website will replace office doctors

[neglect]

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Members don't see this ad.

Do you think a pcp will be able to work from home? After all, the exam is useless.

Check it out:

www.clinicalfrontiers.com

Let us know if its good or bad and why.

 

[The White Coat Investor]

That site has nothing to do with replacing a doctor. It just brings the patient in with a completed history form. I think its a great idea. I've already told my family members to assemble a form with their PMH, SH, MEDS, ALL, and FH and take it to the doctor when they go.

BTW, I don't think the exam is useless. If nothing else it always tells me one thing, sick or not sick?

 

[Freeeedom!]

The exam is useless??
No, you are useless...don't quit serving fries with the steakburgers.

 

[save10]

I got this other website. It replaces food so now you dont have to eat

 

[DrQuinn]

Originally posted by neglect
Do you think a pcp will be able to work from home? After all, the exam is useless.

Check it out:

www.clinicalfrontiers.com

Let us know if its good or bad and why.

I'm sure its your website, so I'll keep it in mind.

I think in general I'd love my patients if they kept a track on their PMH (like Desperado said). However, if someone comes into my ED and says "I went on this website and here's my HPI" I am not sure if I'd even look at it.

Issue being is it a medical document and does it put me at further risk? I wouldn't touch it with a ten foot IV pole...

UNLESS

The hospital I work at or the ED I'm in has a computerized HPI in the waiting room that all patients much go through. Not an optional one where if the patient checked off a miniscule ROS and two years later drops dead from something... and it comes around and bites me in the glutes... no thanks.

Q, DO

 

[neglect]

As it is now, we designed the website for your use. So that you can have the patient give their history via computer, either out in the waiting room of your office, ER, or from their home the day prior to their appointment. This will save on the documentation game that doctors play so they can increase their billing, while saving time. We also think it'll be useful in medical-legal problems, which commonly arise due to poor documentation.

The problem with the entire medical field is that we have this thing called technology. The only people who use technology are doctors in technical fields. For the rest of us, I WISH technology made our lives easier. Instead the converse seems true. I spent more time entering data into computers during residency than I'd like to admit. Sure its great getting labs so easily, but the computer freaks out when the albumin comes back at 3.2.

Overall points, I think technology is underused in medicine. I think part of the reason for this is that its simply not as useful as it could be. And I think that Modus Ponens at clinicalfrontiers.com is not only useful, but can change our lives for the better.

So check it out. If your interested in it, we're thinking of charging a trivial price either per unit of time, patient, or a flat fee.

Look at it for yourself, thinking about how you could apply it to your practice or future practice.

If you see any problems, let me know. We're talking about revolution here.

And thank you for your reply.

 

[edfig99]

Originally posted by neglect
As it is now, we designed the website for your use. So that you can have the patient give their history via computer, either out in the waiting room of your office, ER, or from their home the day prior to their appointment. This will save on the documentation game that doctors play so they can increase their billing, while saving time. We also think it'll be useful in medical-legal problems, which commonly arise due to poor documentation.

The problem with the entire medical field is that we have this thing called technology. The only people who use technology are doctors in technical fields. For the rest of us, I WISH technology made our lives easier. Instead the converse seems true. I spent more time entering data into computers during residency than I'd like to admit. Sure its great getting labs so easily, but the computer freaks out when the albumin comes back at 3.2.

Overall points, I think technology is underused in medicine. I think part of the reason for this is that its simply not as useful as it could be. And I think that Modus Ponens at clinicalfrontiers.com is not only useful, but can change our lives for the better.

So check it out. If your interested in it, we're thinking of charging a trivial price either per unit of time, patient, or a flat fee.

Look at it for yourself, thinking about how you could apply it to your practice or future practice.

If you see any problems, let me know. We're talking about revolution here.

And thank you for your reply.

i currently use several EMR products and am all for the use of technology. I think the website itself, though nice, probably won't be THAT helpful in clinical practice. It does empower patients to be proactive about documenting their health concerns/problems and needs, however, it may not simplify things for physicians all that much -- they still will end up asking the questions, and they still have to document their findings, even if the patient comes in with a printout.

Each physician has their own thought process about how they tackle a problem, and so the way the process flowed was 1) a little too slow for me, and 2) didn't necessarily follow the logic I personally use in attacking a problem.

There is a commercial product that some doctor's offices use that patients pay a nominal subscription to -- they can input data on the web, and it's linked to a key card that they can then insert at their doctor's office on a computer and it imports it into a record...that is a much more time saving feature, and much more useful to physicians. There's a few vendors like that actually.

