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  1. 1. Toys and Technology for the Medical Practice Dr. Neil Baum New Orleans, Louisiana
  2. 2. Why Technology? <ul><li>Have improved medical care by using technology to diagnose and treat medical conditions-now needed in the office practice </li></ul><ul><li>Demonstrates you are on the “cutting edge” if your practice has the latest electronic equipment </li></ul><ul><li>Improves the efficiency of your practice </li></ul><ul><li>Patients are more electronically sophisticated and expect that you are, too </li></ul>
  3. 3. Technology Used to Reduce Overhead Expenses <ul><li>Cannot increase reimbursements </li></ul><ul><li>Can decrease overhead expenses </li></ul><ul><li>Result is improvement in net profit </li></ul>
  4. 4. Voice Recognition Software <ul><li>65,000 word active vocabulary can be recognized (college graduate vocab. <5K) </li></ul><ul><li>Contains complete, current urologic vocabulary </li></ul><ul><li>Vocabulary can be customized and updated </li></ul>
  5. 5. Voice Recognition Software <ul><li>Can speak at rate of 150-250 wpm </li></ul><ul><li>Can FAX referral letters from computer directly to referring physician and MCPs </li></ul><ul><li>Supports CPT and ICD-9-CM codes </li></ul>
  6. 6. Voice Recognition Software <ul><li>95% accuracy </li></ul><ul><li>Can use templates for most common letters and forms </li></ul><ul><li>Can dictate from remote locations </li></ul><ul><li>Can dictate real time using hands-free technology </li></ul>
  7. 7. Voice Recognition Software <ul><li>Can FAX prescriptions directly to pharmacy </li></ul><ul><li>Electronic signature applied to the prescription </li></ul><ul><li>Personalized precaution and interaction information for medication. </li></ul>
  8. 8. Voice Recognition Software <ul><li>Can incorporate x-rays, ultrasounds or other images within the note. </li></ul><ul><li>Can insert a graphic or diagram of an organ, or system and then annotate it to show areas of treatment or pathology </li></ul>
  9. 9. Voice Recognition Software <ul><li>Will print a hard copy of the note for the chart </li></ul><ul><li>Can upload the note to EMR </li></ul>
  10. 10. Voice Recognition Software <ul><li>Can audit the note to ensure compliance with the coding requirements </li></ul><ul><li>Identifies missing information (e.g. review of systems) or to up code the visit if that is more appropriate </li></ul><ul><li>Insures consistency between dictated notes and service level of each visit-can pass a HCFA audit </li></ul>
  11. 11. Requirements for VRS <ul><li>Microsoft Windows 95, 98 & Windows NT </li></ul><ul><li>CPU-Minimum Pentium II </li></ul><ul><li>64-128* MB RAM </li></ul><ul><li>Laser or high quality ink-jet printer </li></ul>
  12. 12. VRS-User Friendly <ul><li>Fast training </li></ul><ul><li>Initially requires 30 minutes </li></ul><ul><li>Several hours to be familiar with the program </li></ul>
  13. 13. VRS-User Friendly <ul><li>On-site installation </li></ul><ul><li>Personalized training for each physician </li></ul><ul><li>Complete customization for each physician. </li></ul><ul><li>1-800 and e-mail technical support </li></ul><ul><li>Follow-up on-site training </li></ul><ul><li>Updates are available through WWW </li></ul>
  14. 14. Advantages of VRS <ul><li>Reduces overhead costs $500-$1000MDmonth </li></ul><ul><li>Referral letters reach the referring physicians within minutes </li></ul>
  15. 15. Voice Recognition Software <ul><li>Medical Dictation Systems </li></ul><ul><li>502 827 8522 </li></ul><ul><li> </li></ul>
  16. 16. Are you playing phone tag with your patients? Solution: Automated patient call-back program P atient R esponse N etwork (PRN)
  17. 17. Improving the Efficiency of Your Practice <ul><li>Patient Response Network (PRN) </li></ul><ul><li>Every time some one in your office touches a chart it costs $3.00 </li></ul><ul><li>Telephone tag is an expen$ive game </li></ul>
  18. 18. Patient Response Network (PRN) <ul><li>Average physician sees 100 patients a week </li></ul><ul><li>66 need a call back to report results of tests </li></ul><ul><li>70% of calls are for normal results </li></ul><ul><li>Each call takes 3-5 minutes of M.D. time </li></ul><ul><li>Automated call back program takes 25-35 seconds a call </li></ul><ul><li>Saves each physician 8.6 hours a month! </li></ul>
