Technology and clinic

[air bud]

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This isn't the paper chart age anymore. What are some recent technological advances you are using in clinic to offer a better patient experience? A laptop/ipad with stylus so you can draw on people's x-rays? Something other than youtube to show the Dr. Glass video on how an evans corrects a flatfoot?

 

[SouthPod7]

I think one of my clinic rooms still has a foot model with all the original bones present.

 

[NatCh]

I make them watch my TikTok and Instagram reels...

My exam room has both a foot bones model and a monitor where I can draw out lines on their x-rays but I think maybe simply making eye contact and chatting with them rather than typing in their Epic chart while you talk provides a better patient experience.

My latest purchase that people have said they appreciate is a HEPA air purifier in the room to make them feel safer from the 'Vid.

 

[Redsting]

I am never on the computer when the patient is in the room, pt satisfaction drops, they feel like they are ignored. I do like the idea of a stylus and being able to draw. But Ill probably just get a board with the foot and a dry erase marker at some point.

 

[air bud]

I make them watch my TikTok and Instagram reels...

My exam room has both a foot bones model and a monitor where I can draw out lines on their x-rays but I think maybe simply making eye contact and chatting with them rather than typing in their Epic chart while you talk provides a better patient experience.

My latest purchase that people have said they appreciate is a HEPA air purifier in the room to make them feel safer from the 'Vid.

Yeah I mean I only havey computer in the room when showing x-rays...and we have established that is not very often.

When you say monitor, you mean a separate unit that displays x-rays like an ipad? Or your actual PC that maybe have a stylus on it?

 

[NatCh]

Yeah I mean I only havey computer in the room when showing x-rays...and we have established that is not very often.

When you say monitor, you mean a separate unit that displays x-rays like an ipad? Or your actual PC that maybe have a stylus on it?

It's a large computer monitor connected to our network so I take the x-rays across the hallway then we sit down at the monitor and go over the images together. It's a touch screen but I use a mouse to drag and drop lines. I can demonstrate what their deformity is and sketch out proposed procedures. I also have surgery animations on there. My screensaver is a slideshow of my photos (hobby photographer) and places I've been. People seem to like it.

This may just be my interpretation but I feel like when the patient and I sit facing the monitor together side-by-side it leads to a connection that's more personal than if they were to just sit there reclined on their podiatry chair while I stand at their feet talking at them.

 

[dtrack22]

Patient does all of the PFSH And ROS documentation on their own at home or at check in on iPad. HPI is done on iPad or dictation on iphone. Physical exam is performed and then most of those findings are entered in front of the patient because as I click on images in the EMR (of a foot/ankle which can be stripped of various layers to get from skin to tendon/muscle to bone) and talk with the patient, the EMR starts populating exam findings and ICD-10 codes in the background. Ultrasound is done on iPad (butterfly iq), xray is shown to patient on ipad. You have to have some sort of screen that connects with your xray system to go over with the patient in the room. Stylus is used to draw on the EMR generated images and can be saved and put into patient note. My stylus doesn’t work on the Xray software used. Plan is completed outside of the room and any instructional handouts are uploaded to the patient’s portal. Unless they demand paper copies. All prescriptions are sent electronically including narcotics, advanced Imaging, and PT referrals.

This gives you an idea of what it looks like when I’m talking with a patient about their problem and documenting at the same time without them really knowing. Obviously we would have a foot/ankle model on screen instead of what’s shown below

 

[NatCh]

Patient does all of the PFSH And ROS documentation on their own at home or at check in on iPad. HPI is done on iPad or dictation on iphone. Physical exam is performed and then most of those findings are entered in front of the patient because as I click on images in the EMR (of a foot/ankle which can be stripped of various layers to get from skin to tendon/muscle to bone) and talk with the patient, the EMR starts populating exam findings and ICD-10 codes in the background. Ultrasound is done on iPad (butterfly iq), xray is shown to patient on ipad. You have to have some sort of screen that connects with your xray system to go over with the patient in the room. Stylus is used to draw on the EMR generated images and can be saved and put into patient note. My stylus doesn’t work on the Xray software used. Plan is completed outside of the room and any instructional handouts are uploaded to the patient’s portal. Unless they demand paper copies. All prescriptions are sent electronically including narcotics, advanced Imaging, and PT referrals.

