C:\Healthcare\Technology\Plus91

Why Your Hospital Needs More Than Just A Website

2011-11-23T15:27:00.002+05:30

The internet has become the most important source of information in the world. A recent survey in India found that seventy two percent of Indians online search for healthcare related information. With an increasingly large number of people going online before making any healthcare related decision, it has become more important than ever for hospitals and doctors to have their websites.

All the larger and teaching hospitals have realized the importance of having a website. The web company, Webometrics has ranked all teaching hospitals of the world according to their web presence, taking into consideration their search engine visibility, available digital content and published studies in online databases. Here’s a list of the top 12 Indian teaching hospitals according to their web metrics in 2011.

Rank In India	Hospital	World Rank
1	Laparoscopy Hospital	455
2	Sankara Nethralaya Hospital	584
3	Amrita Institute of Medical Sciences	690
4	Tata Memorial Centre	753
5	Aravind Eye Care System	840
6	King George Medical College and Hospital	859
7	Sri Ramachandra University & Medical Centre	1019
8	Apollo Hospitals	1037
9	L.R.S. Institute of Tuberculosis & Respiratory Diseases	1062
10	Sir Ganga Ram Hospital	1368
11	Fortis Healthcare	1808
12	Max Healthcare	1898

A number of comparatively smaller healthcare centers in India have also recognized the importance of having a high quality medical website ( eg: Skin Hair Clinic ,Cura Physiotherapy Clinic and Divinations Healthcare).

So what are the five main reasons for building a website for hospitals?

1) Provide Service Information:

Websites allow you to describe complex services available at your medical center in great details. This allows healthcare professionals to educate healthcare consumers about all the services available even before they visit the facility.

2) Build healthcare brand.

Healthcare services are people facing business and all people facing business need to build themselves into a Brand. Websites and blogs are wonderful tools for Brand building among people and news reporters looking for related information online.

3) Improve search optimization ranking.

Just having a website does not guarantee you a high visibility. Websites which contain posts focused on keywords and extensive link building help improve search engine rankings and therefore greater probability of being found online.

4) Distribute informative content.

Websites help hospitals/ doctors inform consumers about latest health research and guide them into healthy lifestyles. Thus medical websites can act as a great resource for people looking for information on preventive healthcare practices. In turn, consumers in need are more likely to turn to curative services which provide them information for their preventive healthcare needs.

5) Build a healthcare community.

Maybe the most important thing a website can do for any healthcare institution is to build an online community. Patients love to be able to connect with doctors and also other patients in similar circumstances as them. Having a website allows a healthcare provider to fill this huge gap of doctor-patient and patient-patient interaction.

A useful medical website is more than just an effort at ego boosting. A truly high quality medical website needs a good blend of technological and medical expertise. To get yourself a truly useful internet presence (as opposed to just a run-of-the-mill website), contact websites@plus91.in today.

Website Features Which Increase The Patient Satisfaction Index

2011-10-17T16:04:00.003+05:30

A large part of managing a patient over a long period of time is communicating with the patient. All old (follow up) cases in medical practices have niche requirements and expectations from their doctors. A satisfied patient is a doctor’s most powerful marketing asset. Healthcare professionals should strive to provide all old (follow up) cases with special features to improve quality of service, which in turn will increase the Patient Satisfaction Index.

A well 'endowed' medical website allows doctors to assist patients in their day-to-day living by providing timely solutions for all their health queries even after a visit. For a patient, this continued access to expert medical advice via simple online tools is one of the most cherished features of any e-practice.

Despite best efforts, many patients make errors while following medical advice. Many times, follow-up patients have new queries they wish they could simply share with their doctors. A large number of patients also do not ask new questions just because they don’t want to look stupid in front of their doctors! These patients are often unsure of the importance of their queries and generally procrastinate visiting their doctors for answers. Sometimes new complaints crop up which may or may not affect the ongoing medical management. The internet, via a medical website, allows doctors to clarify many such small doubts these patients face while following medical advice. A timely word of advice can save these patients a whole lot of pain, literally and figuratively. Important issues which may arise during such advice can be solved by arranging for a new visit.

There are a number of ways medical websites and integrated web 2.0 tools can be used to help doctors improve patient-doctor communications and thus decrease the morbidity among patients. Let’s look at three such applications:

The Embedded Form:
Medical websites allow all registered members (i.e. follow-up cases) to access some parts of the website which are meant only for them. A simple form is embedded within this secure area through which a follow-up patient can ask a question. These questions are then directed to the doctor’s email address. The doctor can answer such questions securely via email or even ask the patient to book an appointment if required. Ideally, doctors should create an email id purely for answering queries of follow up cases. This will help in segmenting all electronic medical communications between doctors and patients. All such queries are also automatically added to electronic medical record of that patient.

Chat Widgets:
Chatting on the internet is something most patients are comfortable with. Medical websites can have widgets which allow patients to directly chat with the doctor or the doctor’s representative. This is a common and simple to add functionality within any medical website. Patients can be given pre-decided timings (say, 9 p.m - 10 p.m on Mondays, Wednesdays and Fridays) when the doctor shall be available for the chat. Such chat transcripts can then be appended to the electronic medical record of the concerned patient. More people can be added to chats so as to allow group discussions (e.g: Friday evening hour long chat session for all Pregnant women, in case of gynae practices).

Facebook Groups and Video Chat:
After email, Facebook is the most commonly used online platform for communications. Doctors can easily use this platform (by forming closed groups) for answering some of the common queries by their patients. All follow up patients who share their primary email id can be added to specific closed groups on Facebook. These patients can post their queries on the group wall (which is not public and viewable only by group members) or send it as a direct message. Answers which have general significance for all patients can be posted on the group wall (e.g.: I am taking Metoprolol XL 50 mg once daily for my hypertension. I am scheduled for a tooth extraction next week. What precautions should I take? ). Personal queries can be answered via direct messaging. Urgent and important issues can be simply escalated to a telephonic conversation. Over time, such a Facebook group shall mature into a powerful resource for all new members. Questions which require visual inputs (like appearance of rashes or swelling on hands and feet) can be handled by using Video chat within Facebook. Important advice can be reinforced by typing it into the chat area so as to create a transcript document of the encounter. There are medical social media guidelines published by many international organizations which can be followed for all such patient-doctor communications on Facebook.

Doctors can also use Skype and payment gateways like PayPal to organize revenue generating e-visits by follow-up cases who find it difficult to physically visit the clinic premises at regular intervals. This is especially the case with geriatric and physically challenged patients. For more such innovative medical uses of the internet, kindly write to a.patkar@plus91.in or visit www.websitesfordoctors.in

How IT can facilitate Information Therapy?

2011-10-13T04:39:00.003+05:30

The end customer in the business of Medicine needs information. Everyday technology adds new ways in which we store and share this information for many to use, reuse, improve and share some more.

In this day and age of the Internet, Mobile Phones and Social Media; Patients are empowered with the possibility of Real Time Communication, 24/7 Access to Information and Live Community Feedback.

Today’s patients have been exposed to numerous possibilities besides the ones which our forefathers would know of. This exposure has empowered this generation of patients to ask for better care, better facilities, cheaper alternatives, and more useful ways of using technology to provide healthcare as well as healthcare information. However, in spite of large amounts of information available today, a big problem that exists today is that the information is not necessarily usable when it is most needed.

To effectively facilitate Information Therapy, Information Technology must bring about a marriage of ideas with utility; IT has to ensure all actors in this ecosystem come together to improve information management for the benefit of the patient, the staff and decision-makers throughout the healthcare sector. Only then can Information Therapy be provided to various participants of the health care ecosystem through the different stages of an illness:

Diagnosis and information gathering
Finding a Provider
Soliciting Second Opinion
Accepting a diagnosis
Participation in research
Being an champion or advocate

For Technology to be successful at this there should be sustained focus on different avenues of Information Therapy.

We explore 5 avenues with roadmaps below:

Avenue 1: Medical Information Sources

IT vendors must work at creating Healthcare and Medical Information Knowledge Bases. This can be about medicines, diagnostics, decision trees, side effects, precautions, etc.

Technology should evolve to allow for more effective ways for Updating Information in such Knowledge Bases. These could be based on curation, criticism, collaboration to ensure that it is self adjusting, effective and patient-centered.

Advancements in Social Technology will provide new ways for spreading this information.

Innovation in Delivery mechanisms will provide easier ways for others to consume this information

This will help

-- Create Informed Patients

-- Create Valued Sources

-- Ensure poor sources are filtered and rejected

Avenue 2: Digital Identities for Providers and Provider Information Sources

The logical first step to creating rich Databanks of Provider Information is to create identities for Providers in the electronic world. The simplest way to do this is to Create Websites for Doctors, Clinics and Hospitals. This may not necessarily be individual websites for practices which don’t want to invest in one, but even simpler informative single web pages to fulfill the purpose of creating an identity for them.

