Advanced Communication Technologies Overview and Potential Uses Alan Brookstone, MD March 29, 2008

Background Family physician – Closed practice June 30, 2007 Partner – The ClearView Group August 2007 National Physician Advisory – Canada Health Infoway Founder of CanadianEMR – National EMR service for Physicians Provincial BC College of Physicians and Surgeons BC Ministry of Health IEHR project BC Provincial Privacy Working Group Regional Vancouver Costal Health eHealth Steering Committee VCH Primary Care IT strategy Privacy Working Group PUG strategy Local Richmond Hospital strategies

Family physician – Closed practice June 30, 2007

Partner – The ClearView Group August 2007

National

Physician Advisory – Canada Health Infoway

Founder of CanadianEMR – National EMR service for Physicians

Provincial

BC College of Physicians and Surgeons

BC Ministry of Health IEHR project

BC Provincial Privacy Working Group

Regional

Vancouver Costal Health eHealth Steering Committee

VCH Primary Care IT strategy

Privacy Working Group

PUG strategy

Local

Richmond Hospital strategies

Question How do we do our jobs more efficiently, accurately, enjoyably when we work in an EMR based practice setting?

How do we do our jobs more efficiently, accurately, enjoyably when we work in an EMR based practice setting?

The Answer will not Arrive through Divine Intervention

Advanced Communication Technologies? Used to support Communication Collaboration Can facilitate groups or person-to-person Some are in wide scale use today eMail Instant messaging Video-conferencing (e.g. Skype) Cell phones Blackberries etc.

Used to support

Communication

Collaboration

Can facilitate groups or person-to-person

Some are in wide scale use today

eMail

Instant messaging

Video-conferencing (e.g. Skype)

Cell phones

Blackberries etc.

Traditional Web-based Tools Bulletin boards – Useful but static Blogs – Useful, provide interactivity. Not real-time Wikis – Also interactive – you can edit and contribute. Not real time

Bulletin boards – Useful but static

Blogs – Useful, provide interactivity. Not real-time

Wikis – Also interactive – you can edit and contribute. Not real time

Potential Benefits Presence (you know an individual’s status - provides context – away, available etc.) Interactive communications Real time Allow an immediate response Can use technologies simultaneously Can switch between different technologies Desktop and/or mobile

Presence (you know an individual’s status - provides context – away, available etc.)

Interactive communications

Real time

Allow an immediate response

Can use technologies simultaneously

Can switch between different technologies

Desktop and/or mobile

Potential Risks Disruptive to workflow Cost and complexity Is it really needed?

Disruptive to workflow

Cost and complexity

Is it really needed?

Technical Support Level of support - specific extent of technical assistance in the total range of assistance that is provided by an information technology product (such as a software product) to its customers. Some companies name their levels of support basic and advanced. Others call them level 1, level 2, and level 3, or Level A, level B, and level C

Level of support - specific extent of technical assistance in the total range of assistance that is provided by an information technology product (such as a software product) to its customers.

Some companies name their levels of support basic and advanced.

Others call them level 1, level 2, and level 3, or

Level A, level B, and level C

Support Typically, when a software user calls for technical assistance, a level 1 technician tries to answer all questions, which might include help with simple problems or general "how-to" questions. If the question is more complex, the user is passed on to the level 2 technician. e.g. advanced features and possible product bugs or failures. If the level 2 technician cannot help the caller, a level 3 technician may be consulted either by the customer or by the level 2 technician. Research and investigation may be required - takes time. Some companies offer certain levels of support only on a fee basis.

Typically, when a software user calls for technical assistance, a level 1 technician tries to answer all questions, which might include help with simple problems or general "how-to" questions.

If the question is more complex, the user is passed on to the level 2 technician. e.g. advanced features and possible product bugs or failures.

If the level 2 technician cannot help the caller, a level 3 technician may be consulted either by the customer or by the level 2 technician. Research and investigation may be required - takes time.

Some companies offer certain levels of support only on a fee basis.

Support You are having difficulty with a certain feature in your EMR Can’t answer question from the in-built ‘Help’ feature Who would you call or email? Best bet: product/technical support

You are having difficulty with a certain feature in your EMR

Can’t answer question from the in-built ‘Help’ feature

Who would you call or email?

Best bet: product/technical support

Scenarios Best – question is answered immediately and you get back to work Worst – you are escalated through higher levels of support. Your question is unanswered Ultimate worst – “Sorry, please contact your hardware or network supplier. This is not a software problem”…. Right! Costly and Frustrating Satisfaction level is reduced

Best – question is answered immediately and you get back to work

Worst – you are escalated through higher levels of support. Your question is unanswered

Ultimate worst – “Sorry, please contact your hardware or network supplier. This is not a software problem”…. Right!

Costly and Frustrating

Satisfaction level is reduced

What are the Alternatives? Advanced communications technologies Such as: Instant messaging Could be used by physicians And especially medical office staff

Advanced communications technologies

Such as:

Instant messaging

Could be used by physicians

And especially medical office staff

Example STATUS OTHERS ONLINE ACTION

Opportunities What if you had a chat application that: Was secure (running on a private or encrypted network) Provided access to: Company technical support (within hours of operation) Users of the product who could indicate Size of practice, specialty and location Status (online, away) Role (mentor, user etc.) Create virtual user groups

What if you had a chat application that:

Was secure (running on a private or encrypted network)

Provided access to:

Company technical support (within hours of operation)

Users of the product who could indicate

Size of practice, specialty and location

Status (online, away)

Role (mentor, user etc.)

Create virtual user groups

Advantages Technology already exists and is in regular use by millions of users Efficient Non-intrusive Real time Appropriate Leverages user experience appropriately Cheaper for practice Cheaper for vendor

Technology already exists and is in regular use by millions of users

Efficient

Non-intrusive

Real time

Appropriate

Leverages user experience appropriately

Cheaper for practice

Cheaper for vendor

Other Opportunities Why stop at an ‘Instant Messaging’ application? Video-conferencing (You have to have a camera) Can have additional advantages Launch-pad to other tools It all starts with….

Why stop at an ‘Instant Messaging’ application?

Video-conferencing

(You have to have a camera)

Can have additional advantages

Launch-pad to other tools

It all starts with….

Putting it into Context Just an extra tool Can help resolve issues and questions more quickly Must not be intrusive Could result in abuse (needs rules – just like telephone use in the office) Could prepare practices for other advanced technologies Tele-medicine Distance monitoring

Just an extra tool

Can help resolve issues and questions more quickly

Must not be intrusive

Could result in abuse (needs rules – just like telephone use in the office)

Could prepare practices for other advanced technologies

Tele-medicine

Distance monitoring

Thank You