patient that is seen at a retail clinic is a patient that was not seen in my office, thus diminishing my bottom line. And, as a pediatrician, I am extremely concerned about the care of children since most providers in these settings are not trained primarily in pediatrics.


Perhaps, when all practices are fully electronic and the exchange of medical information is more seamless, a patient's full medical history will be available, at all times. In the meantime, there can be dangerous gaps in information should a patient not inform the urgent-care provider of a chronic condition or a medication he is taking. There is also cause for concern if the primary-care provider is not told of medicine prescribed by the retail clinic.


Our practice has responded to this need by increasing our hours of operation; with walk-in hours early on weekday mornings and same-day appointments on weekends. Both of these extended clinics are meant for urgent problems, not chronic conditions. Yes, it does cost our practice to staff these extended hours, but we have found that it is worthwhile financially, and more importantly, earns the loyalty of our patient population.


I would advise other practices to develop relationships with local retail clinics in order to establish good communication. This would greatly enhance sharing of medical records with the primary-care office. Unfortunately, our practice has been unsuccessful with gaining the trust of local retail clinics. Nevertheless, it is important to try improving the exchange of medical information between your office and retail clinics.

No matter your opinion on retail clinics, they are here to stay.


Increasing your patients' access to your medical office will help direct them back to your practice. Most importantly, improving communication between retail clinics and your office will improve overall patient medical care and continuity.


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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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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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The Internet of Things: The Reality of Connected Healthcare

The Internet of Things: The Reality of Connected Healthcare | Online Reputation Management for Doctors | Scoop.it

The Internet of Things, the idea that everything will someday be totally connected, is no longer a Jetson’s era fantasy. It’s becoming closer to a reality in healthcare.

We’ve discussed IoT in healthcare and what its impact could be, but what would that look like? How can healthcare be ready for this total connectivity? Most importantly, how will IoT be able to increase the efficiency of the system benefiting both practitioner and patient alike?

Increased Efficiency

Forbes discusses how IoT will be able to increase efficiency in healthcare in multiple ways. As the capabilities of devices enhance, issues can be solved remotely as well as more effectively. Further, when there are issues with devices or supplies need to be refilled, the devices will be able to sound the alarm, and the issue can be dealt with proactively. What this comes down to is that machines will be better able to regulate themselves, and this data can then continue to be used to increase efficiency of processes. Companies with connected devices are already seeing results as to how cost-effective this can be.

Effective Patient Data

How can connected devices support patients? Through data. If we think of Wearables as part of personal IoT, and the health data that Wearables can provide, we know how the data alone can benefit patients.There are many other devices that can be implemented to employ beneficial data. For example, some hospitals have begun to use smart beds, alerting nurses when patients are trying to get up, or the bed itself can help patients get up using varying pressure and support. Devices can even help patients once they leave the hospital like smart pill bottles that know when a prescription needs to be refilled or a patient hasn’t take their medicine.

Utilizing Connectivity

Greater connectivity will become apparent with these new devices, but how can these technologies be incorporated into everyday practices? Take for example Google Glass. Pierre Theodore, MD talks about the possibilities that Google Glass can provide for the doctor as opposed to the consumer. As a doctor you could use a device like Google Glass, or even simply a mobile device, to aid your practice with quick access to patient information, scheduling, and all other data connected to the cloud. This is just one way that the increased connectivity that IoT allows can be utilized.

While achieving total connectivity will require changes to the system, we are beginning to see a shift already, and the privacy and security of this data must also be prioritized. But it is clear that once devices are fully connected in the cloud, collecting data from sensors and intelligent devices, improvements can be made to healthcare. Efficiency will be increased, costs will be driven down, practitioners will have an easier time doing their job and in the end, patients will have a more valuable healthcare experience. How do you see IoT affecting healthcare?


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Three Things Physicians Should Know about Social Media

Three Things Physicians Should Know about Social Media | Online Reputation Management for Doctors | Scoop.it

Like many Americans, physicians have discovered the value of social media. Whether they seek to market their practices, educate consumers about health concerns, or engage with patients online, many physicians see the potential in an economic way to reach large audiences quickly via Facebook, Twitter, LinkedIn, YouTube and other sites.


Over 70 percent of family physicians and oncologists use social media more than once a month, according to one survey. Another benefit, clearly, is these sites allow physicians to keep up with news and trends relating to health, medicine and patient care.


Physicians, and all healthcare professionals, should understand the risks of using social media improperly, as these risks could easily outweigh the benefits. Using social media inappropriately could lead to a liability suit that could damage a physician’s reputation or could cause the release of confidential patient information.