This gives you an idea of what it looks like when I’m talking with a patient about their problem and documenting at the same time without them really knowing. Obviously we would have a foot/ankle model on screen instead of what’s shown below

That setup sounds pretty slick!

Does the photo look odd to anyone else? It's like a 30 year-old head with 70 year-old hands, haha.

 

[dtrack22]

That setup sounds pretty slick!

Does the photo look odd to anyone else? It's like a 30 year-old head with 70 year-old hands, haha.

with all the time you have to enjoy outdoor activities and better yourself from a physical fitness standpoint, I figured your hands would look all veiny too

Im sure those are just the grizzled and irradiated hands of a seasoned ortho (who dyes his hair) in the picture

 

[Steveington]

Which EHR system to you use that lets the patient do the PFSH and ROS at home or on an iPad? That set up does seem great

 

[dtrack22]

Modernizing medicine. I guess the psfh is all they can do at home, but they can enter the remaining history once in the office. It’s probably not worth it for folks who already have the staff overhead in place and aren’t willing to fire people. It costs twice as much as my next favorite system that I looked at, but it saves me way more than $500 a month in labor costs (including billing).

 

[NatCh]

I have an appointment with my PCP tomorrow and I got an email Friday to pre-register. I filled out my PFSH and ROS online using this software: Next Gen Electronic Patient Intake Form and Clinical Documentation Software | HealthAsyst

I don't have any idea how well it integrates with their software or how well it works on their end.

 

[dtrack22]

I have an appointment with my PCP tomorrow and I got an email Friday to pre-register. I filled out my PFSH and ROS online using this software: Next Gen Electronic Patient Intake Form and Clinical Documentation Software | HealthAsyst

I don't have any idea how well it integrates with their software or how well it works on their end.

definitely a market for this until a majority of the EHR systems start adding it. I know eclinical added kiosk check in a couple years ago but I’m not sure how much more functionality it has beyond that.

It’s certainly possible that it works seamlessly. I’ve seen 3rd party apps that do. But it’s the million dollar question with something like that because I bet a whole lot of money it isn’t “cheap.” These companies have a lot of leverage given costs of changing EMRs. If they want some added functionality that their system doesn’t have, it’s not terribly difficult to convince a doctors office to pay a few hundred bucks a month to become more efficient without having to change everything.

I think more of the EHR companies will be offering stuff like this with new versions. You’ll have to pay for it, but they’ll have wizarding engines, patient portals, better inter-operability with labs and other EHR systems, smarter billing systems, etc. For example, mine can receive labs and path reports directly from Quest (and any lab can be added with a simple request). I can also message Epic users directly (or any system that gives users a HISP address) through my EHR. It does all of the Pre-appointment patient reminder calls/texts/emails without needing a 3rd party vendor. Patients can schedule follow ups directly from the portal and I can control which parts of my schedule are available for them to do so. It’s really what EHRs should have been doing all along. Traknet should have never been an option anyone considered, but until recently there weren’t any affordable EHRs that made your office more efficient and communication with patients and other physicians easier than the paper chart days. I think that’s finally changing.

 

[air bud]

I will be using Phoenix. It is an ortho specific EMR. Sounds similar to @dtrack22 . Patients can enter info at home and I. Waiting room. Place built in and x-rays get sent directly or the chart instead of a separate system. We will see once I start using it

 

[air bud]

I feel like a lot of podiatry EMr are like PICA. Stupid and overpriced but for some reason keep being used by podiatrists because duh podiatry.

Also, all these people looking for the cheapest EmR. Pay some money, get home faster because more stuff is integrated. Time is money.

 

[GreenHousePub]

That setup sounds pretty slick!

Does the photo look odd to anyone else? It's like a 30 year-old head with 70 year-old hands, haha.

It's the older dwarf doc sitting on the younger associates lap.

 

[NatCh]

It's the older dwarf doc sitting on the younger associates lap.

Okay, now I can't un-see it.