Saturday, May 12, 2007

Physician Patient Relationship - Patient-Physician Productivity Triple Play

Medfusion. Inc, EClinicalworks. Inc , and Primetime Software, Inc

In yesterday’s blog, I described how patients, given the opportunity to become emotionally and intellectually engaged in their own care through interactive online videos, improved the productivity, satisfaction, safety, and financial returns for all parties – the patient, the physician, and the hospital.

Today, I shall tell how various arrangements between three innovative information technology organizations – Medfusion Inc Eclinicalworks, Inc and Primetime Software, Inc – further advance and enhance these factors.

• Medfusion, Inc is a Raleigh, North Carolina company that has pioneered development of physician Web sites that offer such patient-friendly services as office location hours, physician credential, prescription refills scheduling an appointment, and patient education information. These self-service capabilities increase patient productivity by offering information without going through telephone menus, and physician productivity, by speeding workflow through reducing phone calls, allowing pre-registration and appointment scheduling, delivering lab results, prescription renewals, online, and reminders about annual appointments and preventive tests.
• Eclinical works is a Massachusetts-based EMR/PM (electronic medical record/practice management) company that offers medical practice software to over 10,000 practice physicians in over 50 states at a price of about $10,000 per physician, far below the industry norm. The Eclinicalworks EMR is easy for physicians in small practices to use, learn, and install than more expensive and cumbersome systems. Furthermore, users can customize the EMR and practice management systems for their use by working out the bugs in a transparent web site,
• Primetime Software’s product is the Instant Medical History, which explains its offering this way. “Instant Medical History interviews patients to begin gathering the subjective history prior to the encounter. Branching logic enables patients to progress quickly through adjustable questionnaires from an extensive medical knowledgebase. Sophisticated technology enables this information to transfer to EMRs. Physician productivity increases because as much as sixty percent of the medical data necessary to complete the visit note can be provided by patients and automatically documented in medical terminology through the Internet, in exam rooms, or in waiting areas before the encounter.”

Common Features

Medfusion, Eclinicalworks and the instant medical history have several things in common, they,
• enhance productivity in office practices, achieving gains of up to 60% to 80% in the typical primary care practice;
• reduce expense of data entry, by converting from paper to electronic charts, saving time in finding previous charts, saving space, and, in some cases, replacing personnel.
• make it feasible to structure and standardize the information exchange between patients and doctors, and to close the gaps between the subjective and objective, the evidence-based and non-evidence based, the quality and non-quality related, and the Science and the Art.
• represent the convergence and evolution of multiple IT technologies into one flexible and workable whole.
• demonstrate that IT systems, working together can engage the attention of both patients and physicians and serve as a humanizing influence by freeing up more face-to-face time between patients and doctors.
• Allow patients to leave the office visit with a complete record of the medical history, the physician findings, the treatment plan, and in the process, reduce future misunderstandings and disagreements that might end in malpractice actions.
• are all described or mentioned in my book Innovation-Driven Care: 34 Key Concepts for Transformation and are backed by case studies by those who developed these systems.

When Push Cms to Shove

When push comes to shove, these over-lapping and inter-mapping technologies are more about productivity than humanity, financés than nuances, and documentation than doctoring. They are more about power coding and data loading and restructuring and standardizing a longstanding cultural relationship. They may serve, directly and indirectly, as measures of performance, outcomes, and that elusive still intangible thing called quality.

But they don’t and can’t separate good doctors from bad doctors or more than superficially define the human dimensions of the patient-doctor relationship. Nor can they measure clinical judgment, depth of a physician’s cognitive thinking abilities, extent of patient compliance, final outcomes of a patient’s illness, or doctor and patient individualism and choice of courses of action. Human intelligence remains beyond artificial intelligence, virtually always, at least for now.


Nainil Chheda said...

Thank you for a wonderful post.

Just for the record:

* eClinicalWorks is an LLC.

* The independent users forum of eCW is:

Thank you.

Nainil Chheda

Richard L. Reece, MD said...

Thank you. I always accept compliments with gratitude, I have visited your blog, and I encourage other readers to do so. It's about IT and medical practices as a win-win situation. "Win-Win<" in my book, defines innovation. Sorry about confusing Inc. with LLC. I'm a little fuzzy about the difference.

Richard L. Reece, MD