1. Ronibats.ph

Dr. Ron Baticulon is a pediatric neurosurgeon with an impressive resume and a wonderfully sensitive writing style that manages to convey all the drama of his profession without straying into trite territory. His family’s story alone was deemed gripping enough for a feature on national TV—he comes from a family of 5 children, all valedictorians—but even his professional anecdotes are gripping. He writes about a wife who lost the money for her husband’s hospital bills to muggers, for example, and does so in a way that shows a very real glimpse into the lives of the people trying to save ours.

Dr. Baticulon’s Twitter account: @ronibats

2. The Endocrine Witch

This very active blog is run by Dr. Iris Thiele Isip Tan, who drags so many initials after her name that one has to wonder how long it takes to write them down properly. The blog won recognition in the 2015 Philippine Blog Awards, where it was named the People’s Choice for the Health and Fitness category.

There are a lot of things to like about Dr. Tan’s blog, as she covers a wide range of subjects pertaining to health and medicine in the country. Of particular note are her interests in patient data privacy and medicine in relation to current technology. For instance, whereas most doctors are quick to voice annoyance with patients self-diagnosing through online research, she takes a measured stance that advocates doctors becoming more Internet-friendly. This and this may be something you want to show your physician the next time he insists on you not looking up health information on Google.

Dr. Isip-Tan’s Twitter account: @endocrine_witch

3. The Cast and Curious

Run by orthopedic surgeon Dr. Remo Aguilar, this blog covers a lot of very modern subjects, from Health IT to social media in healthcare. Dr. Aguilar asks a lot of very interesting questions in his field, including whether or not it is ethical for physicians to self-advertise on social media and how healthcare professionals should respond to social media posts that pertain to their profession. Take note that Dr. Aguilar is also one of the founders of HealthXPH, another of the blogs in this list.

Dr. Aguilar’s Twitter account: @bonedoc

4. HealthXPH

HealthXPH is a blog born out of the collaboration of various parties of interest in local healthcare—this includes the patients, take note. Some of its founders have blogs in this list (like Dr. Tan of The Endocrine Witch and Dr. Aguilar, listed just above).

This is a very active blog and offers a lot of deep insight into the ever-evolving field of healthcare. They regularly post material on topics like doctors as patients and the problem of congestion in hospitals, then continue the conversation in tweetchats. This is a great place to visit if you want to be more socially active in the conversation regarding healthcare.

The HealthXPH Twitter account: @healthxph

5. Stef Dela Cruz

This entry sticks out in our list because even though it is a blog run by a doctor, she happens to be a non-practicing one—and it’s okay. Dr. Dela Cruz actually has a Health Media Award from the Department of Health, as well as a finalist’s position in the 2015 Philippine Blogging Awards. If you take a look at her blog, you see why none of this is surprising: she provides a fount of practical health insight by tackling such locally-relevant topics as glutathione for skin whitening and digital dementia.

Dr. Dela Cruz’s Twitter account: @stefdelacruzmd

6. Medical Technology Avenue

Yes, yes, this is technically a blog run by a medical technologist, but it still offers enough value to be put in the list. Janey Danes talks about a lot of practical matters in medicine that could benefit you. For instance, her latest post detailed the possible side effects of withdrawal from Alprazolam, which happens to be among the most commonly-prescribed medications for anxiety and panic. She writes her posts in a very logical and reader-friendly manner, which further highlights the practicality of most of her posts.

Janey Danes’s Twitter account: @neffyjane

7. Sleepless in Cebu

Dr. Helen Madamba is a Cebu-based doctor who also teaches medical students. She provides an insight into the world of physicians training other physicians, into the conferences and structures that go on in that world, and ways healthcare professionals can improve at their jobs. This does not mean that she writes posts exclusively for that audience, though: she also provides data on matters like the Philippine HIV Epidemic, for instance.

Note that Dr. Madamba and Dr. Sison (below) are also behind the HealthXPH site, by the way.