  19. 19. Here’s How It Works 1. Patient receives 1-800 number and patient identification code 2. Patient calls in 3-5 days 3. Patient can call 24 hours a day, 7 days a week 4. Receives NORMAL report from physician in physician’s own voice 5. Physician receives weekly report on patients that have accessed the system
  20. 20. Patient Results Network PRN (800) 613-9050
  21. 21. Too Many No-Shows? Solution: <ul><li>HouseCalls by TeleVox </li></ul><ul><li>Automated patient reminder program </li></ul><ul><li>Interfaces with your scheduling program and contacts your patient the day before their office visit </li></ul>
  22. 22. HouseCalls by TeleVox <ul><li>Regular telephone line and normal voice </li></ul><ul><li>Response options: 1. To confirm appointment 2. To replay message 3. Leave voice message </li></ul>
  23. 23. HouseCalls <ul><li>Includes daily call results report </li></ul><ul><li>Can adjust start and stop calling times </li></ul><ul><li>Best is 5-9 P.M. </li></ul>
  24. 24. HouseCalls <ul><li>Advantages </li></ul><ul><li>Reduces no-shows </li></ul><ul><li>Improves staff productivity </li></ul><ul><li>Improves bottom line </li></ul>
  25. 25. HouseCalls TeleVox 800 426-6184
  26. 26. Marketing the “Hold Button ” <ul><li>The telephone - educate during the hold time </li></ul><ul><li>Prerecorded messages related to your practice </li></ul><ul><li>Do-it-yourself </li></ul><ul><li>“ Marketing on Hold” (713-522- 4333) </li></ul>
  27. 27. Patient Education <ul><li>Dialog Medical DISCussion Software ( </li></ul><ul><li>MDConsult™(Lippencott-Raven Mosby-Yearbook) </li></ul><ul><li>Mdconsult ( </li></ul><ul><li>Clinical Reference Systems ( </li></ul><ul><li>Medifor ( </li></ul>
  28. 28. Discussion TM Program <ul><li>Educates existing patients </li></ul><ul><li>Improves efficiency of the practice </li></ul><ul><li>Prevents malpractice cases </li></ul><ul><li>Improves staff morale </li></ul><ul><li>Provides value-added service to patients </li></ul><ul><li>(May reduce overhead expenses) </li></ul>
  29. 29. Discussion TM Software Program <ul><li>Consents for all speciality procedure in urology, orthopedics, dermatology, cardiology, gastroenterology, invasive radiology, and radiotherapy </li></ul><ul><li>Instructions for the most commonly ordered tests </li></ul><ul><li>Drug information </li></ul><ul><li>Patient education </li></ul><ul><li>Patient instructions </li></ul><ul><li>Commonly used forms </li></ul>
  30. 30. Discussion TM Software Program <ul><li>Easily customized for every practice </li></ul><ul><li>Can be operational in 15 minutes </li></ul><ul><li>Short learning curve </li></ul><ul><li>1-800 support available </li></ul><ul><li>Updates to include new files on an annual basis </li></ul>
  31. 31. Discussion TM Software Program Available at Dialog Medical 1 800 482-7963
  32. 32. Internet and the World Wide Web
  33. 33. Wants of Our Patients <ul><li>Want access to information- quick, accurate, customized and NOW! </li></ul><ul><li>Want well-written educational materials-appropriate font size </li></ul><ul><li>Welcome to marketing on the Web </li></ul>
  34. 34. World Wide Web <ul><li>Demonstrates you are on the cutting edge of technology </li></ul><ul><li>Opportunity to provide useful information to your patients </li></ul><ul><li>Showcases your practice </li></ul><ul><li>Allows you to conveniently communicate with your patients </li></ul><ul><li>Serves as an electronic brochure </li></ul>
  35. 35. World Wide Web <ul><li>A segment of your patients have access to the WWW </li></ul><ul><li>Indicates your cutting edge technology </li></ul><ul><li>MAY have the ability to attract new patients to your practice </li></ul><ul><li>Capture the trend that patients are thirsty for information </li></ul>
  36. 36. World Wide Web <ul><li>Put Sparkle Into Your Web Site </li></ul><ul><li>Make it interactive </li></ul><ul><li>Read Designing Multimedia Web Sites by Stella Gassaway, Hayden Books </li></ul><ul><li>Offer freebies </li></ul><ul><li>Provide connections to other useful Web sites </li></ul><ul><li>Online newsletter </li></ul>
  37. 37. Web Content <ul><li>Photos of the doctors and the staff </li></ul><ul><li>C.V. of the doctors </li></ul><ul><li>Evidence of C.M.E. attended by the physicians </li></ul><ul><li>Honors and accomplishments received by the physicians </li></ul><ul><li>Articles written by the doctors, both journal and lay articles </li></ul>
