Video Informed Consent

Using nothing but a webcam, some good lighting, and a script, you--the doctor--can video an informed consent discussion for any number of procedures you perform and show it to a patient when appropriate.  This way the patients get the information they need to make a decision, that information is complete, but you as the doctor get to save your valuable time.

Win, win.

The procedure video do's and don'ts

With extremely low production costs, almost anyone can make and distribute a video for both educational and promotional reasons.  While a very powerful tool, the video can also cause more harm to your practice them help it.  Here is what to avoid:

• don't be too graphic.
• don't be too long
• don't show too much blood
• don't show injections or needles
• don't show incisions
• don't show a sloppy work station

Do the following:

• edit
• use good sound quality
• use voice over
• use captions
• use transitions
• good lighting
• ask a lay person to review it

How to make it:

• iPhone
• iMovie
• iTunes
• iPhoto

i dun now.

Lot's on my mind. Lots.

I hate the phone

I hate the phone.  There I said it.

Have you ever noticed that everyone has a cell phone yet no one answers theirs?  There are a myriad of reasons why people don’t answer their cell phones; they don’t hear the ringer, they are on another call, the phone is in a no service area, they are busy with something else, etc.  I don’t answer my phone either.

People no longer even answer their home phones.  My own family never answers the phone.  The running joke in my house: if I ever find my self in jail and I get my one phone call, I’d better not waste it on calling my house.  The phone, which once was the most efficient means of communication ever, is now among the worst.

As a doctor I find this very annoying n many levels.  Patients have a right to get their test results in a timely fashion.   I have an obligation return patient calls and to contact them with test results.  It is more than that, however.  I have a desire to be able to connect with my patients.  The phone unfortunately no longer serves this need.  

Typically, here is how most doctor/office—patient calls go these days:

·      Patient calls for doctor—doctor is with patients—take message

·      Doctor call back patient—voice mail

·      Patient calls back—doctor unable to come to phone

·      Doctor calls back again—voice mail

And on and on it goes until either the call gets through or both parties give up.

Is there a better way?  Yes, for everyone else.

But not for doctors.

Why?  Because email is not HIPAA compliant. 

Yet email is the best means of communication ever developed and would serve both doctors and patients needs simultaneously with efficiency, thoroughness, and elegance. 

But email is not legal.  But secure messaging is.  Fortunately we live in America, the land of entrepreneurship and companies have moved in to fill the void and meet the need.   I have been using one such company, which is still in Beta, and have already dramatically reduced the phone call nightmare cycle.   I am happy.  Patients are happy.  And I can even return calls when needed with more ease because the sheer number of calls and call-backs are so dramatically reduced.

Embrace it. 

Lycopene: Good for prostate health

There is some decent evidence that suggests that diets rich in lycopene can protect against prostate cancer. Lycopene is found in tomatoes.

Coverage?

What is coverage? The answer is that it varies. To a surgeon in the OR it means having an assistant. To an attending at a teaching hospital, it means having residents take care of their patient in-house. To a private practice doctor, it means having someone take care of patients when you are away.
If you take ER call, coverage is very important. Coverage in this case enables you to take vacation once in a while.
If you are in a group, coverage tends to not be an issue, unless of course you are doing the majority of covering for your partners as they vacation. This can lead to bad feelings.
As a solo doctor, coverage is vital, yet in many ways easier to come by than when part of a group. In many areas, ER call is valuable, so it is easy to give away. This means as a solo doc you can get away when you want.
Technology has made coverage less vital as well. With cell phones and EHRs, mundane tasks like rx refills and lab checking are non issues. With several minutes a day at a netbook, you can keep up to date and avoid the dread of the first day back mile high chart build up.
Yeh, life is good.

How to Attest For Meaningful Use

I just attested, successfully, for 2012 EHR meaningful use.  I can tell you that this has been no small feat.  I started the process in January 2011 and was it took me almost 20 months to get it right.  And I am a savvy EHR user.  Attesting for MU dollars is a process.  First you must register, then you must report for a 90 day period, then you attest.  Oh yeh I forgot, first you use select a qualified EHR & learn how to use it in a meaningful way.

CMS, the Center for Medicare Services, has lots of documentation on there website regarding MU, attestation, EHR selection, etc.  Click here, https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/index.html?redirect=/EHRIncentivePrograms/32_Attestation.asp to be taken to the site.  I know you will find tons of information on the site, just not a bit of it helpful.  I don't know who developed the content for the site, but either they were oblivious to the needs of the people who use it or intentionally made the site confusing to make especially difficult to start and complete the MU process.

The real link, the one you need to get the $$$ is here: https://ehrincentives.cms.gov/hitech/login.action
I just don't think CMS wants you to know it.

Here is how to do it, step by step:

• Register for MU at the link above
• you must have a NPPES password to do this.  If you do not, you must get one.  If you cannot, you are SOL.
• Answer the questions asked
• Find your EHR number (ask vendor or search on the EHR incentive site.
• Complete MU reporting process
• Return to link, complete questions, hit submit.

Sounds easy.  Is not.

Good luck.