Such websites can be optimized to convey Services, Location and Contact Information, Medical Notes, Special Cases treated. Such optimization will help in disseminating useful provider information to people looking for the same. This isn’t advertising, it’s a service: people today face many choices and are hampered by lack of information, improving their ability to find information quickly is beneficial to them.

For those practices and Practioneers who decide to engage IT to create digital identities (web sites), the following guidelines must be provided:

-- On your website, don’t only talk about you, tell the patients more about what diseases and disabilities you treat, what are the latest treatments, generic advice and maybe even help them going to right person if you weren’t involved.

-- Use tools like interactive patient forms which can be filled before the patient arrives at the center

-- Use query forms on the website so that patients can ask you about their problems and doubts; this gives the feeling to your patients that you are available to them 24/7 without actually being there

As was the case with Medical Information Sources, Advancements in Social Technology will provide new ways for sharing Provider Information.

Technology Vendors must provide easier ways for Provider information to be located and searched and which is available of different types of media.

-- Create Directories of Providers based on Provider Information

-- The Directories allow for Feedback on providers in a controlled environment

Avenue 3: Patient Provider Communication

True engagement comes about through two-way, mutually beneficial
conversations.

Technology must look to create multiple ways to facilitate both formal and informal Patient- Provider Communication. The telephone made a huge impact on the way we communicate, and so did email. Newer technologies must be used to offer ease of use, larger acceptance and lower costs. Many providers today communicate with their patients using skype, google chat and even facebook. Technologies must build on such success stories.

Provider –Patient Communication will also benefit if vendors Link Communication mechanisms to Provider Information Sources and Health Information Exchanges

-- Provide integrations of these mechanisms with clinical and diagnostic software (EMR's, EHR's , etc)

-- Emailing of schedules and reports to patients is a must.

-- Using SMS to send Medical alerts, reminders, and schedules

-- Go the extra distance and use Social Media to provide alerts and reminders to patients via Facebook Messages, Twitter DM's, etc.

Avenue 4: Health Information Exchanges

Technology Vendors must work together to create Health Information Exchanges(HIE’s) based on interlinking of Electronic Medical Records, Electronic Health Records, Laboratory Data and Patient Health Records across Providers and Patients.

They help by providing Patients with the option to switch providers easily, allowing doctors to easily refer patients to other doctors for multiple opinions, providing direct access to laboratory data for physicians along with a number of potential benefits which are expected in the future due to the creation of a huge data bank of Medical Data including Symptoms, Diagnostics and Prescriptions.

HIE’s must be designed with Programming Interfaces and sufficient freedom to allow Technology Enthusiasts and Innovators to be able to create novel ways of using and sharing the vast volume of data within HIE’s as long as patient and provider confidentiality is not compromised.

Avenue 5: Online Health Communities

For years, patients have liked to work in groups, to support each other, to help themselves cope with illnesses which their near and dear ones don’t understand, to seek advice from others who have similar ailments. Bringing people together in collaborative dialogue to explore social conditions that are the major influences of health and illness generates deeper collective awareness and community-driven action.

Since Individuals don’t see their lives partitioned into an online and offline world, Online communities should be given as much value as offline ones. A variety of Online Communities must come up for connecting patients quickly and privately with others who share similar health experiences.

Technology today exists not only in the form of created online communities but also online community frameworks which allow just about anyone with an idea of a community to set up an online one, full with video and audio chats, whiteboarding, discussion forums and groups and all the other good stuff.

This allows the creation for integrated digital ecosystem which simultaneously addresses both individual and social dimensions of health.

-- Allow Patients to engage with each other

-- Allow Providers to engage with this medium

Case Studies showcasing IT providing effective Information Therapy using the avenues discussed above:

- A Hospital Website provides emergency response numbers which earlier would only be found in a book. Today the website acts like an instant phone book for someone looking for these numbers during an emergency. Hence the Website becomes a good medium to share information about the medical entity for someone to access on the go. Taking emergency medicine up a notch by providing real time information through e-health channels

- A Gynaecologist’s website allows a patient to calculate her schedule for check-ups and ultrasound visits and set reminders for the same. Whereas earlier, she would have to get it written down by the Doctor, and sure enough in all that stress call the Doctor each time to confirm, how all she needs to go is go on her trusted Doctor’s website and check the dates herself. E-Health, helping people plan their healthcare long term through tools that promote and help understand what they need to do

- A Cancer patient after each chemo session feels low and unhappy, and is tired of the emotional stress involved. Being a shy person, he never talks to anyone and shies away from contact. Now online, he has a new lease of life, being able to interact and get support from patients just like him. Moreover he can do this anonymously learning how to cope with the pressure and the pain. Learning simple remedies and tried tricks from people who know and feel what he is going through. The power of e-health through patient forums, support groups and medical help portals online, allowing information flow where there was none physically

- A patient in a remote village in South India suffering from acute pain in the abdomen has to make do with the local village doctor’s prescription. A year later, a telemedicine pilot allows this same patient to get a second opinion using a remote video link and also by sharing X-rays of the abdomen using this equipment. He also is able to identify what’s happening to him via the printouts he gets from the telemedicine center and realizes that he must work at improving his diet.

This is the 6th and final Article in a series of Articles on Using IT to facilitate Information Therapy by Nrip Nihalani and Aditya Patkar . These articles form the basis of the chapter "IT for IT" by the authors which they contributed to the book "Using Information Therapy to Put Patients First"

Plus91 Technologies Pvt. Ltd.

http://www.plus91.in

http://www.plus91online.com

http://www.twitter.com/plus91

Online Health Communities : Using IT to facilitate Information Therapy

2011-10-04T19:17:00.003+05:30

Bringing people together in collaborative dialogue to explore social conditions that are the major influences of health and illness generates deeper collective awareness and community-driven action.

Since Individuals don’t see their lives partitioned into an online and offline world, Online communities should be given as much value as offline ones. A variety of Online Communities must come up for connecting patients quickly and privately with others who share similar health experiences. A fantastic example of one such community is Patients Like Me

Technology today exists not only in the form of created online communities but also online community frameworks; These allow just about anyone with an idea for a group or community to set up an online network, full with video and audio chats, whiteboarding, discussion forums and groups and all the other good stuff.

This helps create an integrated digital ecosystem which simultaneously addresses both individual and social dimensions of health. In effect this

-- Allows Patients to engage with each other

-- Allows Providers to engage with this medium

This is the 5th Article in a series of Articles on Using IT to facilitate Information Therapy by Nrip Nihalani and Aditya Patkar .

Plus91 Technologies Pvt. Ltd.

http://www.plus91.in

http://www.plus91online.com

http://www.twitter.com/plus91

Patient Provider Communication : Using IT to facilitate Information Therapy

2011-10-03T01:56:00.000+05:30

True engagement comes about through two-way, mutually beneficial conversations.

Technology must look to create multiple ways to facilitate both formal and informal Patient- Doctor Communication. The telephone made a huge impact on the way we communicate, and so did email. Newer technologies must be used to offer ease of use, increase reach and lower costs. Many providers today communicate with their patients using skype, google chat and even facebook. Technologies must build on such success stories.

Doctor–Patient Communication will also benefit if technology vendors link Communication mechanisms to Provider Information Sources and Health Information Exchanges

-- Provide integrations of these mechanisms with clinical and diagnostic software (EMR's, EHR's , etc)

-- Emailing of schedules and reports to patients is a must.

-- Using SMS to send Medical alerts, reminders, and schedules

-- Go the extra distance and use Social Media to provide alerts and reminders to patients via Facebook Messages, Twitter DM's, etc.

This is the 4th Article in a series of Articles on Using IT to facilitate Information Therapy by Nrip Nihalani and Aditya Patkar .

Medical websites Help Clinics Compete Against Large Hospitals

2011-09-23T21:52:00.002+05:30

Practicing medicine in the private sector is a very tough proposition. It’s not enough to be a very good doctor. You should be known to be a very good doctor. It’s not enough to provide all the latest treatment options and services. Everyone should know (or be able to find out easily) all the services provided at your clinic/ hospital.

Traditional Healthcare Communication Meant Word-Of-Mouth Publicity

Traditionally, physicians and medical practices have relied on word-of-mouth publicity to establish themselves. A patient who has undergone an event-free angiography at the local cardiac care center would then tell five others about his/her wonderful experience. So now five more people know about the latest angiography services at that cardiac center. Hopefully, this positive review continues in a geometric progression as more and more people visit the medical center. But is that enough? What about the high tech cardiac catheterization and latest stenting services also available at that center? There would be hundreds of bits of positive details about your hospital most patients don’t even get to know of. Hoping that all visitors to a medical center realize all its plus points and then remember to pass these plus points to others is so optimistic, it’s foolish. Thus word-of-mouth publicity serves a very limited role in evangelizing any healthcare services.

