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Physicians Practice® spoke with Rachael Sauceman, the head of strategic initiatives for Full Media—a digital marketing agency based in Chattanooga, Tennessee—about how practices can best market their services in the digital realm. 

Digital Marketing for Independent Practices

Physicians Practice® spoke with Hari Prasad, CEO of Yosi Health, about how what practices need to know about setting up and making the most of their virtual waiting rooms.

The Virtual Waiting Room

Physicians Practice® spoke with Dr. Reena Pande, chief medical officer of AbleTo, about the current standards and challenges physicals are facing with care and access solutions.

Combating "Point Solution Fatigue"

Physicians Practice® spoke with Michael Morgan, at the time the CEO of Updox and a contributor to Physicians Practice, to discuss the new technologies that you should consider implementing in your practice and why implementing a virtual care strategy will be so important post COVID. 

The Paperless Practice: Virtual care strategies

Physicians Practice® spoke with Michael Parisi, Vice President of assurance strategy and Community Development at high trust Alliance, about how physicians and practice owners can discern whether or not communications technology they are interested in integrating into their practice is certified secure. 

Certifying Your Communications Technology is Secure

Physicians Practice® spoke with Chuck Lee, MD, about the complications of low patient health literacy levels and how physicians can improve these levels through communications, partnerships, and outreach.

Increasing health literacy levels in your patient populations

 Continuing our focus on Burnout this month, we are featuring my conversation with Dr. Jonathan Wisen about speciality telemedicine and how it might help reduce increased telehealth burdens reported during the pandemic.

 Dr. Jonathan Wiesen, Founder and Chief Medical Officer of MediOrbis wrote, "Approximately 

 have at least one chronic disease, and 77% have at least two, hence the urgent need to enhance and support the adoption of telemedicine and digital monitoring among Medicaid and Medicare Advantage (MA) patients. The Center for Medicare and Medicaid Services (CMS) has slowly come around to this realization, and cloud-based telehealth-based remote monitoring programs for managing chronic diseases are now 

A helpful place to start for this particular discussion is to identify what exactly 'specialty telemedicine' is and

 Telemedicine, telehealth, general telemedicine, and specialty telemedicine mean different things to different people. In our company, when we refer to specialty telemedicine, we're describing a mode of telemedicine which is nuanced, which is specific to an area, and which requires a higher level of expertise. That might be specialty telemedicine, much as you think of clinical medical specialists like cardiology questions, nephrology consultations, and endocrine issues; or it may be a very specific area of focus, like chronic disease management, which is which is unique and requires a level of sophistication and expertise. So, general telemedicine has been around for a long time. It's a well-trodden path. But developing very specific and specialized areas of expertise is something that we've been working on many Orbis.

 One area in which specialty telemedicine may increase effectiveness is in chronic care management.

 One of one of the issues in medicine that we've been struggling with for years is the “silo effect”. Physicians, care providers, patients, and technology have all been working in their own individual areas and domains and there hasn't been good integration between them.

Specifically, weight loss programs have been around from time immemorial. I mean, I remember my grandmother, starting a weight loss program, when I was just a few years old. And that had nothing seemingly to do with some of the programs that we're seeing now. But it was very specific, and it wasn't with the recommendation of precision physician, it wasn't integrated into overall clinical care. And so, when you have a specialty telehealth program, led by physicians like we [MediOrbis] do, it improves patients—not just their particular program that they're involved in, but the overall clinical and medical picture, because it's integrated with care providers.

Digital health has been around for quite some time, and especially over the last few years, we've seen great growth in that area. But all too often we find that it's a path to nowhere, and you may get an alert or a notification that something is amiss, but there's no one to really help you manage that. And so, by integrating everything under the auspices of a physician, or a specialist who's trained and knowledgeable in the areas that you're working under, you're able to not just monitor clinical conditions and give recommendations, but actually manage them from a clinical medical standpoint.

 Telemedicine may present new obstacles for physicians, and specialty telemedicine—with its unique focuses—is no different.

 I think that in any area of telemedicine, you encounter obstacles. But the truth of the matter is that in clinical medicine you do as well.

I've been practicing clinical medicine now for 15 years, and I've been in resource-poor environments and resource-poor clinics. And I've also been in some of the top medical institutions in the world. And everywhere that you practice there are components of the care that you deliver that rely on your surroundings and others that you have to realize, “Okay, I don't have access to those particular components and therefore have to function independently of the area that I find myself in.”

Telemedicine is no different. There are some areas of telemedicine of clinical care that are much better with telemedicine. I find that sometimes you can establish a rapport more easily with telemedicine because you're sitting down, you're focused, there's nothing else bothering you. You can you also have to take a great history.

I’m a pulmonary specialist and patients come to me all the time with abnormal CT scans. You know, the first thing they do is they hand you a disc and then you look at it and sometimes I don't even get to hear their story. Whereas with telemedicine, you're forced to encounter the patient, to interact with the patient, create a connection with the patient, hear exactly what's going on, and then make your clinical decisions. There are certain limitations—I'm not standing next to you, I can't do a procedure if it's indicated, and it could be that there are certain diagnostic tests that I would like that I can offer as well. At the same time, I think that there are great benefits as well. And just like in clinical medicine, if you know what you have access to and know what you don't have access to, then you can practice appropriately for the environment that you find yourself in.

 For physicians looking to use telemedicine to treat patients with chronic conditions, Dr. Wisen says that there are three things you should be striving for in your telemedicine program.

