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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Managing online reputation for dentists

Managing online reputation for dentists | Online Reputation Management for Doctors |

The Internet has become the ultimate symbol of an individual’s right to information and freedom of expression. As a result, there is plenty of good information available on the Internet regarding doctors and dentists. However, along with the good information, there is also the risk of misinformation and negative biases finding its way to the World Wide Web.

The very nature of the Internet ensures so much freedom for every individual that it becomes difficult for dentists to control and manage their professional reputations online. The number of rankings or ratings websites have also increased, and some are focused exclusively on physicians. While these websites present an opportunity for dentists to promote their practices through word of mouth publicity, they also pose the risk of creating unfairly negative pinions against them.

Types of ratings websites

Doctor and dentist rating websites can be broadly classified into four categories. The first is the no-fee sites that offer free information to patients about the listed doctors. Some of these sites earn their revenue through advertising, while others charge a fee to the listed doctors. From a dentist’s perspective, it is relatively easy to control information on such a website because there is a financial tie-up between the site and the practitioner.

The second category of websites are the ones that have no relationship with the doctors, but charge patients a fee for privileged access to information about doctors. Dentists can exercise little or no control over the views and reviews that the website chooses to publish about a practice.

The third category includes insurance company websites, which have doctor reference sections, and the companies give their own ratings to the listed doctors.

The final category includes government-controlled websites that provide information about doctors licensed in the states.

How are ratings determined?

Doctor and dentist rating websites usually follow one of three approaches to develop rankings or ratings. The first involves the use of an algorithm or formula that attaches different weights to different sets of credentials of the doctor, such as education, experience, and any special training. Some sites may differentiate on the basis of the type of dental school a dentist attended. If the doctor has settled a malpractice suit out of court, some sites may consider this as grounds to attach lesser weight to the doctor.

The second approach to determine ratings involves feedback from patients. The website will invite patients to rate their doctors on various parameters. Average ratings for a doctor are then computed on the basis of the patient feedback.

The third approach is a hybrid of the first two, which is a more comprehensive way to develop ratings. However, rating a dentist still remains a highly subjective area because the opinions vary widely from patient to patient. That makes this entire system of online ratings inherently controversial.

Proactive online reputation management

From a practicing dentist’s point of view, it makes a lot of sense to be proactive in protecting and managing his or her online reputation. A growing number of patients are inclined to check out a doctor’s background on the Internet, and it may become an important factor in their decision to choose a doctor. The first challenge for a doctor is to ensure that the ratings and review websites maintain the latest information about the doctor’s practice. Most such sites do not have a system to ask for such updates, and the sites expect the listed doctors to provide updates on their own.

Patients may get mixed up when two or more doctors have the same or similar names. It may lead to misplaced patient reviews and ratings. Sometimes a particular patient may have made an unfair, false, or incorrect accusation, which can be countered only if the doctor takes care to tell his side of the story. Apart from damage control in such instances, dentists should also reach out to ratings and review sites to provide accurate facts so that the chances of misinformation are minimized.

Challenges of anonymous ratings

The Internet offers a great deal of anonymity, which can be misused to make irresponsible, incorrect, or false statements online, without any fear of being held accountable. Many individuals operate under pseudonyms on the Internet. So while they can hide their identity and protect their reputation, they can potentially jeopardize the reputation of a dentist or other professional online. To tackle this challenge, Google Plus has taken the initiative and revoked the ability of users to post reviews anonymously, or even pseudonymously.

While this kind of restriction is a welcome step for most businesses and professions, it poses another unique problem in the area of health care. Patients are usually willing to be most candid when their privacy is protected. Less than 5% of patients willingly give out their full names when providing feedback about a doctor online. Therefore, restriction of their privacy is a dilemma that may discourage patients from providing reviews and ratings about doctors and dentists on respected forums such as Google Plus.

Hire online reputation management experts

Dental practitioners who are looking to grow and expand their practices in their area can no longer afford to ignore the marketing power of the Internet. They should have a professional and dynamic website that creates an outstanding image for the dentist and practice. Secondly, such a website needs to be promoted professionally so that it achieves high rankings on all search engines, which allows the maximum number of local patients to reach the website. Thirdly, the dentist must be able to protect his or her reputation on third party websites on the Internet.