Challenges In Healthcare Communication

Medical practices can no longer rely only on word-of-mouth to inform the world about their existence. But they also face a big handicap. They need to make themselves and their quality services known without resorting to overt advertising. Clinics and smaller hospitals face a specially forbidding challenge in breaking through this glass ceiling of ‘perceived quality’. Sheer size has allowed larger hospitals to carry an aura of quality, irrespective of the services they provide. In contrast, many clinics which provide top-of-the-line services are just not accorded due respect or simply remain unknown.

Medical Websites In healthcare Communication

Despite providing the best services, many small practices are labeled ‘poor quality’ simply because of low visibility. Technology has broken down this artificial divide between small and larger medical practices. A high quality website has become the single most important way to establish your credibility, authority and niche online. Websites and social media channels provide an easy to access free platform for showcasing your expertise to any targeted/ segmented population.

A website becomes the way people remember and recall your clinic. A website creates a visual brand for your medical practice, allowing strong recall value even among people who may never have visited your clinic. With the help of a high quality medical website, a niche specialty clinic can achieve the same recognition as many large super-specialty hospitals.

Beyond branding, the practical utilities medical practices can provide the patients via their websites are plenty. Appointment scheduling and lab reports can easily be accessed via medical websites. Interactive patient communication widgets and electronic health records can add an entirely new dimension to the concept of medical websites. To know how a website can transform your medical practice, kindly write to a.patkar@plus91.in

You can also visit www.websitesfordoctors.in

Digital Identities for Providers and Provider Information Sources : Using IT to facilitate Information Therapy

2011-09-23T04:21:00.000+05:30

The logical first step to creating rich Databanks of Provider Information is to create identities for Providers in the electronic world. The simplest way to do this is to Create Websites for Doctors, Clinics and Hospitals. This may not necessarily be individual websites for practices which don’t want to invest in one, but can even be simple informative single web pages to fulfill the purpose of creating an identity for them aka http://www.about.me

For those Practices and Practioneers who decide to engage IT to create digital identities (web sites), the following guidelines must be provided:

-- Use tools like interactive patient forms which can be filled before the patient arrives at the center

As was the case with Medical Information Sources, Advancements in Social Technology will provide new ways for sharing Provider Information.

Technology Vendors must provide easier ways for Provider information to be located and searched and which is available of different types of media.

-- Create Directories of Providers based on Provider Information

-- The Directories allow for Feedback on providers in a controlled environment

This is the 3rd Article in a series of Articles on Using IT to facilitate Information Therapy by Nrip Nihalani and Aditya Patkar

Using IT to facilitate Information Therapy : Medical Information Sources

2011-09-21T01:04:00.001+05:30

To effectively facilitate Information Therapy, Information Technology must bring about a marriage of ideas with utility; IT has to ensure all actors in the medical ecosystem come together to improve information management for the benefit of the patient, the staff and decision-makers throughout the healthcare sector.

Medical Information Sources

IT vendors must work at creating Healthcare and Medical Information Knowledge Bases. These can be about medicines, diagnostics, decision trees, side effects, precautions, treatment data and more.

Advancements in Social Technology will provide new ways for spreading this information.

Innovation in Delivery mechanisms will provide easier ways for others to consume this information

This will help

-- Create Informed Patients

-- Create Valued Sources

-- Ensure poor sources are filtered and rejected

In the next article we'll look at How Establishing Digital Identities for Providers(Doctors/Clinics) and Provider Information Sources will enhance the spread of Information Therapy

This is the 2nd Article in a series of Articles on Using IT to facilitate Information Therapy by Nrip Nihalani and Aditya Patkar

Plus91 Technologies Pvt. Ltd.

http://www.plus91.in

http://www.plus91online.com

http://www.twitter.com/plus91

Using IT to facilitate Information Therapy

2011-09-20T04:07:00.001+05:30

The end customer in the business of Medicine needs information. Everyday technology adds new ways in which we store and share this information for many to use, reuse, improve and share some more.

In this day and age of the Internet, Mobile Phones and Social Media; Patients are empowered with the possibility of Real Time Communication, 24/7 Access to Information and Live Community Feedback. Today’s patients have been exposed to numerous possibilities besides the ones which our forefathers would know of. This exposure has empowered this generation of patients to ask for better care, better facilities, cheaper alternatives, and more useful ways of using technology to provide healthcare as well as healthcare information. However, in spite of large amounts of information available today, a big problem that exists today is that the information is not necessarily usable when it is most needed.

- Diagnosis and information gathering

- Finding a Provider

- Soliciting Second Opinion

- Accepting a diagnosis

- Participation in research

- Being an champion or advocate

For Technology to be successful at this there should be sustained focus on different avenues of Information Therapy. We explore 5 avenues in this series:

- Medical Information Sources

- Digital Identities for Providers and Provider Information Sources

- Patient Provider Communication

- Health Information Exchanges

- Online Health Communities

In the next Article we'll look at Using Medical Information Sources to build the foundations of a Digital Ecosystem in Healthcare, thus creating a useful paradigm for providing Information Therapy

- By Nrip Nihalani and Aditya Patkar

Plus91 Technologies Pvt. Ltd.

http://www.plus91.in

http://www.plus91online.com

http://www.twitter.com/plus91

Medical Practices Planning Websites Need 8 Answers Ready

2011-09-03T11:18:00.005+05:30

All Top Websites should concentrate on a few things; Appearance, Content, Functionality, Ease of Usability and Search Engine Optimization. Medical websites are no different. They are just more focused. So once the basics of design and technology are taken care of, Medical websites need much more than form to rise to the top. Before you jump into the online world for reputation management and brand enhancement, all medical professionals and practices need to ask themselves some questions first. To focus your medical website for the right audience, you need to have these 8 answers ready when you plan your digital excursions:

1) What are the Three Top adjectives that describe your practice and Three Top services you provide:
All medical practices have some USP that distinguishes them. You should have yours defined before you create an online presence.

2) Who is your competition:
You are the best judge of your own competition. That’s where your patients go to when they don’t come to you. The same goes for the patients looking for Doctors online.

3) Which medical websites do you appreciate:
Your affiliations online decide your digital brand. Choose some idols of online medical presence and follow their best practices. Always link to and comment on good quality content.

4) Is there anything you don't want on your web site:
Your aversions decide you as much as your affiliations. Have a clear brand strategy for your professional appearance online.

5) What do you want visitors to do when they get to your site:
Have a clear navigation plan for your visitors and decide where you want them to finally land up on your website.

6) How do you want the web site to help your practice:
Know what you want to do and why you are doing it.

7) Do you have a collection of all digital media you might have created over the past 5 years:
PowerPoint slides, videos, text articles or posts online are good resources for high quality medical websites. A regularly updated website will always do better for your brand than an outdated one.

8) Do you plan to delegate people for managing your complete online presence via social media and PR:
Facebook, Twitter, Linkedin and community platforms are the crux of an online presence. You need skilled people managing these channels for you 24/7/365. That’s a long term question ideally decided when you start a website.

Websites For Doctors allows you to create high quality websites by a simple template based process. You can check some examples here.
• Ankur Fertility Center
• Om Pathology Lab
• Dr Manoj Pradhan's Athena Heart Care Clinic

You can contact us here.

Five Free Simple Google Tools For Doctors

2011-08-10T12:21:00.006+05:30

Digital technology has done a lot to change healthcare over the past 20 years. And Google is the biggest influence on the web over the past 14 years of the internet. Their “Do No Evil” ‘philosophy’ has given us a whole stable of free and easy to use tools which can make all work easier and better.

Google's premier patient offering, Google Health was quietly buried. There have been no comparable Google tools for doctors. Their Raison d'être, the Google search has long been a much maligned tool for medical professionals. But there is lots more a doctor can do with free Google tools. Let’s take a look at *Five Free Simple Google Tools For Doctors.*

1) Gmail

This is the most useful service ever by Google, barring Google Search. And you can have more of it! You can use Gmail to create 2 (or more) free accounts. So you can create one personal and another public email address for your medical practice. Eg: one can be *dr.nirmal@gmail.com* and another
*neuromumbai911@gmail.com*. By going to settings, you can then set to import your other email account into any one primary gmail account.

You can also enable ‘*multiple inboxes*’ via Labs subtab in mail settings, allowing you to receive neatly segmented mails. Check this video

You can reply by your choice of account, enabling you to keep your personal and professional emails separated by different accounts, yet accessible and answerable from one single account. Here’s a detailed screenshot enhanced post about this feature on MakeTech easier. Read this Gmail tutorial for lots more info on these features.

Websites for Doctors by Plus91 lets you leverage on Google’s email offering creating social media profiles for you and letting you use your own personalized email ids.