 It's really, really important to put together a program that's intuitive, that's intelligent, and that's easy for patients. You know, I actually taught for four years in between undergrad and medical school and I learned from a great mentor that he said: “It's not important what I teach, it's important what the students learn.” And it's the same idea in medicine: what I say is irrelevant, what the patient does is important. If I prescribe a million medications, and they don't take a single one, I've accomplished nothing.

So, we designed a program, where it's engaging, where it's simple, where it can be accessed from any device at any time, where everything is presented with a nice user experience that the patients can easily access it, they can easily ask for help with just the click of a button. They can interact with staff very simply through technology modalities, or any means that they prefer some of the elderly patients prefer to call up call us on the phone, younger patients, we just want to send a text message and be done with it. Whatever your preferences, that's what we want to provide. And again, it's not really important, what I say it's important what the patient does. And we designed all of our chronic disease programs and our clinical programs in the specialty realm with that in mind.

That's really important for all patients to know that having digital health solutions is not sufficient, having just telemedicine is not sufficient, but having a health record that that can pull in all the information from the different components that can pull in all the information from your physicians, and that can present it in a manner that's simple and easy to access is crucial and integral.

So again, EHR, and we won't get into all of my feelings about EHRs in general, but an EHR is supposed to be an electronic modality for managing your care. And to the extent that it does that, it'll be useful and to the extent that it doesn't do that it will not be useful. And that's exactly how we designed ours as well.

Physicians Practice® spoke with Dr. Jonathan Wisen, Founder and Chief Medical Officer of MediOrbis, about specialty telemedicine for the treatment of chronic conditions and how these technologies can improve a practice's offerings and patient outcomes. 

Specialty telemedicine for independent practices

 Happy Holidays everyone! As you recline into your various festivities, feasts, and celebrations, business should be far from your mind.

If you are one of the lucky few who have downtime at this point in this hectic year,

The offices at MJH Life Sciences are closed for the holidays, but we still wanted to bring you our conversation with Elizabeth Woodcock, founder and principal 

 [and an adjunct faculty at the Rollins School of Public Health at Emroy University in Atlanta, Georgia].

A little fun fact about this special guest: she was actually the 'director of knowledge management' at Physician's Practice from 2003-2004. Our contemporary Pearls writers are a direct result of her work—she originally christened our newsletter 'Pearls', and that title has lived on though migrated to our regular expert contributors.

Earlier this year, Elizabeth joined me to answer some questions about telemedicine. Then, the concept was fresh as most practices were attempting to understand and implement these strategies while simultaneously trying treat through these platforms.

We began by discussing whether or not it is too late for practices to begin setting up those services.

 A great question of the day. And the answer is actually: Absolutely not. In fact, I've worked with physicians who have been up and running literally within hours. Now I know I mean, a decade maybe even a year ago, the technology interface was not particularly user friendly. And, you know, there weren’t great features; but now there are and prices are actually ranging from totally free to monthly subscriptions that are starting at $20 to several hundred dollars. And you know, it's interesting, after we spent a few years kind of all getting EHR systems—which were very, very expensive, this one is a fraction of that cost.

 Good, good. Even for you listening to this podcast right now—whenever 'right now' might be—it is not to late to begin setting up these services.

The next question is: how do you get started quickly?

 Well, I like to go to the horse's mouth. So I would say talk to colleagues, look at listservs that have been very active or like specialty societies, particularly if you're in a specialty and you really want you know, you have some nuances that might dictate specific product for your specialty; your state medical societies; you can do an internet search, but I actually find the best thing to do is to ask colleagues.

Now I will say, Drew, though that the easiest part, maybe the platform actually, the more difficult part is the workflow, like who will answer the phone? How are you going to explain all this to patients? They're used to seeing you in person? What is you know, what is the meaning of all this? Are you going to see new patients? Are you just going to see established patients where you still see in person visits? Are you moving everything to telemedicine? And then what is your scheduling template going to look like? And then Oh, the By the way, how are you going to register patients collect consents, insurance cards, etc.

Now, I don't mean this in any manner to be a comprehensive list, but I think it pays to sit down and just kind of think about like, what, what is my workflow in the office? And then what should it look like when my patients aren't standing there in person. And quite often, of course, my team, my staff isn't standing there in person. And if I may, a couple of like best practices that I've heard from physicians is to definitely sign up every patient on our portal, because this avoids that telephone tag afterwards. Especially since you aren't seeing the patient in person. A lot of the portals now have electronic signatures, you can upload insurance cards, so that can kind of take care of that.

And then the other best practice I've heard is, okay, so there's going to be no shows, right? You have this telemedicine, the patient may not be able to get their video to work. So, another great best practice is to have your MA or your nurse actually initiate the visit. And maybe they can perform like the clinical intake or rooming you know, ask the patient about medications if they have a home blood pressure monitor or ask for their BP, etc. but this really kills two birds with one stone because now instead of sitting there trying to figure out, is the patient going to show up? Do they have the right technology? You are ready know that when you're seeing the patient, the patient is going to be ready for you. So definitely, it was thought I would mention those two best practices from a workflow perspective.

So, when some I think the platform is actually one of the easiest decisions. What really is something you need to work through is the workflow.

 So you've chosen your telemedicine platform, you've planned out your workflow strategies—what's next?

Before you jump right into telemedicine, consider whether or not you can actually be reimbursed for these services.

Physician's Practice® spoke with Elizabeth Woodcock, founder and Principal of Woodcock and Associates, about what physicians need to know when setting up telehealth services at their practice.

Technology and Patient Engagement

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