All these tasks can be performed efficiently and cost-effectively with the help of a professional SEO and online reputation management services provider. With the support of recognized experts in this area, it is possible to build an impeccable online reputation for a dentist, while following the highest ethical and professional standards.

It takes years to build an online reputation, and it can take one bad review that goes viral on the Internet to tear it down. With the growing influence of the World Wide Web in our lives, it is a smart move for practicing dentists to take the steps to build and protect their professional reputation online.

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PAs and Malpractice Risks: A PA's Perspective

PAs and Malpractice Risks: A PA's Perspective | Online Reputation Management for Doctors |

I occasionally get questions from physician colleagues that highlight the confusion some physicians have about practicing medicine in teams with PAs, and the concerns many of them have regarding the malpractice risks associated with the PAs on these teams.

These are valid questions and concerns and, given that more PAs are practicing in teams with physicians and many have a significant level of autonomy in delivering care, I am encountering such questions and concerns more frequently than in the past.

Here's how I respond to such questions, and some guidance I have for physicians who are working with PAs, or considering doing so.

Do Your Homework

It behooves the physician working with a PA to vet the PA well to understand the training, experience, and capability of the individual PA. Physicians should keep in mind that a PA's capabilities may vary depending on experience. A new PA graduate in his first job requires a much more hands-on approach to team practice than a PA who has been practicing in that particular specialty for 10 years to 20 years.

While the main reason for vetting the PA is just good, responsible patient care, the secondary reason is that the physician is responsible for the care of each patient that the PA treats, whether the physician is aware of this patient or not.

In other words, when a PA is practicing medicine, he is the “agent” of the physician. This means that the actions and orders of the PA are considered the same as if the physician took the action or made the order.

Consider the Benefits

I have heard some physicians use malpractice risks as a reason to not work with PAs. I always counter with the “two heads are better than one” argument when it comes to caring for patients.

A more important argument is that historical data shows that PAs are sued at a much lower rate than physicians, and, when they are sued, the awards and settlements are much smaller than for cases involving physicians.

One of the maxims one of my physician colleagues taught me many years ago is that when your patients like you, they are much less likely to sue you and much more readily willing to forgive medical errors and subsequent injury. This is an area where I think that PAs really add value to a practice.

My physician partner and I have a robust plastic and reconstructive surgery practice. He is extremely busy and covers two hospitals. I am able to interact with our patients in a more timely and less harried manner; I handle the never-ending and sometimes overwhelming administrative burdens associated with a hospital-based practice; I give the patients validation for their questions and concerns; and I “triage” those concerns to determine which issues my surgeon needs to deal with directly.

Patients see usas a team and a united front. We both take time to get to know our patients, and address their concerns. I extend that ethos and capability to a level that I know increases patient satisfaction because our patients continually tell us so.

The bottom line is that if a physician does due diligence, he can confidently work in teams with PAs and other providers, and enhance the overall safety and effectiveness of the practice while at the same time reducing the liability risk to the team.

Guidance for Physicians working with PAs

Here's what physicians working with PAs should focus on to minimize their risks and maximize the benefits: 

  • Know the skills, experience, and training of the PA. This should determine how much you interact with the PA and how much autonomy she receives.
  • Discuss clear guidelines for managing difficult patient problems, so that everyone on the team is on the same page.
  • Be available and approachable for interactions on patient care questions and concerns. This intuitively makes sense and is the basis for my belief that two heads are in fact better than one when it comes to patient care.
  • Document the actual interaction/consultation you have with the PA. Given the ease at which these interactions can be documented in this day and age, there is no excuse for not documenting on the patient chart  all the team consultations that occur. My in-house H&Ps, as well as my consultations, always include documentation of my interaction with my surgeon, when it occurs.

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Marketing Your Practice Online

Marketing Your Practice Online | Online Reputation Management for Doctors |

In previous years the conversation around marketing your medical practice centered on "Should I market my practice?" and "How much should I spend on marketing my practice?" Which then evolved into "Should I be online?" and "Is Facebook or social media really necessary to market my practice?"

Not anymore.

The conversation is now "How much time and money should I invest in online marketing?" It is now accepted that online marketing is not just an option for practices any longer; it is something they must do to attract new patients and stay competitive.