The release of patient information would violate HIPAA, which requires physicians and all healthcare entities to safeguard what it calls protected health information (PHI). The law defines PHI as any individually identifiable health information that medical practice or any associate of the practice maintains or transmits in any form. Such a broad definition makes physicians, anyone working for the practice and any vendor who contracts with the practice potentially liable if PHI is released to the public.


Several organizations, including the AMA and the American Association of Family Physicians, have published guidelines for social media use. Another excellent source of such guidance comes from the Federation of State Medical Boards, the group that represents the agencies in every state that discipline physicians. The federation’s 14-page Model Policy Guidelines for the Appropriate Use of Social Media and Social Networking in Medical Practice, is designed to educate state boards on social media. In one section of the guidelines, the federation outlines its recommendations for physicians who use social media and social networking personally and professionally. It recommends following these three steps, saying physicians should:


1. Limit discussions with patients about medical treatment. Therefore, they should never do so on personal social networking sites because anyone with access to these sites could view a physician’s comments about a patient’s care.


2. Provide no information that could identify patients because doing so could be a HIPAA violation.


3. Assume all risks related to the security, privacy and confidentiality of their posts when posting online. Assuming such risk means that when moderating any website, physicians should delete inaccurate information and posts that violate the privacy and confidentiality of patients or that are unprofessional.


Perhaps the best way to sum up the federation’s advice is this — always be professional. Always follow the same principles of professionalism online as you would offline. Use separate accounts for personal and professional social networking sites and for email. This way you can maintain professionalism and confidentiality in your professional postings and still enjoy personal, more casual conversations where appropriate on your personal sites.

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Google+ for Physicians: A Free Tool for Reputation Management

Google+ for Physicians: A Free Tool for Reputation Management | Online Reputation Management for Doctors | Scoop.it

With the expansion of rich information found on social media and review websites, the modern patient is empowered like never before. Researching physicians is as simple as browsing for a car or laptop: search engines and rating websites provide current or former patients a platform for sharing their experiences. Reputation management is a global process that begins and ends with networking sites like Google+. Social media is changing the healthcare game into something much more interactive. That is an exciting concept for professionals looking to amp up their referral systems.


Doctor review websites


Why Online Reputation Matters in Healthcare
People are increasingly referring to mobile devices to perform research online. A study by the Pew Research Center suggests that one in five people who use the internet to find a doctor rely on physician ratings.


The flip side of an internet presence is the potential for damaging feedback – that is the basis of reputation management. Any brand or physician should habitually search its name on Google to look for negative reviews or comments. In the medical world, this is how doctors keep up on what their patients are saying about them and what future patients see.


How does Social Media Fit into Healthcare?


A social media page on Google+ adds a way for doctors to better connect with the public. It’s an upbeat way to manage professional reputation and improve patient care. Patients see the bond with their physician as a very personal one. They appreciate the opportunity to vocalize their satisfaction or frustration with a specific physician or experience. Social media creates an e-patient scenario that allows the physician to promote healthy living, generate trust, and market the healthcare brand. For a doctor, time is in short supply, but fostering a positive reputation online allows you to stay ahead of the curve.

Building a Social Media Voice


The process of developing a “voice” will differ among physicians and service lines. A doctor with a full practice might spend only one hour a week on Google managing his online reputation, while a new cosmetic surgeon will need to commit much more time to creating a brand. Other doctors use their online voice to educate and promote wellness as a way to further their patient’s quality of care. Most businesses, medical or otherwise, realize the power of a professional website. Social media is just another tool to amplify that voice.


Doctor on twitter


What about Referrals?


Engaging with one person through social media translates into interaction with friends and family at the same time. Social media takes word of mouth to the next level. Consider some practical tips for using social media healthcare to enhance referrals:


Research your options – This is critical factor. Many healthcare facilities and organizations have specific rules and guidelines about social media. Take the time to investigate social media polices that affect your strategy to build an online presence.


Privacy is key in social media – Patient privacy is paramount, but it is easy to lose sight of that fact when interacting with a computer screen. Keep in mind the number of eyes that see posts on a social media page. This includes other patients and family members in addition to healthcare administrators, government bodies and content journalists.
Disclaimer, disclaimer, disclaimer – Include an upfront disclaimer on all social media healthcare pages and posts. If communicating with patients through social media, such as during an hour-long Q&A on Twitter, point out that you are not providing a medical diagnosis or treatment.