There are other large scale commercial products that allow patients to view and edit their info on the web....I'm blanking on the names now.

In terms of EMRs, I like Epic systems EMR (EpicCare) -- it's probably one of the best products out there. Amicore is also a great product (it's what I use in one of my offices) -- based on the tablet PC and uses templates to speed the process. it's also customizable. PMSI's practice partner is also an okay product. Logician is another good product...

all in all, i think it's a nice concept but not quite ready for prime time and DEFINITELY not ready for a fee...someone can do the same thing with microsoft word or excel (or in html/java) for free, or get one of the previously mentioned comprehensive tools for more bang for the buck.

 

[neglect]

Hello, thank you so much for your reply. I just have a few things to comment on where I don't think you see the application of clinicalfrontiers.com.

You mention,

"it may not simplify things for physicians all that much -- they still will end up asking the questions, and they still have to document their findings, even if the patient comes in with a printout."

Here's where I don't think you quite got the application. The power of the internet: once the patient has completed their history, its just a simple copy/paste into your EMR - whichever EMR you use. The program is in Java, so if your computer with EMR also has the internet, then the patient's history is available. The patient isn't going to hand you a printout. Before you go into the room, you can printout their history from the website, or pull it up and into your EMR.

The history is just a history. Every problem a patient has, no matter what, can be broken into a beginning, a progression, constant/episodic, and the like. These general questions can be used by the computer to obtain better histories than many doctors (especially those with time constraints to see patients in under 15 minutes) - IF the patient is the one entering the data into the computer, not you.

Although one might question the following, I wouldn't call obtaining a history a thought process, I'd just call it collecting data. Modus organizes the data better than any patient I've ever encountered (and I've actually treated quite a few physicians and quite a few highly articulate people from all walks of life).

The other products for use in this way cost 10,000 at least for a single practice and MUCH more for larger groups. To say nothing of support. And the last we checked, they weren't web based, which makes them very limited. As far as slow, the program is quick (not that it REALLY matters because its the patient's time, not yours, to be perfectly frank).

If you use Logician (simply terrible if you ask me) or a similar EMR, then you know how horrible it is when you enter a long history while talking to the patient. I'm almost totally dissociated from the patient while taking a history in our clinics. I type while they talk. Otherwise I'm in clinic for another hour entering data. Modus Ponens allows you to quickly aquaint yourself with the history, add to it if you like, confirm as much or as little as you feel comfortable with, edit as you need, and move on. But, no matter what, your documentation is already done - you can just talk to your patient. Wouldn't that be a novel idea?

Agree with the prime time assesment. Needs to be more pretty. Blue background, right? Very healthy.

Again, thank you for your comments. Much appreciated.

 

[edfig99]

hey neglect...some good points in that post. after playing around for a little while longer with the program I would agree with most everything you typed.

i guess the question to start with is - is there a big need for patient data entry into a medical record...i mean i don't know the answer, i guess your pre-marketing data will reveal it. i assume there is some type of needs assessment going on to evaluate this. do patients want this? do doctors want this? i know people NEED it....

while more and more homes are having computers and internet access, I don't know if these are the same people that are going to the doctor...so a product like Modus could be targetting generally younger people who tend NOT to need go to the doctor to begin with... it also goes on the assumption that either 1) patients will remember their id number or 2) that the doctor's office will have readily available internet access. some offices do...some don't...some use *gasp* dial-up.. It can potentially exclude people with impairments, as well as people with poor literacy, or health-literacy. what about other languages? i serve an 80% latino population...

As a patient, I hate the idea of having to do some "homework" before going to the doctor...and the reality is that the doctor gets paid to write this stuff down, so why should I do it. As a doctor, I have always preferred to take my own histories - i can touch type and pay attention to my patients, or using my tablet pc and Amicore, I can just click checkboxes -- patients really don't mind as much as we think... I get into a certain groove and switching things around - i.e. some patients do have their printout, others don't - would disrupt my flow... their written history will still have to be reviewed and edited (particularly if there are things in there that aren't necessary or helpful) meds will still need to be entered into the EMR's proprietary format, along with all the other stuff, and so how much of a time saver can it really be? (i guess another thing to study 🙂 )

there's also the security/privacy concerns. those histories are stored for 24 hours...where? who has access to that? it's not on a secure server or encrypted...what about when I access it from my office..

again, i think it's a neat little program...I'm not sure I would have my patients use it at this time...they wouldn't be able to. or at least, a significant number of patients would be unable to...and all the young healthy people who I never see anyway would.