Eg. drrajan@ivfinindia.in (www.ivfinindia.in)

2) Google Alerts

If there are certain terms you want to follow on Google and receive any new mentions directly to your email inbox, create a Google Alert. Fill in the term you need to follow, like ‘*neurology India news’* or ‘*dr. nirmal surya’* and set the frequency/type of alerts required. *Stay updated via email.*

You can also directly add such feeds to your website thus making it an information resource for others to see for a particular topic. E.g. PIPCDocs Website at the bottom left corner

3) Google Maps

Maps and *Places* allow you to mark your professional locations and timings on a map. Link this marked map within all your emails. Henceforth *all patients you email will see how to reach you easily via a map*, with additional info about consultation hours that you might want to share.

Every Website made by Plus91 comes with its own embedded Google maps to allow patients to easily track your location. E.g. Dr Karnik’s Clinics under the Location Tab

4) Google Scholar

You don’t need to always go to Pubmed for all your medical searches. Head to Google Scholar and do any *advanced search* (author, type, publication year and lots more filters). You will get More Results. You will search more medical databases. Try it
.
Plus91 has numerous initiatives to help promote your website using information tools like slideshare and Collaborative Online Journals like Indian Health Journal which will get you listed sooner than later.

5) Youtube Channel

Online videos are the most important medical info resource. But you don’t need to create videos to run a medical educational channel for your patients. Just create a channel by free login and start marking as *favourite the best medical education videos* you think might help your patients. Set channel settings to demonstrate your video favourites. You can also create multiple playlists on multiple topics and share them separately. Thus, you have a full blown video channel. Zero cost!

Now create your own You Tube channel with us at Websites for Doctors and upload videos of surgeries, patient testimonials and also a tour of your clinic.

We are planning another post on 5 Advanced and Free Google tools For Medical Practitioners. If you want to read that soon, *Share this*. If you need help with any of the above tools, comment below.

Article by: Dr Neelesh Bhandari and Co-edited by Aditya Patkar

Top 5 Free Medical Reference Apps For Android Smartphones

2011-07-27T14:37:00.006+05:30

Use of Smartphones in healthcare is the latest intersection of Technology and Medicine. These inexpensive handheld computing devices allow users to download third party applications (apps) which can perform specialized tasks.

Most Smartphones run on either the Apple iPhone’s iOS or the Android OS and there are literally tens of thousands of medical apps available for either of these operating systems.

Clinical care is information intensive and some of the most commonly used mobile applications by physicians are for medical reference. By providing the latest evidence based medicine updates at the point-of-care, Smartphones are proving to be a very important tool for improving quality of healthcare. At Plus91, we have made a list of Top 5 Free Medical Reference Apps For Android Smartphones which physicians can use everyday for clinical purposes.

1) Medscape : Medscape is a popular web resource for physicians and other health professionals. This is a must have application which provides offline access to clinical reference tools like Drug Reference, Disease & Condition Reference and Treatment Guide, Procedures Reference, Tables & Protocols Reference and Drug Interaction Checker.

2) Skyscape Medical Resources : Founded by a group of Indian innovators, Skyscape is a worldwide leading service for providing trusted medical information via mobile devices. The Skyscape portal provides a number of free as well as paid medical apps for almost all specialties.

3) Epocrates : Epocrates is a publisher of mobile device software applications, designed to provide information about drugs to doctors and other health care professionals. The Epocrates application is the most popular of its kind providing a huge amount of information about pharmaceuticals. Regular use of this app can definitely help reduce errors in drug prescriptions.

4) PubMed Mobile : An uber useful app by the National Library of Medicine, PubMed Mobile allows the user to search its database with over 21 million citations for articles and journals, save articles and searches, view abstracts, and export selected abstracts and citations for future use. NLM also provides a number of other mobile optimized tools and apps. Check the NLM Mobile Gallery here.

5) WebMD : WebMD is the leading health information portal of the United States. It was founded in 1996 by Jim Clark and Pavan Nigam as Healthscape, later Healtheon, and then acquired WebMD in 1999 to form Healtheon/WebMD. The free app provides access to information regarding health and health care, including a symptom checklist, pharmacy information and drugs information.

The following is a guest post by Dr Neelesh Bhandari.

Twitter Handle: @edrneelesh

What EMR & Medical Software Options are available for doctors who use an Apple Mac !

2011-06-01T19:09:00.004+05:30

In the Health Care industry EMR’s, Practice Management Software’s and other Clinical Productivity Tools are primarily built for the ubiquitously available Windows platforms. A huge number are also available for Linux, most of these Open Source, and a very small number for the Macs.

In the United States, the EMR business is filled in with over 300 major vendors, however as per this report by from Software Advice there are 8 vendors offering EMR's natively built for the Mac's in the United States.

Very few vendors actually support the Mac. Many doctors over the years have wanted a Mac, but would’nt get one due to the lack of Medical Softwares for it. Though lately there has been a surge in the number of vendors promising native Mac versions in the future.

In the interest of the majority of doctors reading this, lets ask the questions: “What does a vendor mean when they say that their EMR is natively supported on a Mac? What exactly does it take for an EMR to be supported on a Mac ? What is this native thing I’m talking about”

For an EMR to be natively supported on a Mac, The EMR program’s software code must be understood by the Mac ; In simpler terms, The program must speak the Mac’s language and follow the Mac’s set of rules. Windows has its own set of rules and they are different from a Mac. So a program made for Windows unfortunately may not run on a Mac.

Summarizing

The Mac and the Windows are inherently different, and a software program built for one may not run on the other as the other operating system might not understand what the program is trying to say/do

For an EMR to natively run on a Mac, its underlying code must be understood by the Mac, and it must be following the rules of the Mac.

Given this criteria and the fact that the number of Mac based software are few, what jugaad can be done to provide more choices to the Mac users?

Enter Virtualization
Enter Web based Applications

Virtualization:

Virtualization is based on the concept that if you have a software made for the Mac, and you can make Windows understand it, then it will run on Windows : And Vice Versa

A Virtual Machine is a type of software used to create a Virtual Environment, which is referred to as Virtualization. Virtualization may be used to run multiple operating systems at the same time on one Physical Machine. Through the help of a virtual machine, the user can operate software built for one Platform (Or Operating System) on another.

THUS A SOFTWARE NEED NOT BE NATIVELY SUPPORTED ON A PLATFORM TO BE USED BY IT ANY MORE, AS LONG AS YOU CAN USE A VIRTUAL MACHINE WHICH ALLOWS YOU TO USE IT ON THE INCOMPATIBLE PLATFORM.

The virtualization industry is a boon and it is booming because it allows people more choices

Here is a link to 2 fantastic Virtual Machines for the interested. As always, feel free to drop me a line at n.nihalani AT plus91.in for any help.

Virtualbox

VMWare Fusion

In recent times, whether it is due to Apple’s advertising or the Word of Mouth spread that works with Doctors, a Number of Indian Doctors have told us that they are buying a Mac; and if the Clinkare Physician EMR would be supported on it. Yes of Course! Both the desktop version and the SaaS version are supported on the Macs.

Web Based / SaaS Aplications:

The category of SaaS and Web Based EMR’s is exciting. THEY ARE USUALLY PLATFORM INDEPENDENT, UNLESS THERE IS A PC COMPONENT WHICH REQUIRES NATIVE SUPPORT: LIKE A SCREENSHOT PLUGIN, OR A VOIP COMPONENT, OR A DICTATION COMPONENT;

Web Based EMR's are EMR's which can be used directly via your browser, the same browser you are using to read this article. They are usually available on a remote internet connected server and thus free you as a user from worrying about the nitty gritties of configurations, operating systems and the administration issues which come with time due to these.

In this article on MAC EMR Software, the author states that “Web-based EMRs are the best long-term investment for doctors using Macs. Unlike their on-premise counterparts, vendors offering web-based software won’t have to support two versions of their software (i.e. one for Windows, one for Mac) in the long run ”

One can’t agree more. Every Web Based EMR vendor, knows that their EMR can be used using a Windows , a Mac, a Ubuntu; Users can even use the EMR’s on Tablet PC’s as well as Low Cost Netbooks.

There has been a surge in the adoption of the iPads in many health care institutions(pictures below), here in India, and as reported in the United States, United Kingdom and Singapore. iPads with their form factor well suited for use by On Round Doctors in In-Patient Wards, Nurses while taking down Vitals in Charts and even Assistants in OT’s for Managing Checklists are a hit.

LabC: Pathology EMR on the iPad

The Clinkare EMR on the iPad

With Virtualization being available and Web Based EMR’s being the popular flavor with vendors, there are now choices available to Physicians and Clinics for Medical Software which can be used with their Mac’s.

If you are in the United States, you may want to use this comparison to help you select the Web based EMR which works best for you

If in India, you really should give the Clinkare Physician EMR a try ...