Determining cost

When determining a budget for your online marketing, it is best to start with the end in mind. Begin by looking at what your goals are for your online marketing program. I think it's best to frame them within short-term and long-term scenarios.

Here are some examples to get your creative wheels turning:

In 90 days, I would like to see an established and engaged audience of X number of people.

In 120 days, I would like to see my audience at X number, and receive X new patients per month from online efforts.

Once you have your goals set, you can determine the cost to achieve them. There are a number of factors to consider when determining the cost:

• Where does your ideal patient hang out?

Hint: Almost all practices should start with a website and Facebook.

• Who is managing the online effort — in-house vs. an outside firm?

There are many different levels of service available; from assistance with in-house efforts to complete outside management.

• What is the cost to reach your ideal patients?

Do you want to reach the 22-year-old diabetic patient in Boise, Idaho? You can, and often times for pennies. If you want to make your message more specific, it may cost a little more or less depending on the characteristics you seek?

• How will you stay in touch?

All of these variables, and many more, factor into what kind of investment you will need to make to reach the patients you want to see.

Compare these figures to what a single patient is worth to your practice to calculate how much time and money you should invest in online marketing efforts.

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How to Improve Patient Engagement in the Provider Community

How to Improve Patient Engagement in the Provider Community | Online Reputation Management for Doctors |

Patient engagement strategies have been heavily discussed in the media and among the vendor community, but digital participation on both the provider and patient side has been meek at best.

The latest report from Chilmark Research on the patient engagement market shows that the healthcare sector is still participating very minimally in digital communication with patients post-discharge or between visits.

In an interview with, report author Naveen Rao from Chilmark Research spoke about the potential of patient engagement for bringing broader models of care to the industry. More outreach is especially helpful for patients with chronic conditions or severe illnesses.

“We wanted to find out — what are people actually using today. Not what’s actually being sold but what’s being bought. We wanted to find out from the provider’s perspective, what are the limitations of the tools that are being purchased,” Rao revealed.

“Usually, there’s a feature or two that are dedicated to engagement,” he continued. “So we wanted to look at those features and see whether they are actually working. Are they cutting edge? Are they not?”

Specifically, Rao mentioned the benefits of mobile technology in the healthcare market. While some vendors have mobile-compatible apps, there is very limited device integration in healthcare. The provider side is not much better, as few physicians are utilizing mobile health technology to improve patient engagement. However, mobile health apps could improve administrative aspects of care such as faster scheduling as well as managing post-discharge care.

“If you look at the state of affairs when it comes to mobile tools for the patient in the year 2015, it’s pretty disappointing, particularly on the provider side,” Rao stated. “Providers don’t acknowledge that there’s this really great tool that every one of their patients is leaving the office with. They can and ought to be leveraging [it] a little bit more effectively.”

The most common tool in patient engagement is the patient portal. Some aspects that Rao encourages health IT vendors to include in the patient portal are mobile health tools and the longitudinal patient health record that is connected to their EHR. Additionally, health information exchange (HIE) capabilities that can pull in data from other hospitals across the country would benefit the patient portal greatly.

Patient-generated information and biometric data like blood pressure and diabetes management analytics could also be incorporated into patient portals and EHRs. However, vendors will need to move more quickly to incorporate some of these tools into the patient portal.

“We have the technology to send information and collect it from point A to point B,” Rao mentioned. “It’s not happening. There’s no way to put it [biometric data] into your record. Five or ten years from now, things are going to become more digital. The vendors out there aren’t really with the program.”

The Chilmark Research report focused on how the average providers are lacking effective patient engagement strategies. For providers who haven’t begun incorporating patient portals, Rao said the first step to take is to improve patient-doctor communication. Physicians should speak with their patients to find out their preferred method of contact.

After an appointment, doctors should follow-up with their patients via secure messaging/email, text, or phone call in order to enhance communication. After “mastering these basics,” providers should implement patient portals to improve patient satisfaction.

“There is a lot of capability possible through just a basic patient portal. That’s not exactly the most advanced tool that we have today, but it’s a great starting point,” Rao said. “Providers have the ability with their patient portals to send secure emails. But are they actually doing it?”

