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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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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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 | Scoop.it

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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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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Is Your Hospital Embracing or Ignoring Social Media?

Is Your Hospital Embracing or Ignoring Social Media? | Online Reputation Management for Doctors | Scoop.it

At this point, I don’t think there’s any argument that social media influencers our health choices. In the above mentioned survey, 40% of them realize that it’s impacting them. Trying to say that social media doesn’t influence health decisions is like trying to say that your friends and family don’t influence your health decisions. Social media is the new way we communicate with friends and family. They influenced our health before social media and are still doing it, but in the new social media medium.

We know that social media is influencing health decisions, but is your hospital embracing the power of social media or trying to ignore it? I bet most hospital CIOs have no idea. I bet most hospital CMO (Chief Medical Officers) don’t know much better either.

There’s a simple way for you to know how well your hospital is embracing social media. Just ask yourself the question, “Is social media in my hospital considered a marketing and PR task?”

If the answer to that question is yes, then you have not embraced social media in your hospital. Certainly there is a lot of opportunity for a hospital marketing and PR department to use social media and they should (Side Note: I have a conference focused on hospital social media, so I intimately know the power of it in marketing and PR). However, if social media is only considered a marketing and PR task, then your hospital is missing out on so many benefits that can come from a hospital using social media.

The first step to embracing this culture is involving your hospital CIO and hospital CMO (Chief Medical Officer) in social media. They’ll have ideas and insights into how to use social media that go well beyond marketing a hospital’s services. In the new value based reimbursement world, this new form of outreach and connection to patients is going to be critical.

The second step to embracing hospital social media is to put budget and resources (ie. people) behind the initiatives that are created by your marketing/PR team, IT team, and medical team. There’s very little value that’s created from a meeting of these people without the ability to follow through on the ideas and suggestions they create.

Sadly, most hospitals have never even had this meeting (possibly because they don’t want to commit the resources). Those few hospitals who have had this meeting haven’t committed the resources needed to turn their ideas into reality. I think these are both failed strategies for hospitals that will catch up to them in a big way. I think a hospital’s approach to social media will soon tell us a lot about a hospital’s approach to patient care.


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'Mix and Match' Documentation for Higher Reimbursement

'Mix and Match' Documentation for Higher Reimbursement | Online Reputation Management for Doctors | Scoop.it

Recent changes in how CMS permits you to select evaluation and management (E/M) service levels are a benefit to providers who manage patients with multiple chronic conditions.

E/M services may be provided at various levels of intensity, with more intensive services garnering higher reimbursement. E/M service levels (and the codes that describe them) are assigned according the elements of patient history, exam, and medical decision-making (MDM) documented in the provider’s encounter notes.

CMS allows you to choose between two sets of guidelines when translating provider documentation into E/M codes: The 1995 Documentation Guidelines for Evaluation and Management Services and the 1997 Documentation Guidelines for Evaluation and Management Services. The guidelines differ in how they define the history and exam portions of an E/M service (the guidelines are identical regarding MDM).

The ‘95 guidelines define the exam component such that specialist providers found it difficult to report higher-level E/M codes, even when services warranted doing so. The ‘97 guidelines addressed this issue by providing bullet points for single organ system examinations, thereby allowing specialists to report higher level services for intensive, problem-specific exams. The ‘97 exam requirements tend not to work as well for general practitioners, however.

The ‘97 guidelines also differ in the history component, and allow “the status of three or more chronic conditions” to qualify as an “extended” history of present illness (HPI). Under the ‘95 guidelines, providers must document four or more HPI “elements” (location, quality, severity, duration, timing, context, modifying factors, and associated signs and symptoms) to attain an extended HPI.

Each set of guidelines has its advantages and disadvantages. For many providers, the ideal guideline would combine the ‘95 exam requirements (which are more subjective, as compared to the ‘97 exam requirements) with the ‘97 history element (which are more flexible than the ‘95 guidelines when defining the history of present illness). For many years, such “mixing and matching” of the guidelines has not been allowed.

Effective since Sept. 10, 2013, CMS has revised its E/M Documentation Guidelines to allow an extended HPI, as defined by the ‘97 guidelines, with the other elements of the ‘95 guidelines. As a result, “the status of three or more chronic conditions” qualifies as an extended HPI for either the ‘97 or ‘95 guidelines. 

CMS announced the change as a “Question and Answer” on its website.

Q. Can a provider use both the 1995 and 1997 Documentation Guidelines for Evaluation and Management Services to document their choice of evaluation and management HCPCS code?
A. For billing Medicare, a provider may choose either version of the documentation guidelines, not a combination of the two, to document a patient encounter. However, beginning for services performed on or after September 10, 2013 physicians may use the 1997 documentation guidelines for an extended history of present illness along with other elements from the 1995 guidelines to document an evaluation and management service.

CMS has also updated its Evaluation and Management Services Guide to reflect the new policy.

Ask your coding staff if they are aware of this change, and if they are measuring E/M services against the revised guidelines. Those physicians who manage patients with multiple chronic conditions, especially, may find that the new rules allow their coding and billing to better reflect the documented level of service provided, thereby legitimately boosting E/M levels and reimbursement levels. If providers are already documenting their services well, they won’t have to change their process to realize an advantage from these revised E/M guidelines.


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