Disclaimer: This post is a modification of the post Why are there no Mac’s in the clinic? from Nrip's Personal blog Wirelysis

EMR'S: PROVIDING INDIAN DOCTORS WITH AN EDGE: VOL 2

2011-05-05T16:48:00.001+05:30

APPOINTMENT MANAGERS FOR EFFICIENT TIME MANAGEMENT

Managing time is a major issue for all professionals in today’s fast paced world. This is even more so for many doctors, especially those who work at multiple locations: Clinics, Hospitals and Medical centers. Workshops on effective time management are regularly organized at different financial and IT firms to help hard working professionals. Gyan is imparted on setting Alerts for Reminders, and To Dos for Task management and the importance of diaries, blackberries and calendar reminders is emphasized here.

Physicians have a slightly bigger problem. Their schedules are majorly dependent on set appointments with patients. While they do have other areas of concern, the majority of their daily schedules are built around patient appointments. What complicates this for a consulting doctor is that every day he may have different visiting hours at different locations. This makes Time management even more crucial for Physicians.

Effective Appointment Scheduling for Physicians thus becomes an extremely important activity, and many firms are trying to make an industry out of it alone. It makes more sense though to ensure that Appointment Scheduling is not taken up stand alone, but is an integral part of an EMR system. Add an effective Appointment Management Process to an EMR, and you have added a strong case with Physicians on adoption.

The Appointment Management Process can be divided into 3 parts:

1.    Appointment Scheduling
2.    Scheduled Appointment Tracking
3.    Patient Visit

Mandatory Requirements for an Appointment Management System:

It should allow for different mediums of Appointment Scheduling

E.g. Via a Website, Via A Phone Call, Via SMS

It should permit Rescheduling
It should be able to handle Walk-In Patients
Besides the process, the screens should be simple – Non IT friendly users should be able to easily use it

Color Coded Entries: Pending, Completed, No Show, Bill Pending
Point And Click with Minimum Data Entry

Should be rigid enough to prevent Scheduling Errors
Should Support Multiple Doctors and Multiple Specialties
Maintain 2 Daily Calendar Views

Appointment View for Front Desk staff, Online Portal
Scheduled Visits View for Physicians

Appointment Management Workflow

Useful Features in an Appointment Manager which add value to the Appointment Workflow

A Good Appointment Manager allows appointments and available spots to be displayed across multiple locations ensuring quick coordination.

It has a visit calendar that showcases the status of the patient’s appointment right from the initial booking stage to the consultation and finally to the bill payments post check-up.

It contains Smart Customization features that help the staff and doctors to configure the appropriate time slots, visit options and default visit duration.

It offers Multiple Calendar Screens to View the Appointment Schedules Daily, Weekly and Month wise.

Sometimes patients forget appointments, which adversely affects the practice’s cash flow as well as adds Delays in the patients’ treatment. A Good Appointment Manager will offer automated appointment reminders built into the Appointment manager. This will help reduce No Shows as well as Reduce Confusions over time of Scheduled Appointments. These Reminders can be

Email Reminders
SMS Reminders
Automated Phone Calls Reminding the Patients of the Scheduled Appointment

The control center of a successful medical practice is an EMR with an efficient and user-friendly scheduling system. It will help your practice run smoothly with increased productivity and optimum patient satisfaction.

by Nrip Nihalani

Plus91 Technologies Pvt. Ltd.

http://www.plus91.in

http://www.plus91online.com

http://www.twitter.com/plus91

If you missed it here is a link to

EMR'S: PROVIDING INDIAN DOCTORS WITH AN EDGE: Vol 1

Information Technology Orientation For Starting Hospital Administrators

2011-05-04T14:32:00.000+05:30

Information technology and computer science tools are definitely the most rapidly growing segment of the world ecosystem. The development in the sector permeates every human activity; social, economic, cultural, religious, political, professional, personal and healthcare. Information technology has radically altered the way many people work and think. Information Technology has made a significant difference to the Quality and Standards of Life. Learning some of the common IT application an individual can carry out any activity of your work life simpler and easier.

There is a rising awareness about the need for better healthcare in India. The demand for healthcare is growing with the increasing affordability of Indian middle class, a new breed of patients have emerged with enhanced expectations for better quality of healthcare, both patients and doctors exposed to international healthcare setting demand more, number of insurance players playing a key role, net savvy population, more number of independent hospitals have made the healthcare market more competent and complex.

Over the years, technology has touched a new zenith and now it is not constrained to developed countries. Developing countries such as India have kept pace with the world in modern technology. Healthcare professionals can no longer disregard the application of information technology to healthcare because they are key elements for competing in complex healthcare competition.

The major component that can give an edge in terms of patient care and effective decision making is IT support. Today's corporate hospitals compete on the basis of the technology with investment in it being the major benchmark.

Technology in healthcare has brought better therapeutic & diagnostics delivery of services, integration to various components of large healthcare providing entity, very similar to that of any other sector like manufacturing and banking sectors. Healthcare IT has huge potential in India as the hospital are emerging, growing up and healthcare workers want to upgrade.

When a fresh post graduate with medical and non medical background entering in the market searching for a job in the healthcare administration side with little or no knowledge on IT, he has to be a part of following job codes

Job code 1 He joins an ongoing cooperate hospitals that has an established IT infrastructure, enterprise wide software and a well integrated system. The hospitals have already invested heavily on IT applications and using them successfully, the expectations from a fresher to perform in the new setting are high. To deal with this situation the fresher should be oriented with basic operational domain knowledge as well as trained by application specialist.

Job code 2 When a fresh post graduate joins a hospital from the scratch (for a new hospital which is in the inception/ setting up stage). The fresh post graduate has to plan, coordinate, budget, execute, install, and train the employees, built an entire IT system for a new hospital for which he should have a sound knowledge of IT application in his post graduation as a core subject.

Job code 3 When a fresh post graduate joins a consultancy and suppose the consultancy is working on an IT project for an established hospital or a new hospital. The fresh post graduate has to work with IT vendors and make a decision regarding the IT infrastructure. He has to plan, budget, execute, install, and train the employees built an entire IT plan for a new hospital and act as a facilitator, catalyst as a change agent

Job code 4 When a fresh post graduate has mobilized enough funds to start his own hospital as the owner he has to make a tough decision regarding IT infrastructure .He should know his budget, requirement and growth prospect .He can plan the entire schedule by himself or take the help of IT consultant

Job code 5 This is the toughest of all the jobs codes, you are working with existing software and reported some modifications either want to add new features or replace it you have been assigned this duty to select , administer , execute, train, budget the entire program( he has to act as a change agent, motivate the staff and convince the management ). It is very risky. The individual may have little or no knowledge of new technology and application. The success of the project depends up on you which involves time, money and efforts.

What Are The Software Options?

As a fresh post graduate who is in the future going to be an administrator should understand few basic principals about IT software either to go for (Build software vs. Buy software) or (Make decision vs. Buy decision). This is the most important and curtail of all the decision of IT infrastructure.

If it is Make decision then it is development of software in house which follows SDLC (System Development Life Cycle)

If it is Buy decision then checking out your hospital requirements, listing out various vendors who supply readymade software product on contract bases, evaluate their features, select the best from the available, install the software, train the employees with application specialist, have a backend support with vendor.

Basic Check List Elements

Check list 1 The first responsibility that the administrator has is to ensure is that the software which is being used has an End-User-Licensing-Agreement. It should not be pirated one

Check list 2 The administrator should instruct the IT manager to have all the detailed about hardware, software, number of computers, date of manufacturing, their warranty period, when was the annual maintenance contract renewal (AMC), when is it to be renewed and so on. This all should be maintained as a hard and soft copy.

Check list 3 The administrator should instruct the IT manager to have total control over the network, support your system with a good firewall which scans each piece of data that goes out or comes in, a good antivirus with daily updates with Malware and spam mail options, a sound multi-level authorisation to ensure what data is viewed only by authorised personal. Site-blocker software should be installed which blocks illegal browsing sites.

Check list 4 A sound backup and recovery program is very important. (Offsite backup is preferred).

Check list 5 Check the various insurance options for IT which include (Insurance for the entire hardware and software installed in the system and even the user is supposed to be insured. (If you are not aware of the insurance policy then hire an insurance broker)

Check list 6 Plan the IT– infrastructure by seeing the existing workload, technology up gradation etc. A definite amount of budget should be allocated to the IT- Manager. A maintenance budget and an operational budget

Check list 7 Regular training programs should be conducted for the new employees, as well as for the existing ones. Eemployee feedback should be taken about IT and evaluated by the administrator and IT manager.

Check list 8 An easy to navigate, light, perfect, interactive website or portal should be maintained by hospital IT-Department. This can be browsed on any browser. All the employees should possess an Email for any form of internal communication.