Seek expert advice – Companies that specialize in reputation management are popping up every day. Find a firm that creates strategies to develop a social media voice. They can handle some of the preliminary legwork and ease you into the process.


Don’t mix business with pleasure – Keep separate social media accounts for your personal communication. If you use Facebook or Twitter to stay in touch with friends and family, don’t use them to foster a professional online reputation. This is as much a safety concern as business advice.


Conclusion


There is a new generation of patients out there, and they are more than just internet-savvy – they are internet-reliant. Doctors need to understand that reputation management and generating referrals online are now a concrete component of digital marketing. The internet, and specifically social media, is part of the modern medical practice.

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Physicians: Safeguard Your Online Reputation in 5 Steps

Physicians: Safeguard Your Online Reputation in 5 Steps | Online Reputation Management for Doctors | Scoop.it

In my previous posts, I've walked you through the challenges and burdens of suing a patient for online defamation. Such lawsuits are expensive, time-consuming, stressful, and full of risk. In short, they are a last resort, only to be used when your reputation is so severely in peril that legal action is your only viable option. This final post will offer a few ideas of proactive steps you can take to safeguard your online reputation.

Given the prevalence and influence of online reviews, physicians cannot ignore their online reputation. A simple Internet search will turn up reviews of your practice in seconds. Survey data makes clear that potential patients will read those reviews and form an impression of you before they've ever set foot in your examination room.

You cannot stop a patient from defaming you online, but taking these steps can help lessen the reputational damage of a single negative review. The goal is to create a substantial and positive online presence

You should be aware that on many doctor rating websites, anyone can create your profile. For example, on RateMDs, the patient need only complete the most basic information about a doctor (name, specialty, address) to create a physician profile. Then the patient can review the doctor, and the profile and review are available for anyone to see. Other websites (such as Healthgrades) pull practice information from public sources to create profiles. Either way, you may not be aware that such profiles even exist.

Here are a few steps you can take right now:

First, if one does not already exist, create a profile on the major review websites, including general review sites like Yelp.


You want to be the person to describe your practice, ensure that contact information is correct, and provide an accurate description of your specialties and experience. It sounds silly, but a warm, approachable headshot —taken by a professional — can offer a strong first impression.

Second, if someone else created a profile for you, "claim" your profile to make any necessary changes to the information in it.
For example, the patient may have listed an incorrect subspecialty or the wrong fax number. By claiming and verifying the profile, at least you will be sure that prospective patients can find your office and contact you.

Third, take steps to create a substantial and positive online presence so that a single negative review will cause little harm.


You can ask patients to write reviews when you have treated them or their close family member. It is not right to pay for reviews, write your own reviews, or post negative reviews on another doctor's profile. Some websites prohibit the solicitation of reviews. But there is nothing wrong with asking your patients to review your practice if they are happy with it.

Fourth, constantly monitor your online reputation.


If you do not know what is being written about your practice, you have zero chance to protect your reputation. You need to check your profile regularly and read all the posted reviews. A staff member can be assigned to this task on a daily, weekly, or even monthly basis, depending on the size of your practice. Apart from finding reviews that you may want to try to remove, this effort also provides you with invaluable feedback about your practice and may help provide ideas to tweak your office policies to fix problems that patients identify. As I have written before, there may be times when you need to respond to negative reviews on the review website itself.

Fifth, be aware that the presentation of online reviews on some sites may not accurately depict all of the reviews of your practice.
Yelp has come under considerable criticism for its internal algorithm that decides which reviews are prominently displayed and which reviews are hidden on a separate page. I talked with one home renovation company that had several one-star reviews on their Yelp profile page but numerous five-star reviews hidden on a second page. The upshot is that even if current patients write positive reviews, this is no guarantee that those reviews can be found easily by potential patients. This is simply one of the problems with online review sites.


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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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Pay doctors and nurses for the time they spend charting

I have a unique perspective as a physician. Having traveled to many hospitals in the past two years, working as a locums emergency physician, I can comment on a variety of issues with a reasonable amount of experience.

One of those issues is EMR, or electronic medical records. I have spent plenty of time writing about this in the past, and I will continue to do so. Because all across the country the same problems, the same frustrations are evident. And the institutional lack of concern is well-entrenched and well understood by everyone affected.Whether working in an academic teaching/trauma center or a small community department, one theme emerges.


EMR is so inefficient, and patient volumes and acuity so high, that charting isn’t done real-time. Unless it is accomplished with scribes, or by dictation, doctors stay after their shifts, or chart from home, or come in on their days off in order to complete their documentation. Needless to say, this is unlikely to create the best possible chart. Not only is this true, I have watched as nurses sat for one to two hours after their busy ED shifts, catching up on the ever increasing documentation requirements in their EMR systems.

