Improve patient care as well as your business

today’s urologist has to stay current with new technology and care models and cater to patients who seek more knowledge and participation in their care. In part two of this two-part article, I will discuss how these practices are both good for business and for improving the quality of the care you provide.

Neil H. Baum, MDIn my previous guest column, I discussed business and practice management aspects that are imperative to all urology practices. Many of these revolve around today’s changing landscape of care: online reputation management, cost transparency, and simultaneous focus on wellness and illness.

In addition to those topics, today’s urologist has to stay current with new technology and care models and cater to patients who seek more knowledge and participation in their care. In part two of this two-part article, I will discuss how these practices are both good for business and for improving the quality of the care you provide.

Work with “e-patients.” It’s important to become comfortable with the electronic patient, or e-patient. A patient arriving with an armful of information downloaded from the Internet is common in most urologic practices. Today, the e-patient is a health consumer who participates fully in his/her medical care. Sometimes referred to as "Internet patients," e-patients see themselves as equal partners with their doctor in the health care process. E-patients gather information about medical conditions that impact them and their families, using electronic communication tools (including Web 2.0 tools) to cope with medical conditions (Sultan Qaboos Univ Med J 2010; 10:169-79). It is not good business to dismiss the patient’s interest in learning about their medical care; instead, embrace this desire and provide them with credible information from the Internet.

Have a patient portal and offer patients copies of their records and visit notes. (OpenNotes is one such initiative dedicated to providing patients with their visit notes.) A patient portal is a secure online website that gives patients convenient 24-hour access to personal health information. Using a secure username and password, patients can view health information such as recent doctor visits, discharge summaries, medication, immunizations, allergies, and lab results.

Also read: How to safeguard your patients’ information

Some patient portals also allow patients to exchange secure email with their health care teams, request prescription refills, schedule non-urgent appointments, check benefits and coverage, update contact information, make payments, download and complete forms, and view educational materials. With patient portal implementation, your practice can enhance patient-provider communication, empower patients, support care between visits, and, most importantly, improve patient outcomes.

Next: engage in shared decision-making (SDM)

Engage in shared decision-making (SDM). SDM is a key component of patient-centered health care. It is a process in which doctors and patients work together to make decisions and select tests, treatments, and care plans based on clinical evidence that balances risks and expected outcomes and, most importantly, takes into consideration patient preferences and values.

With SDM, patients are more knowledgeable and better prepared for dialogue with their physician. SDM builds a lasting and trusting relationship between doctor and patient. It helps doctors and patients agree on a health care plan. When patients participate in SDM and understand what they need to do, they are more likely to follow through and be compliant.

In many situations, there is no single “right” health care decision because choices about treatment, medical tests, and health issues come with pros and cons. SDM is especially important in these situations:

• when there is more than one reasonable option, such as PSA screening or a treatment decision for localized prostate cancer

• when no one option has a clear advantage

• when the possible benefits and harms of each option affect patients differently.

Embrace technology. Doctors are comfortable with technology to clinically treat patients. Now, we have to use technology in our offices to care for patients.

We must learn to change our style of caring for patients, for example, by offering shared medical appointments and emailing patients to follow up or answer questions.

Another way of using technology to better care for our patients is via telemedicine. Telemedicine includes a growing variety of applications and services using two-way video, email, smartphones, wireless tools, and other forms of technology.

I was of the opinion that there would be reimbursement issues related to telemedicine. However, there is usually no distinction made between services provided on site and those provided through telemedicine and often no separate coding required for billing of remote services.

Also read: How ICD-10 is changing how you do Dx coding

Telemedicine can provide a wide variety of remote health care. Patient consultations via video conferencing, transmission of still images, e-health including patient portals, remote monitoring of vital signs, continuing medical education, consumer-focused wireless applications, and nursing call centers are all considered part of telemedicine.

In summary, tomorrow’s doctor needs to be doing a much better job of dealing with today’s medical challenges, because they will all be here tomorrow… and the day after tomorrow.