Note: The document has not covered the technical details of various elements like firewall, backup, recovery, browser, portal, insurance broker etc

This is a Guest Post by:
Syed Murtuza Hussain Bakshi

Associate Professor

Department Of Hospital Management

Owaisi Hospital and Research Center

murtuza_in21@yahoo.com, murtuzain21@gmail.com

Mobile: - 09948662135

Improving Patient Care through EMRs

2011-03-25T18:55:00.004+05:30

EMRs-Electronic Medical Records are a modern revolution in the field of healthcare improving the standards of quality in healthcare and raising it to a higher level. With all the numerous benefits of EMRs to doctors, it eventually signifies the benefits to patients and thereby improves patient care.

Using EMR in medical practice can improve patient care in the following ways:

Safe and secure medical records: Electronic medical records are safely and securely maintained in a PC in contrast to the paper-based records let out in open leading to forgery, loss of records or damage due to natural factors. Records inside the PC cannot be damaged or lost and thus a patient is tension-free with respect to the security of his records.

Make better decisions: A patient history well maintained helps you make better decisions in your treatment. EMR is a tool to maintain such patient histories and take decisions accordingly increasing patient care.

Less time in management and more relief to patients: Paper-based records and registers pile up and become difficult to manage. Moreover, it takes a lot of time for the receptionist to search the record and hand it over to the patient. Instead through EMRs, the doctor searches the records in a single click and reduces the time spent in searching them inside the clinic. This eventually gives a relief to the patients as their waiting time is curbed.

Email the reports to non-local patients: Mailing the reports is a great way to showcase care for patients. If they are paper-based, it becomes a tedious task to deliver it to the patients who are not in the same city, state or country. However, if the doctor uses EMR and mails the reports it saves time and improves patient care.

Reduction in chaos, happy patients: A messy clinic with cluttered papers, chaos and mismanagement gives a bad impression of the doctor and the clinic. Instead resorting to EMR with no papers lying around, a clean clinic and proper management smoothens the practice giving a good impression to the patients.

Say no to Memory-based treatments: A memory based treatment proves dangerous for both patient and the doctor. So no more risk of giving bad treatment to your patients with EMR having records of the diagnosis and treatment available within seconds. EMR based treatments have proved safer in contrast to the memory-based treatments improving patient care.

A specialists’ and colleagues’ opinion: EMR stored inside a PC is easy to share with your fellow colleagues and specialists to discuss a rare clinical case. Paper-records require a lot of time to share as compared to an electronic record. With a handy device and a sharing access, medical record distribution is a cost-effective solution.

Handwritten Prescription Risk: A hand-written prescription can prove highly dangerous for the patient. Drugs which are spelt similarly or having a difference of few alphabets/structure are more liable to be misunderstood by the pharmacist and handing over wrong medications. Resorting to a PC-based prescription along with the record neutralize the perils of handing over some other drug increasing patient care.

Quick response to emergencies: Digitized records on a centralized server ensure quicker response to emergency situations for patients. Entire patient history can be referred by the doctor in a short time and proceed with the treatment unlike the paper-based records where it requires a lot of time to search and refer patient history.

Adverse Drug Reactions: Side effects of drugs if not informed to the patient can lead to a patient’s health in danger. EMR software which records ADR definitely makes you inform the patient while prescribing the drug. Patient safety and patient care ensured.

Patient’s access to records: Giving another dimension to EMRs; from a doctor’s accessibility to patient’s accessibility of medical records, EMR is a boon to patients as well. Not only does it eases access of records in faster and simpler manner but is helpful when a patient is at different locations. A medical record integrated with a doctor’s portal is accessible worldwide limiting it only to the doctor and the corresponding patient providing patient care.

Patient Consent: Smart EMRs with consents help patients make decisions about the choices available in the treatment they are about to undergo. Issues related to patient consent are reduced with EMRs that give you options of the treatment and lets the patient beware of the risks and benefits associated.

An in-depth medical knowledge may care and cure the patient but added services like EMR will retain patient care.

By Pooja Raval

Learnings from Japan: National Health IT Networks are required

2011-03-13T14:58:00.002+05:30

The past few days have involved almost all of us praying for Japan which was ravaged by a severe earthquake and tsunami. Japan's most powerful earthquake in 140 years struck the north-east coast on March 11^th 2011, triggering a massive tsunami leaving behind many homeless and stranded. (Information and Situation Report from WHO)

As we continue praying for hope in Japan, we are also learning all we can about how disasters can impact the way we live and seek to improve. Sadly, Japan now faces severe logistical problems and with the latest news on the mishap at a nuclear reactor, the situation only seems to be getting worse. While Japanese officials have more pressing issues on their hands, a problem that will arise as time progresses will be that those left alive may find themselves without their medical records. Natural disasters wipe out everything — including paper medical records as well as computer and communication networks.

In this time of national crisis, it would have certainly been helpful for Japan to have a robust Healthcare IT network in place. A collaborative one where it is easy to share data, which is securely backed up redundantly in multiple locations that would leverage geographical diversity as a means of countering nature’s unpredictability: Geographical Division Multiplexing if you please;

While Japan does have a Healthcare IT strategy setup, with benefits and stimulus funds, it is relatively new and yet to mature. Health data digitization and Electronic Record Keeping is still in its infancy. Japan does not boast of large scale Electronic Medical Record coverage.

Wouldn’t any country ride out disasters better with health data sharing in place? This should be taken as a wakeup call as well as a learning lesson by all nations which haven’t yet devoted time and money to setting up Nationwide Health IT Infrastructures.

India for one must be looking at learning from this. Having a Nationwide Health IT Strategy should be treated as important as a Tsunami Alerting System (TAS). Purists will argue that a Nationwide Health IT System is not intended for alerting and helping contain situations like the TAS. And they are not completely wrong.

In many cases it has been observed that long term benefits are eventually forgotten. Instead, this concept of “Long Term benefits” must be replaced with Pre-planned Goals which must be “Sought” on maturity of a model. Now, any system can provide a set of benefits directly on implementation, and an additional set when it has matured.

Similarly, the use case of using a Nationwide Health IT System for predicting and alerting requires a certain amount of usage at first. A sophisticated and mature Nationwide Healthcare Network built using technology can identify the emergence of possible pandemics. Trends in symptoms can help identify risk areas, and collaborative diagnosis can help is sharing treatment plans and improving them.

One must understand that if maturity of a network is required for additional goals and since that takes time, one must seek to implement early.

Links of Interest

WHO Page on Environmental Health in Emergencies

WHO page on Myths and Realities in Disaster Situations

EMR'S: PROVIDING INDIAN DOCTORS WITH AN EDGE: VOL 1

2011-02-02T06:33:00.015+05:30

Typically, a patient's record is just a folder with his details and probably a photograph on the front cover, coupled with sheets and sheets of data recording his previous visits. While some of this data, especially prescriptions may be recorded in a hospital, can you imagine the long hard search that one endures to locate them when required. Also, this search by no means guarantees a consolidated view of a patient's information which would equip the doctor with a complete overview of the patient's health history. There is a serious need for a system in place which can ensure this Information be available Timely, Efficiently and Sensibly. All of a Patient’s information must be available at a single point of contact.

An Electronic Medical Record or EMR is a secure electronic file of patient history, medical transcription notes, billing information, and all other information necessary to have a complete patient profile. EMR's, or computer-based medical records of patients, have already gained importance in the western world with governments taking up initiatives to implement them across each nation. However, in Asia, esp. in countries like India and China, there is a long way to go before the benefits that are available to the entire Health Ecosystem by EMRs can be realized. In reality, here EMRs and other Health Softwares are still considered an undesired luxury. Many physicians tend to drag along the process of migrating to EMR's because of the cumbersome training, additional equipment, change in mindset and lack of immediate financial gains involved with the shift.

While it is true that the EMR systems are indicative of a faster-paced informational age in which larger quantities of information warrant a more effective IT infrastructure (primarily faster machines, better software and efficient databases) , there are many benefits to both the medical service provider and the consumer which still make their need viable in today's times.

Prospective users must be sufficiently informed and educated to help them gauge these benefits for themselves. Selling EMR packages should not be the goal but a by-product for EMR Vendors and Consultants here. Software Vendors should be willing to invest time and effort to educate the doctors, patients and clinical staff of the benefits to them which will follow an EMR implementation. Also, vendors must don a consultant hat and sell the appropriate package which would be the right fit. It is encouraging for the future that EMR vendors in developing nations have started providing the equipment, training and continued customer support that doctors need to make EMRs successful in their practices.

Further, like any other technology or practice, EMR will not gain a foothold unless there are sufficient incentives in a national healthcare system.The years ahead will be exciting as a number of developing countries such as India and Brazil seem to be slowly showing inclinations in enforcing IT in healthcare. The new NABL guidelines and the in-process ART Bill in India seem to be steps in the right direction, even if they have their detractors.