Dr. Madamba’s Twitter account: @helenvmadamba

8. Sand and Stone

Sand and Stone is a doctor’s blog, but it is really more about life in general from the perspective of a doctor. Dr. Gia Sison provides some very sincere and touching posts on many topics, though, especially that of her struggle through cancer.

This is a nice blog to read if you need a shot of something life-affirming. Dr. Sison actually writes more like a Zen philosopher or yogini than an internist, and her positivity may well rub off on you.

Dr. Sison’s Twitter account: @giasison

9. FLARE

Dr. Allan Corpuz, aka the Rayuma Doktor, writes about technology, his love for photography and uses the blog to further educate patients about gout, arthritis among other things. You can read more about his story on his about page here.

Dr. Corpuz’s clinic hours and contact info: Click here

Updated: September 2019

The post The Top 9 Philippine Doctors’ Blogs You Should Be Reading appeared first on SeriousMD Blog.

80 of Central Maine Healthcare’s 300 physicians were alleged to have left this year due to discontent with an EMR, for example. Many studies have also linked EMR use to increased physician burnout. The late Pulitzer-prize-winning journalist Charles Krauthammer even called the EMR “healthcare’s Solyndra”.

There are many sources for the tension EMR adoption appears to cause. We’ve addressed some of them before. In this article, we’re focusing on one of the most important: the challenge of process integration.

At its simplest, process integration asks if the organization’s workflow is a match for the EMR’s. Can the EMR be incorporated into the practice’s way of doing things? Can the practice’s existing processes be made to fit into or work with the one built into the EMR?

This is critical in deciding how people respond to an EMR. When a mismatch happens, tension arises. In fact, reviewing the different studies of doctors complaining about EMRs, this is the chief source of trouble: “It’s not the way we do things.”

Of course, not all change coming from EMR adoption is viewed negatively by healthcare professionals. Consider the following passage from a study of how EMR/EHR usage affects physicians’ decisions to continue practicing at their hospitals:

Results suggest that when EHRs create benefits for doctors, such as reducing their workloads or preventing costly errors, their duration of practice increases significantly. However, when technologies force doctors to change their routines, there is an obvious exodus, though it’s more pronounced with older doctors, especially specialists, and those who have been disrupted in the past by IT implementations.

So changes can be tolerated if they are mitigated by a benefit. In some ways, those changes might act more like facilitators. On the other hand, the changes that bring no benefits are viewed as disruptions (which admittedly brings to mind Christensen’s seminal theory of Disruptive Innovation—a suggestive association!).

What Is Disruptive About EMRs?

The best way to answer this question is to look at the users’ complaints. These tend to differ because preferences and EMRs vary. There are some commonly-brought-up remarks, though. Consider the responses to our survey of Philippine doctors who have already tried EMRs. Some of the most commonly-given complaints have been represented in the quotes below:

“I used a local software that was being promoted in PGH. I tried it, started to use it but there were no updates and it was inconvenient to use. I sent my feedback and they never responded.” – Oncologist from Baguio

“I used an EMR from a US software company. It’s fine, but it’s not tailored for local and it has been in beta for years. Not many big improvements over the past years.” – Ophthalmologist from Taguig

“I came from an Australian-based app company. It fit my needs with managing the schedules and patients but the notes were limited. I used them for a year but switched because it was obvious that they were not going to add anything specific for doctors.” – Obgyne from Makati

Other common complaints include the following:

• Cluttered interfaces
• Non-user-friendly design
• Lack of simultaneous access (for physicians and their nurses)
• Excessive alerts (some EMRs don’t let users filter their messages/alerts, which leads to added work when the application sends the user hundreds of messages that he must wade through just to find a few important alerts)

This screenshot of cluttered EMR interfaces was taken by Juhan Sonin, an aesthetic designer and Creative Director of Involution Studios. Sonin had been inspecting EHR booths at the HIMSS Conference ’08 and described most of the programs’ usability and design as “horrid” at the time. Doctors are still saying the same of most EMRs today. Image license here.