“Are you actually sending messages to patients between visits? If someone comes in with lower back pain, you send them home with a pill and you never follow up… when it comes to advanced models of care, we can use email to do a lot. If the doctor isn’t doing simple things like sending a follow-up, then what’s the point of having this technology in the first place?”

Providers will need to put greater emphasis on patient-doctor communication and follow-up contact in order to improve the quality of healthcare services. Naveen Rao also spoke about the type of health IT tools providers can utilize when gathering population health statistics. These include data management, data analytics, and stratification tools as well as information exchange and registry capabilities. Digital and mobile health applications can also play a lesser role in population health management.

Rao mentioned that telehealth and mobile technology will have a “big impact” on the healthcare industry in the coming years. He sees it become adopted more broadly in the next three to five years. The most important aspect, though, is to ensure multiple physicians can access the same patient records in real time. Telehealth services will have a strong, transformative influence on rural healthcare as well as patients with weather and geographic limitations.

As a greater shift toward population health management and patient engagement takes place, the healthcare industry will see providers rely more on multiple IT vendors. This is likely because a single vendor rarely is able to offer every single aspect of medical technology. This offers physician practices positive opportunities such as reducing the issues associated with limited EHR systems. However, with all benefits, come some disadvantages like more staff training, higher workload, the costs associated with new systems, and the overall responsibility of working with multiple vendors.

Physicians who are looking to increase patient engagement should consider the following strategic steps. First, find out a patient’s preferred method of contact. Next, partake in the patient activation measure, which essentially means work toward improving patient interest in their medical care and treatment protocols.

Doctors can also improve patient satisfaction by checking in and following up after an appointment. The last step to incorporate is patient-reported outcomes by recording data after receiving secure messages. Physicians looking to improve communication with their patients should consider implementing this patient engagement strategy.

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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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The Reason Many Medical Practice Change Initiatives Fail

The Reason Many Medical Practice Change Initiatives Fail | Online Reputation Management for Doctors |

Good is rarely good enough, and opportunities for improvement are never lacking. Unfortunately, the success rate of major change initiatives in medical practices is often low due to poor management of the change. 

Physician leaders and practice managers should expect and accept disruption and resistance to change, and never lose sight of the fact that costs are high when change efforts go wrong. 

The consequences of poorly executed change are not only financial costs, but also lost opportunity, wasted resources, confusion, and diminished morale. 

Here are three major areas to focus on to help with your change management efforts.

Clarify direction
As the saying goes, “culture is everything.”  To effectively manage change, you must consider your practice culture, and thus clarify how the change relates to your practice culture, vision, and goals.

Communication is paramount when trying to raise the level of understanding of why the change is taking place. Employees should be told why the change is taking place, what the change will mean for them, when the change will be happening, how the change will be carried out, what support will be available to help them adjust to the change, and what will be expected of employees as a result of the change. 

Over-communicate your goals, direction, and expectations.  It's not enough to send out an e-mail addressing those points. Communication should be regular and should continue over an extended period of time.

Invite and acknowledge concerns
Make change a part of your business and an expectation among staff and providers.  Many members of your practice are innovative and eager to contribute their insights and suggestions for improvement.  Treat them as a natural part of the process and address resistance by asking for input. 

Work with all staff to measure “real” vs. “perceived” disruption.  The path of rolling out change is immeasurably smoother if these people are tapped early for input on issues that will affect their jobs. 

The goal is to quickly get employees through the denial and resistance stages and on to the commitment phase where you get the buy-in from staff.

Develop commitment
Work on developing commitment from the staff and avoid demanding compliance.  People respond to calls to action that engage their hearts as well as their minds, making them feel as if they’re part of something consequential, so make the rational and emotional case for change together. 

Their full-hearted engagement can smooth the way for complex change initiatives, whereas their resistance will make implementation an ongoing challenge.  Address any reservations and give some consideration to possibly rewarding initiative.  You must either build commitment or prepare for the consequences.

Medical practices must constantly change in order to survive in today’s competitive healthcare arena.  Practices should never settle for something that is considered completed; all things can improve with change. 

Managing change in an already busy practice environment, however, can be challenging and you may want to consider bringing someone in to help structure the rollout of a project and guide you through key change initiative milestones.  When employees who have endured real upheaval and put in significant extra hours for an initiative that was announced with great fanfare see it simply fizzle out, cynicism sets in.