Similarly, the systems must be able to handle the pressures of the existing infrastructure. While a purely online EMR sounds wonderful, intelligent offline availability of these EMRs is critical (especially in India) where where internet availability is not reliable, and internet adoption (especially amongst senior citizens) is not that high. Offline availability can be enabled through smarter software designs, as well as storage devices such as CDs, USB drives, etc. It is important that the offline usage scenario has the same user-friendly search and retrieval capability as an online usage would provide.

Benefits of Electronic Medical Records

Electronic Medical Records can deliver numerous benefits to the various stakeholders in the healthcare process. Lets summarize a few: Over the course of this series we will delve into these and many more.

For Patients :

EMR's simplify the management of the patient medical history across multiple doctors, hospitals and other facilities.

They also enable quick access and retrieval in case of an emergency.

They reduce the risk of loss of valuable heath data, bills, prescriptions and insurance details.

For Hospitals and Other Care Providers

EMRs simplify the overall records management process.

Help in improving process flows within the hospitals

Provide insights into trends over time

EMRs enable quick review of past history of a patient and aid in rapid diagnosis.

They also enable doctors to collaborate and discuss a patient’s condition with colleagues or external specialists.

In the next Volume we will take a deeper look at how EMR's can positively impact the speed of provision of care at Medical Practices and how this improves efficiency.

By Amit Kumar and Nrip Nihalani

Plus91 Technologies Pvt. Ltd.
http://www.plus91.in
http://www.plus91online.com
http://www.twitter.com/plus91

What do Doctors love doing on the Internet?

2011-01-22T19:24:00.001+05:30

Thanks Doctor for visiting. We are conducting a survey under the prerogative of Indian Health Journal. We would love to hear about how you spend your time on the Internet.

Click here to take this survey

Hoping to make the online experience for Doctors an enriching experience.

The results will be part of a publication and will be available freely. To know more about Indian Health Journal , Please email indianhealthjournal@plus91.in

Thank you from all of us at Plus91

Technoclinics- Upcoming scenario in India

2011-01-17T04:53:00.001+05:30

Medical industry in India is proud to have adopted the latest medical equipments in every specialization and has achieved tremendous results in terms of rapid and effective treatment. The benefits that the Indian IT sector has made in the global village the past 15 years, are now being extended to the Indian Healthcare industry too!

Taking advantage of these some clinics are transforming into “technoclinics” by smartly using technology and software in their practice. Dr. Ankit Khanna (MDS) at Pune, who uses a Blackberry to track his online appointments says, “Advances in technology have definitely changed today’s scenario in the dental practice. Earlier for root canal treatments, X-rays taken were on a thin film which gave information only about pathology and cavity. But with the Digital X-ray, it is now possible to know the bone density, height, thickness along with the conventional pathological details and cavity of the teeth.”

Moreover, the paper-based records are now shaping into Electronic Medical Records storing all the patient details along with the medical history and previous visits. Searching a patient record barely takes seconds and all the information is available at fingertips. Dr. Khanna cites out the benefits of EMR, “With EMR, the medical records are a proof which reduces the conflicts between doctor and patient. If a patient visits two dentists for treatment, with the software now it is easy to show the patient which treatment he came for to avoid the confusion.” Dr. Khanna confides in software stating that he can now provide warranty with the treatment as he successfully manages and tracks the patient records strengthening the patient-doctor relationship.

Most of the clinics are still maintaining the paper based records which eventually lead to frustration and chaos. There are some clinics where the doctors prescribe medicines on a follow up visit memorising the patient history which proves dangerous for the patient as well as the doctor! Imagine how much better it would be if the doctor knew the patient history and accordingly prescribed the medicines? That’s where the software plays the role and reduces the risks of memory-based treatment.

The doctors of “technoclinics” are enjoying their practice because they only have to concentrate on proper diagnosis and treatment whereas the entire clinic administration is managed by the software. Within the coming years, its predicted that the majority of clinics will resort to software, thus improving their practice, benefit in terms of hassle-free practice, improved profits, time and money savings and also building stronger patient relationships. This revolution is what awaits the healthcare sector in India.

by Pooja Raval and Nrip Nihalani

Wirelysis: Facebook for Medical Practices and Doctors

2011-01-01T21:06:00.003+05:30

"Facebook has seen unprecedented growth in the last 4 years. From a small community site, specific to colleges, it has overtaken Google to become the favored haunt of the webophile. One of the reasons for this has been the number of applications that are built on Facebook, but a bigger reason is that because "Everyone is On Facebook". Lets face it, if you want to know what someone did last Sunday, or last month, Facebook is a bigger help than any friend that you have. Coming to the point, the last year has seen a serious growth in the number of doctors creating Facebook profiles"

Click to Read More at Wirelysis: Facebook for Medical Practices and Doctors

Do EMRs increase clinic or hospital profits?

2010-09-15T11:35:00.000+05:30

What is the most common question asked by Doctors and Hospital Administrators when they meet me? Safe to say it is quote unquote: How does implementing an EMR solution increase my clinic/hospital profit?

Now first let’s go into the economics of the whole thing.

Profit = Revenue – Cost

So to increase profit an EMR needs to either increase revenue or decrease cost, and also factor in its own development, implementation and training costs.
So let us look at revenue first:
A good EMR system can drive revenue up in following ways:

1. Cause: Better customer service
SMS alerts, Quick Generation of reports, No confusion in terms of appointments, neat printed prescriptions, Doctors more attuned to patients with their complete history available, Emailing of reports
Effect: Patients keep coming back to you due to their pleasant experience, they develop a fan following and also recommend relatives and friends thereby driving up revenue.

2. Cause: Better Management of Time
Quicker access to Patient History, More Accurate Appointment schedules, Quicker Generation of Reports, Easy one Click Generation of Management Reports and Statistics
Effect: Man Hours saved by Doctors, Nurses and Attendants can be effectively used to see more patients’ thereby increasing revenue.

3. Cause: Minimizing Errors
Accurate prescriptions, Better Access to History, Improved note taking, Auditing of stored information
Effect: Less time spent on un-doing errors, less chances of revenue loss and time wastage on medico legal cases.

4. Cause: Portability and Access
Online Appointments, Online availability of EMR, Online Access to reports by Doctors, SMS and Email Communications
Effect: Access over the Internet to Patients and Doctors increases work time, provides more avenues for patients to interact with the hospital or clinic thereby potentially increasing revenues. E.g. Charging Patients to access their records online, or Doctors giving reports in quicker due to online access.

5. Cause: Offering More Services
Online EMR, Patient History Printouts, Fast Insurance Clearances, Multiple Doctor Schedules
Effect: New Services offered can be charged increasing the revenue streams

6. Cause: Better Decisions
Unpaid Bills Reports, Daily Registers, Medical and Administration Statistics
Effect: Where is your largest revenue coming from, which service, what kind of patients, which days, answers to all these questions which are now at your fingertips lets you plan better to increase and maximize revenues?

Increasing revenue is just one end of the bargain. The other is saving costs! How?

1. Decrease Staff Size: A good EMR system lets you maximize your efficiency especially on the administrative end. This lets you streamline your staff activities and in some cases even reduce staff.

2. Generating Important Reports: Report on Unpaid bills let you call the requisite clients to follow up and recover the money, a time consuming affair on paper. Or important statistics on schedules lets you find the bottle necks in Doctor Timings and improve the scheduling, decreasing losses to the setup.

3. Save Paper: Less work is done on Paper leading to long term benefits and gains.

4. Save Space: Less paper means less storage space required. Use the clinic and hospitals to provide new services or better service.

5. Manage it all: A good EMR allows you to manage your practice as well, integrating basic accounts and inventory to prevent losses, theft and effective reminders when stocks or balances run low.

Now for the down side, what costs are attached to the EMR?

a. Development: For a customized solution or a product you will spend on developing vis-à-vis buying a ready product, this is the direct sunk cost.

b. Hardware: Choosing a good EMR can greatly reduce this cost, but this too is a sunk cost.

c. Training: Time and effort required in training the staff and migrating to the new system takes time and since time is equal to money there is a cost attached to this.

d. Upgrade and AMC: Support costs are also involved with any software, so is upgrading it to newer versions. But this is vital to pay, because in the long run, PC problems do crop up and its best to be protected.

In the long run however, the ROI on a good EMR system can be tremendous.

Our product case studies for our Clinic Management Software Clinkare showed that a doctor using all the features of Clinkare in a multi-user setup can save upto Rs 15000 per month directly and in man-hour estimates.

But nothing will increase your Profit as much as using all the features of an EMR in a proper manner and fully utilizing its potential. The real value comes when you are ready to work with the EMR and not against it, when you can understand where all it can help you, increased profit is then certain.