Weary from a long day or long night, they sift through notes and charts, orders and code blue records, trying to reassemble some vague estimation of what happened in the chaos of their 8 or 12 hours on shift, when they were expected to function simultaneously as life-savers and data-entry clerks. Further, the nurses are frequently tasked with entering specific charges for billing as well. It all constitutes an unholy combination for any clinician.

Dear friends, colleagues, Romans, countrymen; dear politicians and administrators, programmers and thought leaders, this is unacceptable. Entirely unacceptable. If the charting system is so poorly designed, and so counter-intuitive to the work we do that it can’t be used real-time, then it should be replaced with something far better. And if it isn’t replaced, then everyone needs a scribe to chart for him or her, or we should allow dictation all around. And if none of that is acceptable, if even those reasonable options are rejected, then every nurse and every physician who stays after shift should be paid their regular hourly rate for time spent charting.

The thing is, these systems are generally not the idea of the clinicians who are saddled with them. They are imposed by corporations and administrators who believe the salesmen and hope to capture more billing and data. They are imposed by the meaningful use regulations of the federal government. But as a rule, when we clinicians say a system is bad, or won’t work for us, we are patted on the head and dismissed.

“It’s fine, it’s an industry standard. You can learn to use it. You don’t want to be a problem doctor do you?”

One of my friends is in a group shopping for new systems. When his partner asked to take the potential EMR for a test drive, the salesman said, “Sure, as soon as you sign the contract.” Pathetic. I call on everyone involved in implementation of EMR to find the simplest, most physician and nurse friendly systems possible. And to do it by asking and involving the end user. By which I mean those who provide patient care, not those who cull through it for billing and documentation. Some people chart more slowly than others. That can be an individual issue.

But when a system consistently causes good, efficient doctors, nurses, NPs and PAs to stay long past their shifts, or come in on days off, or chart from their homes (which should be places of recuperation and rest), then we need to give them something back. Equally toxic, some physicians and nurses can only get out in time by charting in a manner that results in a pages long list of checkboxes, rather than a descriptive, informative story.

America’s emergency departments are overwhelmed with passwords, required fields, clicks and key strokes, at the same time as they are overwhelmed with the sick and dying. They are the last safety net for the uninsured and underinsured. They are the point of rescue for the poor, the brutalized, the traumatized, the addicted, the psychotic. Day in and day out, nurses and physicians in emergency departments, indeed all over the modern hospital, do their best against sometimes overwhelming odds. In the midst of this, poor charting systems constitute a crushing blow.

Pay the staff for their time spent charting, or fix the systems. Or both. But something has to give.


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Efficiency of Remote Clinical Documentation Improvement Work

Efficiency of Remote Clinical Documentation Improvement Work | Online Reputation Management for Doctors | Scoop.it

Would working remotely on clinical documentation improvement (CDI) improve efficiency at a healthcare organization? Some may not think so, but the results from Baystate Health indicate otherwise.

As part of its CDI program, Baystate Health in Springfield, Mass., began teaching CDI specialists to work from home with the help of health IT tools, according to the Journal of AHIMA.2014-10-15-Doc-at-PC

So far, working remotely has led to greater accuracy and efficiency among CDI employees. Several years ago, the organization began expanding its CDI hiring base and moving some staff members off-site.

By 2014, the CDI team rose from four specialists to ten. The original four workers were transitioned to working from home after establishing strong relationships with physicians and coders when working on-site. Both email and EHRs were used to run queries by CDI specialists working from home.

This allows providers to focus on their patients and get back to documentation questions afterward. Essentially, it brings better care to patients by preventing interruptions to workflow.

Often, CDI specialists work on hospital floors and ask physicians or nurses directly about queries, but supervisors explain that little has changed by allowing this work-from-home program. The health information management department has also developed software that allows CDI workers and coders to communicate about cases and records.

Another useful tool that simplifies working remotely is an instant messaging platform the organization incorporated. This system-wide messaging capability allows CDI specialists to pose questions and manage issues with anyone from Baystate Health, whether it is the billing department, the health information management department, or medical and surgery.

“We don’t interrupt the productivity of our individuals by having them pair or mentor off another individual, but we use these tools to understand where the variations lie and where there’s other opportunities,” Jennifer Cavagnac, CCDS, Assistant Director of Clinical Documentation Improvement at Baystate Health, told the news source.