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3 Things Doctors Can Do to Connect With Patients

3 Things Doctors Can Do to Connect With Patients | Online Reputation Management for Doctors |

Patients have been coming into my office for several years telling me that they looked me up on the Internet and that I have great reviews. I always dismissed these comments, as I knew that these reviews were influenced by many factors and not necessarily accurate. Plus, the reviews were favorable so I gave it little thought. Eventually, I took the opportunity to Google myself and was amused by much of what I read. Patients often made strong statements about me without much evidence. Again, it was largely complimentary so I let things be.

Over time, it dawned on me that virtually every patient was looking me up. I went back to the Internet and tried to picture what I would think if I were a patient looking me up. I realized I was passively being defined, as opposed to actively defining my own image -- and the method of others defining me was often incomplete and arbitrary.

I decided to launch my own website so I could define my online image. I wanted to project what I believe in, and how I practice medicine so that patients who research me can more accurately see if my philosophy truly resonates with theirs.

Of course, it's not so easy. Just putting something out there doesn't assure that it will be what patients find when they search. More importantly, it got me thinking about the doctor/patient relationship. It is clear that patients want to connect with their doctors. Doctors, however, seem more ambivalent about making such a connection. To some doctors, it is as if forming a connection will somehow undermine the traditional relationship which is best kept as formal, paternalistic, and standoffish. We are running our practices the same way they were run 30 years ago. This is a terrible mistake.

I believe I can gain more by giving, learn more by listening, and influence more by connecting.

1. Doctors should focus on connecting with patients.
The world has changed. Most other businesses have changed. Every physician should have his or her own website which patients can easily access. If the physician boldly puts his or her personality and philosophy out there for scrutiny, there will be some who like what they see and some who don't, but the patients who make appointments and ultimately come in to the office will have more productive experiences.

2. Doctors should provide content.
Consumers want content when they do research. Consumers of health care are no different. The best way to advertise is not to yell about how great you are, but simply, to teach. Patients are attracted to content, and particularly, to how the content is presented. You don't have to tell consumers of your value, when you can provide them with content of value.

3. Doctors should embrace social media.
Most doctors pride themselves in getting patients from word-of-mouth. This has always been considered the most desirable method of growing a practice. But word-of-mouth is not as useful as it has been traditionally considered.

Think about researching a restaurant. What is more likely to draw you to a particular restaurant: hearing from several arbitrary people that it is great or not only hearing from these several arbitrary people, but hearing from some specific people who have a track record of making good suggestions about restaurants and also having access to the menu, the restaurant's philosophy on cleanliness and the rigor with which food is selected and procured?

Social media is more than simple word-of-mouth. It enables patients to access meaningful opinions, and then make informed decisions about doctors' practices. Social media gives physicians the opportunity to help empower patients. If a doctor does not embrace this burgeoning technology, his or her prospective patients will end up elsewhere.

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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 |

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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Marketing Your Practice Online

Marketing Your Practice Online | Online Reputation Management for Doctors |

In previous years the conversation around marketing your medical practice centered on "Should I market my practice?" and "How much should I spend on marketing my practice?" Which then evolved into "Should I be online?" and "Is Facebook or social media really necessary to market my practice?"

Not anymore.

The conversation is now "How much time and money should I invest in online marketing?" It is now accepted that online marketing is not just an option for practices any longer; it is something they must do to attract new patients and stay competitive.

Determining cost

When determining a budget for your online marketing, it is best to start with the end in mind. Begin by looking at what your goals are for your online marketing program. I think it's best to frame them within short-term and long-term scenarios.

Here are some examples to get your creative wheels turning:

In 90 days, I would like to see an established and engaged audience of X number of people.

In 120 days, I would like to see my audience at X number, and receive X new patients per month from online efforts.

Once you have your goals set, you can determine the cost to achieve them. There are a number of factors to consider when determining the cost:

• Where does your ideal patient hang out?

Hint: Almost all practices should start with a website and Facebook.

• Who is managing the online effort — in-house vs. an outside firm?

There are many different levels of service available; from assistance with in-house efforts to complete outside management.

• What is the cost to reach your ideal patients?

Do you want to reach the 22-year-old diabetic patient in Boise, Idaho? You can, and often times for pennies. If you want to make your message more specific, it may cost a little more or less depending on the characteristics you seek.