  38. 38. Web Content <ul><li>Articles written about the doctors and the practice </li></ul><ul><li>Information on the areas of interest and expertise of the practice-this is where you make an effort to differentiate your practice from other practices in the community </li></ul><ul><li>The office logo </li></ul>
  39. 39. Web Content <ul><li>Interesting articles and useful information about your practice and your specialty </li></ul><ul><li>A map to your practice </li></ul><ul><li>Names of managed care plans and health care plans </li></ul>
  40. 40. Web Content <ul><li>A history of the practice </li></ul><ul><li>Online consulting with the practice </li></ul><ul><li>Ability for patients to ask the doctor a health care question(s) </li></ul><ul><li>Other useful web sites </li></ul>
  41. 41. Web Content <ul><li>Testimonials </li></ul><ul><li>E-Mail address for feed back </li></ul><ul><li>Last time the site was updated </li></ul><ul><li>A count of the number of previous visitors </li></ul>
  42. 42. Web Content <ul><li>Ability to make an online appointment with the practice </li></ul><ul><li>Online reporting of tests and studies using codes to ensure security and privacy </li></ul><ul><li>Ability to conduct online chats </li></ul>
  43. 43. Web Site Creation Urology Channel
  44. 44. Internet and Web Site Development <ul><li>Survey of 2000 M.D.s </li></ul><ul><ul><li>1101 don’t use computers (58%) </li></ul></ul><ul><ul><li>414 use computers, not WWW (22%) </li></ul></ul><ul><ul><li>390 use WWW (20%) </li></ul></ul><ul><ul><li>own a Web site ( ?%) </li></ul></ul>
  45. 45. Patient Tracking <ul><li>Tracker Software Program </li></ul><ul><li>AMS </li></ul>
  46. 46. Why is Tracking Important? <ul><li>Patients often do not receive effective treatment the first time </li></ul><ul><li>Patients abandon treatment </li></ul><ul><ul><li>Ineffective </li></ul></ul><ul><ul><li>Painful </li></ul></ul><ul><ul><li>Expensive </li></ul></ul>
  47. 47. Facts on Patients Abandoning Treatment <ul><li>Sildenafil is ineffective in 35% of patients with E.D. </li></ul><ul><li>90% of patients with BPH on alpha- blockers will abandon therapy after three years </li></ul><ul><li>50% of patients on finasteride will abandon treatment at 5 years </li></ul><ul><li>Incontinence- ?% </li></ul><ul><li>CaP-?% </li></ul>
  48. 48. Areas Covered <ul><li>E.D. </li></ul><ul><li>BPH </li></ul><ul><li>Incontinence </li></ul><ul><li>CaP </li></ul><ul><li>Other modules under development </li></ul>
  49. 49. What Does the Tracker Program Accomplish? <ul><li>Creates a data base of patients with ED, BPH, incontinence, and CaP </li></ul><ul><li>Enhances communication with patients and referring physicians using existing letters or customized letters </li></ul>
  50. 50. What does the Tracker Program Accomplish? <ul><li>Use a dozen template newsletters </li></ul><ul><li>Permits the creation of newsletters that are customized for the practice that can be sent to existing patients, new patients, and referring physicians </li></ul><ul><li>Provides dozens of patient information and education handouts </li></ul><ul><li>Managed care friendly </li></ul>
  51. 51. <ul><li>Large impotence practice </li></ul><ul><li>Large incontinence practice </li></ul><ul><li>Large CaP practices </li></ul><ul><li>Practices that have large numbers of patients on medical therapy for BPH </li></ul>Urologists That Benefit From the Tracker Program
  52. 52. Electronic Medical Records
  53. 53. Electronic Medical Records Logician by MedicaLogic 503 531 7000
  54. 54. Electronic Medical Records <ul><ul><ul><li>Current Obstacles </li></ul></ul></ul><ul><ul><ul><li>Most are too rigid and not flexible for modification </li></ul></ul></ul><ul><ul><ul><li>Software does not combine office computer with hospital, lab, pharmacies and radiology </li></ul></ul></ul>
  55. 55. Electronic Medical Records <ul><li>Best guess </li></ul><ul><li>“ A true (practical and affordable) electronic medical record for most physicians’ practices is at least five years away.”* </li></ul><ul><li>* Wall Street Journal, 10/19/98 </li></ul>
  56. 56. Transition to EMR Cross Pad
  57. 57. Summary The Chinese symbol for crisis is the same as the symbol for opportunity Do we see the glass of milk as half full or half empty?