Patient Safety

2010-08-10T12:20:00.000+05:30

Few Sundays ago we were privileged enough to be invited by Dr. Nikhil Datar, a pre-eminent gynecologist and medico-legal expert to witness his premier talk on Patient Safety. It was hosted by IMA Dombivali and had a strong audience of over 40 doctors waiting to hear Dr. Datar’s talk. Dr. Datar had recently returned from UK where he attended a program organized by WHO on Patient Safety. Plus91 Technologies believes in making patient centric solutions which don’t just automate the clinic or hospital but also improve quality and service. Keeping this in mind, the presentation was interesting not just for the doctors but also for us.

The doctors were interested in the talk, intrigued by what new information can they hear. It started slowly but filled with practical examples the doctors soon were eager to know more. More than that they realized in their own practice they need to reflect and close loopholes so that they ensure patient safety. The doctors really got involved with questions, interactive cases and videos. We think they all walked out little bit wiser. As a software company involved in Healthcare, we think patient safety becomes a vital cog in what we are doing and it works at multiple levels. 1. Creating solutions which ensure and promote safety, 2. using the patient safety angle to promote such solutions which benefit the doctor in many more ways, but they finally see it as useful when something hard hitting as this is spoken about and 3. Increasing patient interaction and service allowing patients to feel safer and learn on how they should protect themselves too.

So what all does patient safety entail? It covers a lot of ground from something simple like washing your hands before a physical examination to something complicated as giving instructions during a high pressure surgery. They key learning was awareness that things can go wrong and improving communications and processes to prevent minor errors from becoming major issues. Simple techniques like reading medicine names allowed, using color coding on various instruments, storing patient records in a neat and systematic manner help provide better quality care to the patient. We think from hearing his talk, the biggest initiative one can take in improving patient safety is increasing ones awareness in their surroundings. Being aware of the possibility and the effects of your actions goes a long way in preventing mishaps that can happen. Some major inferences were: Out of the 3.7% cases, only 1% could be called as negligent, 50% of these are preventable and most notable – majority of them were not individual failures but the system failures.

We think a lot of good work is now being done in this field by numerous players. The ones which Plus91 Technologies is directly involved with include Dr. Nikhil Datar an epxert in the field, PIET (Patient Information and Education Trust) and NGO, PEAS (Patient Education and Awareness Series) who make wonderful videos and content driven education material, HELP (Healthcare Education Library for People) which have seminars weekly apart from the actual library initiative and Dr. Malpani who is organizing a conference in October in Mumbai exclusively dealing with Patient Safety. As technology pervades healthcare, we can already envision so many places where Plus91 can actively help improve patient safety standards. The possibilities are exciting not only in their scope and challenge but also because this is probably one place we can actually be able to claim we saved a life and that thought gives us a tremendous boost.

Improved Patient Safety Using Software

2010-08-02T20:54:00.001+05:30

Patient Safety is a vital aspect of healthcare. With a fairly large number of indirect deaths and also potentially life threatening situations resulting directly from lack patient safety it becomes a vital cog in the healthcare machinery. Software products are introduced in any setup to increase efficiency and accuracy, both important factors when trying to improve safety. I am going to highlight some basic examples how inherently as well by actual design patient safety measures can be improved through normal Electronic Medical Records or Practice Management Software.

1. Prescriptions and Medications: The most common errors are seen when doctors write prescriptions on paper and the patient or the chemist misread the prescription. This is a common occurrence and a printed prescription generated from software with already present Drug Data is the safest bet against such a mishap. Other errors which can be prevented include, mistakes made by doctors in writing the dosage or strength, which in software can be fixed to prevent wrong entries, also a check on concomitant medications interfering the drug can be done. These features are already present in the Plus91 clinic package Clinkare. Ensures no errors happen due to differing writing styles or hand writing.
Another neat feature is sending reminders to the patients/nurses to take the appropriate medication at the correct time via SMS. This ensures no missed dosage which could have lead to problems. This feature is available in ClinION the hospital management solution from Plus91 Technologies.

2. Patient History: Doctors in a hurry, if patient comes without papers can prescribe the wrong treatment in case the data is not properly documented. It is vital to know previous visit experiences which can help the doctor make a better decision. Almost all softwares allow storing overall patient and current complaint history which helps doctors make better and more accurate decisions thus ensuring patient safety. This feature ensures that reliance on memory is less!
In the new age software patient history can also be coupled with Clinical Decision Support systems to help the doctor make his or her decisions in a better and more accurate manner.

3. Patient Data Entry: This is an exclusively software based point. Accurate entry in the system can be ensured by various validation measures and checks. This may slow down the process but a good process ensures the software protects the basic problems that can happen. Some key examples are: a. Validated fields which take only certain values and anything outside throws an error, b. Every time a new page is opened or traversed the patient name is popped up to double check the correct patient data is being filled in, c. Two person check entries at very vital and critical data entry points (used often in clinical trial data management), d. SMS or Email alerts in case of a vital sign going outside normal range at the ICU

4. Consent Checks: A patient must know what procedure they are undergoing, the risks and also most importantly dos and don’ts. A software can for all the procedures ensure that the consents are filled using a reminder / validation system to ensure the patients have been given the once over either by the doctor as a series of questions and answers which are entered in the system or using a video/presentation format with a consent thumbprint or electronic signature taken at the end. This is vital so that the patient does not make mistakes because of not knowing he or she had to come empty stomach for a procedure.
Plus91 softwares automatically allow you to link vital consent forms to various tests, procedures and consultations and remind you to get them filled.

5. Check lists: The Indian Born adviser to the American President on Healthcare issues is Dr. Gawande just released his new book “The Checklist Manifesto”. A checklist is the doctor and hospital staffs most trusted friend. Often negligence cases leading to patient safety mishaps happen because proper procedure was not followed. Many types of software come with check lists which need to be marked as complete before the next screen of tasks can be accessed. This ensures that all important steps are carried out and in order.
Checklists can be determinate that is fixed in nature like an inventory for a particular type of surgery. Some check lists can be flexible, like an in house patient prescription check list or schedule followed for an entire ward. Using software both can be checked and managed without a fuss.

6. Improved analysis: Software allow us to collate all sorts of medical data, this data can now also be analyzed to make future decisions better. Knowing what kind of patients react to which medication, or which months cause more complaints of a particular type of disease or maybe information on which doctors have better recuperation rates vis-à-vis their treatment methods all allow the healthcare system to better prepared for future patients.

As a Doctor I want to use technology to be able to … an Indian perspective…

2010-05-12T13:37:00.000+05:30

As we improve our software products and work with more doctors, we are learning a lot about what doctors in India want from information technology . How do Indian Doctors view IT as an enabler ?

In theory, one would expect doctors to want to use IT for the following applications.

1. Computer Based Medical Records (EMR)
2. Clinical Information Sharing Networks
3. Clinical Decision Support
4. Administrative Functions – Accounts and Patient Profile Management
5. Computer Generated Prescriptions
6. Better Patient Communication and Care

However, what the practicing doctor wants in real life is quite different !

So what does the typical doctor’s list look like?

1. Accounts and (Mis)-Management

Indian Doctors give a lot of importance to accounting in their Clinic Software; they expect the package to bill as per their requirement. Unfortunately, because many of them do not always want to declare all their income , they want the software to provide “deductions” . We have to educate them that a good package will help them to improve their cash flow and collections by allowing them to track their patient inflow so that they know what business they are generating on a regular basis. Intelligent software will help to prevent embezzlement and will discourage the office staff from pocketing the doctor’s hard earned money ( which is easy to do , since this is still a predominantly a cash business today)

2. Referrals Management

Referring patients to specialists and other clinicians is a common practice the world over, but in India it has an additional financial angle. Doctors want to know how many patients they were referred and by whom, so that they can make the necessary payments back to the referring doctors.

3. Medical History

Doctors want easy access to their patient’s information to help them make better medical decisions. While they are happy about the fact that the software gives them instant access to the patient’s medical records, they are still reluctant to use clinical decision support tools, as they would rather depend upon their clinical ability, than use a computer .

4. MIS ( Management Information System( Reports and Patient Registers

MIS reports and registers are a commonly requested feature . Sadly the uninitiated ones forget that data first needs to be entered properly , so that it can be intelligently extracted. The reasons for the MIS reports are both noble (research purposes) and mundane (for filing income tax returns) .The biggest challenge here is designing forms and data capture mechanisms which give useful reports. Often , there is a big disconnect, when doctors design incomplete templates , and still expect to be able to generate relevant data ! . Garbage In = Garbage Out !

5. Custom Designed Templates

Plus91’s software has designed so that doctors can customize their own templates , to suit their personal preferences.. Doctors love this feature, as each one wants to design something as per their own workflow.

What of the future ? We hope that as the Indian doctor matures and becomes more comfortable with using IT, he will want the following features as well.

a. Clinical Decision Support

b. Computerized Prescriptions

c. SMS/Email alerts and reminders

d. Online EMRs

e. Insurance Claims Management

Plus91 software is already built to provide these enhancements, which will give a definite boost to the quality and efficiency of their practice , and also help them to improve their profitability.