• How will you stay in touch?

All of these variables, and many more, factor into what kind of investment you will need to make to reach the patients you want to see.

Compare these figures to what a single patient is worth to your practice to calculate how much time and money you should invest in online marketing efforts.

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Sharing Job Performance Standards With Medical Staff

Sharing Job Performance Standards With Medical Staff | Online Reputation Management for Doctors |

An interesting event occurred this week in my practice that I'd like to share with you. Although on the surface this seems like one of those "Well, of course" moments, oftentimes managers overlook the obvious and then wonder what went wrong.

A staff member requested and was given permission to split his time between two medical offices, hoping to build up his portion of the business in two locations rather than just one. A few weeks ago, I noticed some lax behavior on his part, resulting in not meeting expected job performance in the areas of billing charges out, completing chart notes, and communicating scheduling times. I watched and monitored his behavior to gather enough consistent information to approach him and address the problem. What resulted was a fantastic meeting of the minds; a positive and non-threatening interaction that resulted in much improved performance.

When we sat down to speak, the staff member appeared very anxious. I was unsure why this behavior was being exhibited, but knew there was a reason. So, as we started talking, I explained to him that the second office he was now working in had higher expectations from their staff members than perhaps some of the other practice locations. Many of our staff members want to work in this location due to the clinic directors' leadership style. So, as a result, the expectation of staff performance, communication, and professional attitude is higher.

The staff member asked me to expand on that. I mentioned that he failed to chart and bill out charges within 24 hours of the patient visit. I asked him why he felt this was appropriate behavior. He told me no one had ever spoken with him about what was required or expected in this area. I then asked about communication regarding scheduling. A similar answer was produced. It occurred to me that when the staff member was hired, he was pointed in the direction of his workstation, and told, "Okay, go to work." That was it.

Now, I understand that everyone gets busy and when a new employee starts, sometimes it seems like no one has the time for a proper introduction, training, or communicating basic requirements of the job. This is clearly the case with this employee. After a mere 30 minutes of explaining what the requirements for working in this office meant, we had some brainstorming and idea discussion. The employee had not been exposed to having the autonomy to "own the position," and be part of the solution, rather than part of the problem.

The result? All missing chart notes were completed within 24 hours of our meeting, and have been kept up with the expectation that was provided. The staff member has been asking for assistance with marketing the office and working in the new location. He is communicating with the front desk about their scheduling needs and requests. The staff member is keenly aware that there is transparency in that office and that he is required to meet and exceed the standard provided if he wants to remain in that location.

It's a win-win all around. The staff member feels good about working for the practice; and the clinic director is very pleased with his addition to the team, and his performance, attitude, and overall teamwork.  So remember that instead of throwing the baby out with the bathwater, take a step back and figure out why a staff member behaves the way he does, and just have a frank conversation with him.

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Making Your Practice a 'Best' Place to Work

Making Your Practice a 'Best' Place to Work | Online Reputation Management for Doctors |

Every office has something the employees get excited about, whether it’s the summer picnic, bring-your-child-to-work day, or Taco Tuesday. At my office, we’ve never met a party that we didn’t like.

We celebrate birthdays and holidays and promotions and each of the goals we achieve. But no celebration is more meaningful than Fortune day.

Last week, our parent company CHG Healthcare Services was ranked 16 on Fortune magazine’s “100 Best Companies to Work For” list (and here’s how we celebrated).

One reason our company stands out as a great place to work is that fostering a healthy workplace culture is a top priority for us.

Here's why workplace "culture" is so important, and how you can cultivate a great workplace culture at your practice.

Culture Sets You Apart From Your Competition

After the dark days of the Great Recession, the economy has bounced back. In many industries, and especially in healthcare, people have gone from worrying about just hanging onto their job, to having the freedom to be picky about where they choose to work.

In a job seeker’s market, it’s important to ask yourself some tough questions. Why would a physician or staff member choose to work with your practice?  What makes you stand out from the competition? What are you doing to keep your current team engaged?

If you’re doing things right, the answer to each of these questions will be the same: We have, and cultivate, a strong company culture.

Cultivating a Great Culture

Making your practice a place where people want to work isn’t easy. It takes consistent and concerted efforts. Here are some of the things that can help.