All of these indicate a process issue. Just think about it:

An EMR is inconvenient to use when it gets in the way of the user’s routine.

It’s inapt when it isn’t designed to meet the more specific (sometimes location-sensitive) needs of its users.

It’s a hindrance when it doesn’t let users take the notes they need or permit staff access as required.

In other words, the problem is that there’s no synergy between the process preferred by the EMR and that preferred by the users.

Who Should Make Changes?

So what should you do when the organization endorses one method of doing things and the technology endorses another?

Generally speaking, it would be wiser for the technology to adapt. Adjusting tech is usually easier than forcing change on organizations (and the people in them). Besides, there’s also the matter of who’s in charge when determining the way an organization should work.

If you make the organization adapt to suit the tech, that essentially gives outsiders (the tech developers) the final say on the topic. That doesn’t make sense when they don’t actually work in healthcare: they’re typically programmers, not physicians/nurses. They lack the sustained, in-the-trenches experience necessary to make determinations like that.

Outsiders like businessmen and developers can have useful insights for a hospital’s staff, but they shouldn’t run the show.

Some developers work with physicians when creating their programs, of course. We certainly did, and other serious EMR providers have done the same. But there are problems that can crop up even then.

1. The resulting EMR may be geared too specifically towards a particular organization’s way of doing things. This goes back to the fact that different doctors/teams have different processes. If the EMR developers tailor their program too closely to just a small number of doctors’ (the ones they work with) preferences, they may end up alienating other users with the end product.
2. The physicians chosen for feedback and consultation may not be representative of the EMR developer’s target market. What if they happen to use processes that are wildly divergent from the ones used by most other doctors in the target market, for example? Again you get a product that doesn’t cater to its target users’ needs.
3. The developers’ feedback loop may not be conducive to actual improvements in the development process.

These are just a few of the possibilities. Even if all of these could be overcome, there remains a deeper issue. After all, there’s a critical assumption we’re making here: that the processes employed by the end-users are actually ideal.

But “ideal” isn’t a reality we face often.

Current Healthcare Processes Could Be a Problem Too

A recent article from the Harvard Business Review raised this point. Writers John Toussaint, MD and Kathryn Correia noted that there may be an inherent problem in the US healthcare system’s processes. Many of them are technically under-efficient, non-standardized, and of questionable efficacy.

According to the article, the processes tend to be individual-dependent, not system-dependent:

The hard part is to get the doctors, nurses, and administrators to agree on what is the best way to deliver the care. Since the doctors control most care decisions, the rest of the provider team follows the doctors’ lead. If the doctor wants to do things a certain way, that’s what is done. The problem is the next doctor wants it his way and so on. Eventually, we end up with a hopeless mess in which no one knows how anything should be done on any given day. And good luck to a new nurse or technician coming into the system who must learn a multitude of work processes and remember the doctor-dependent differences.

If this is true, it would show even more often in large organizations than in small, independent practices. That’s because there are more physicians involved in the former.

This is definitely the case as well for other countries, including the Philippines.

How We’re Dealing with Process Integration in the Philippines

I could continue to go on and cite different references or I could just talk about how we are dealing with EMR process integration.

Like what I mentioned at the start, process integration mainly asks if the organization’s workflow is a match for the EMR’s.

Does the workflow FIT with what the EMR can offer or can the EMR be adjusted enough to FIT the existing workflow? To cap it off, it needs to have a clear benefit for the users.

As long as there’s enough visible benefits, physicians will tolerate, forgive and work with the software but at the same time, there needs to be trust that the software vendor will continue to improve and make the physicians’ life easier in the long run.

It’s a fine balance and both sides will have to work together.

One of our goals for the past years with SeriousMD was to better understand the needs of the Filipino physician. To understand the different workflows and to build that trust by showing that we are improving and that we continue to innovate.