One of the main reasons that the organization introduced working remotely was to improve job satisfaction. Moral in the workplace rose due to increased flexibility. This also led to better retainment of top CDI employees.

Cavagnac goes on to explain that team members who work remotely are encouraged to communicate with the rest of the team and ask questions about cases in order to keep them connected to the workplace. The supervisors attempt to ensure workers don’t feel isolated and that resources are available even when working remotely.

Technology like instant messaging, EHR systems, and telehealth services has not only allowed employees to work remotely but also enabled patients to receive basic healthcare assistance outside of a medical office.

The Federal Times reported that caregivers are able to reach patients on a daily basis through telehealth services but a more integrated system will need to be developed so that patient data can be stored securely and shared in real time.

The Department of Veterans Affairs (VA) began a telehealth network four years ago in order to provide healthcare services in rural areas without a strong hospital system. The medical industry will continue to adapt and improve technologies such as videoconferencing, image storing, and wireless communication in order to strengthen the capabilities of telehealth.

Whether it is to increase work flexibility or improve telehealth services for patients around the nation, technology plays a vital role in connecting individuals across the healthcare spectrum.


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Keeping Employees Happy During System Implementations

Keeping Employees Happy During System Implementations | Online Reputation Management for Doctors | Scoop.it

Implementing a new patient management system is a huge investment in terms of time and dollars. It can also be very stressful on all involved. Changes in the healthcare climate often contribute to an organization’s decision to implement a new system in an effort to meet current and future healthcare mandates. New systems often offer technology that is more technically advanced and robust, causing concerns among employees about their ability to learn new functions and workflows in a relatively short amount of time. These concerns often result in real and imagined barriers to staff adapting to the change. So how do you get employee buy-in during a system implementation?

Foster Employee Involvement

In any organization, change is better received when not strictly mandated downward. It is important to create an environment that allows employees to feel that they are a part of the decision making process. The transition to a new system can be successful when opportunities are developed for active engagement among the management and staff. Several steps should be taken to encourage participation and keep employees engaged during this time of significant change, while still keeping the timeline and projected costs in check. We recommend the following:

  • Create a workgroup to categorize, review and understand current state policies and procedures.
  • Create a repository for the existing policies and procedures. Review these policies often throughout the system development and implementation phases. The goal should be to identify gaps and opportunities between current state and future state.
  • Be ready to share. Hold monthly “town hall” meetings during the build phase to provide staff with glimpses of the new system and provide information about next steps, answer questions and concerns.
  • Develop training that is role-based and centered on policy and procedure workflows. It is not uncommon for end users to be highly stressed at the thought of learning and adapting to a new system. Providing training specified on workflows creates a real world environment, allowing users to practice scenarios that are relevant to their job role and improving their comfort level.

Cultivate System Champions

In order to be successful, it is imperative that there is involvement from different employee groups that utilize the system, both non-clinical and clinical. Often, organizations approach a project of this magnitude with a rigid project management stance in order to keep the project timeline and budget intact. Not enough time is spent on gathering “buy in” and system acceptance to reduce the anxiety of the staff that is most impacted. I Involving staff early and often can pay huge dividends in terms of buy-in, satisfaction and timeline. We recommend the following strategies:

  • Map current workflows from start to finish with the aid of designated staff who utilize the functionality
  • Ask staff to list opportunities for improvement and identify workflows that are currently working well.
  • Review workflows for redundancy and encourage new ways of looking at an old issue or process. There are always different ways to obtain the same result. Avoid the all too common idea of, “we’ve always done it this way.”
  • Create access to the new system that is based on user role, testing and training by role. This way, people can learn in an environment that mirrors production. This will greatly decrease potential end user frustration.
  • Choose staff from each modalitythat can act as “super users” who are willing and ready to:
    • Disseminate positive information to his/her department
    • Bring questions and concerns back to implementation team
    • Help develop/update policies and procedures based on new system workflows and best practices
    • Help users understand the new system functionality by utilizing the approved workflows defined at the beginning of the project

Involving staff is important, not only to gain insight into job functions and activities but also to create system champions excited for change.

Participation, Not Delegation

System implementations can be both exciting and exasperating at the same time. Involving staff in a strategic way will improve the overall end result. Allowing staff to have input will ensure that all end user needs have been identified, reviewed, streamlined and implemented if appropriate. Staff buy-in will be heightened if employees feel they are involved. Allow for input, understand current processes, and track employee feedback regarding both current pain points and needs when developing a system implementation strategy.


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