1. Hire for cultural fit and train for skills. When it comes to hiring staff, strong skills and an impressive background are nice. But if you really want to hire the right candidate, focus on who they are as a person. Will they fit in with the team? Do they care about the mission of the practice? Will the job help them reach their long-term goals?

Remember, job candidates who are engaged not only make better employees, but they’re much more likely to stick around.

2. Give your team a voice. People want to work for someone they can trust. One of the keys to building trust is to ask for regular feedback from your team, whether it’s through formal channels like surveys or through more informal meetings.

But gathering feedback is just the first step. You also need to be willing to implement some of those ideas and be transparent about decisions affecting the practice.

3. Take care of each other. One of the best parts of working in healthcare is the opportunity to make a difference in the lives of those you serve. But that service doesn’t have to be constrained to the walls of the practice. Encourage your employees to give back to the greater community by offering them paid time off when they volunteer.

Creating a strong culture won’t happen overnight, but it will happen. As we’ve implemented these practices at our office, we’ve seen retention improve and engagement increase. Not surprisingly, our success in building culture has resulted in success in building our business.

And that’s something worth celebrating.

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Can forces align to use health IT to improve care and lower costs?

Can forces align to use health IT to improve care and lower costs? | Online Reputation Management for Doctors |

Health information technology (health IT) is essential to providing clinicians and patients with the information and tools necessary to make decisions that can improve health outcomes and lower costs. While the 2009 Meaningful Use program (included in the federal stimulus package) and other initiatives have increased the adoption and use electronic health records (EHRs) there are many concerns about the benefits of health IT and the future of health IT policy. These concerns are particularly timely given the recent U.S. Department of Health and Human Services announcement to expand the use of value-based payment models in Medicare, as well as the release of a national roadmap to achieve interoperable health IT. Likewise, in the private sector, many organizations are shifting to value-based payments and are developing innovative products and services to capitalize on the potential of health IT.

On March 4, the Engelberg Center for Health Care Reform hosted an event to discuss the current state of health IT adoption, its potential to reinforce a quality and value-based payment system, and identify which policy changes will be necessary to support meaningful health IT transformation. The discussion included keynote remarks from Karen DeSalvo, National Coordinator for Health IT, U.S. Department of Health and Human Services, as well as health IT and other policy experts.

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Efficiency of Remote Clinical Documentation Improvement Work

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

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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How to Apologize for a Medical Error

How to Apologize for a Medical Error | Online Reputation Management for Doctors |

Apologizing to a patient when an error occurs is critical to reducing malpractice risks, says Sue Larsen, president and director of education at Astute Doctor Education, Inc. "They always say that anger and not injury is what drives a patient to sue, and everybody hates a cover up," she says. "So when something goes wrong and the physician goes missing, that's when the patient feels deserted and they suspect that something has gone wrong." Ultimately, Larsen says, that anger and the resulting broken relationship with the physician can propel the patient to sue.

Of course, apologizing for a medical error is not easy, and Larsen says how you say sorry is crucial. Make sure your apology is:

• Sincere;

• Empathetic; and

• Indicates mutual disappointment.

"As a doctor, you are disappointed in the outcome and you are sorry the patient is disappointed as well," says Larsen. "This isn't admitting fault, it just is a way of showing the patient that you care and that you understand."

Once you make the apology to the patient, emphasize that you are committed to ensuring this error will never happen again, and that you are going to follow up to determine why the error occurred.

Then, attend to the patient's immediate needs that you can address, says Larsen. "Avoiding the patient or deserting the patient is absolutely the worst thing you can do, and it's going to put you at a much higher risk of having a claim made against you."

To help you determine the right approach next time you need to make an apology, Larsen shared this example of the proper phrasing to use:

"I'm really sorry this has happened to you, it's obviously not the outcome that any of us would have liked to have seen. I'm disappointed. I'm disappointed that you have had to go through this. I know that you are feeling very upset and frustrated that this has happened and perhaps even quite angry, and I can understand that you'd be feeling that way. All I can do is say I'm sorry that you are in this situation and we are going to do everything we possibly can to try and understand the events leading up to this so that we can avoid it happening again. In the meantime, I'd like you to know that I am here for you, if there is anything I can do."

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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 |

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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