It’s not perfect. We’re not perfect, but it’s good enough. We’re still improving and we continue to do so each and every day.

SeriousMD at this point can be plugged into almost any workflow and be configured to adapt to different needs, locations and use-cases.

At the end of the day, our users from all around the country are our testament. They come from all sorts of fields, backgrounds and practice types. They all have their own workflows, forms and more. We’ve learned and we’ve made sure to hone SeriousMD to be able to adapt to their different needs.

[metaslider id=1990]

The post Solving Process Integration Challenges in EMR Adoption appeared first on SeriousMD Blog.

Stanford Med’s experts are positive about the future of healthcare thanks to increasing health data.

Stanford Medicine’s Health Trends Report has just come out, and continues a theme it previously touched on last year. According to the report, there are 3 key influences driving the democratization of healthcare today: intelligent computing, information sharing, and data security.

As the healthcare data we have available continues to accrue, experts foresee a future where healthcare becomes more prevention-focused. There is still much work to be done in order to make more of the data truly usable, of course, but the authors of the report are optimistic about what is to come.

New Digital Health Interventions Being Developed to Counteract Social Media’s Dangers

The place of digital health interventions, diagram from Amnesty Lefevre.

Social media’s ironic tendency to increase loneliness (among other things) has spawned myriad attempts to mitigate some of the worst mental health issues associated with users’ feelings of isolation. Facebook’s attempt to monitor teenagers’ content for signs of worthlessness and insecurity, for example, as well as the Betterhelp counseling service. Both have come under fire, however, due to criticisms of privacy violation and monetization of mental health interventions.

Fortunately, new solutions are being developed that show better promise. Wisdo, for example, is a social network that tries to connect users with others who have gone through the same thing they have. This may place more control in the users’ hands while also giving them the nurturing support networks they need over a digital channel.

US’s Affordable Care Act Signups Down Compared to Last Year

Lowered signups worry US officials this year.

US officials have reported almost 20% fewer new signups for the Affordable Care Act this year compared to last year. This could mean a rise in the number of uninsured Americans is coming after previous years’ insurance expansion. It could also mean bad news for the insured later, as insurance premiums tend to be most stable when there is a steady influx of new sign-ups.

While some say this points to lower interest in government-subsidized coverage, others also note other factors like the following: the Trump administration’s weak promotion (compared to the Obama administration’s) of the ACA, the repeal of the fine for not being insured, and persistent fears over immigration from would-be-sign-ups with green cards.

Ghanaian Physicians Protest Government’s Medical Drone Service

Drones like these are going to be carrying medical supplies in Ghana soon.

At first glance, it looks like something that would get physicians’ approval: a state contract that will have drones delivering medicine and medical supplies to underserved parts of Ghana. However, the $12M agreement has been disputed from the beginning.

The Ghana Medical Association or GMA has protested the initiative, echoing concerns from the Ghanaian parliament’s minority that it smacks of misplaced priorities. According to the GMA, modern healthcare technology should augment current systems. Even if drones are employed to deliver medical materials, they claim there will be few benefits reaped if current human resources and referral systems are not improved simultaneously.

In spite of the opposition, the project shall push through thanks to a parliamentary vote of 102-58 in its favor. Supporters argue that the drones shall make a big difference for medicine and health supply access among the country’s inhabitants.

The post Best Medical News for December 2018 appeared first on SeriousMD Blog.

The discussion around the subject (as well as the term itself) of “give-up-itis” is one of the more interesting happenings in the medical scene at the moment. These were largely sparked by a paper from University of Portsmouth senior research fellow Dr. John Leach. Available on pages 14-21 of Volume 120 of the Medical Hypotheses journal, the article is entitled “’Give-up-itis’ revisited: Neuropathology of extremis”.

In the paper, Dr. Leach discusses psychogenic death and its usual connection to trauma. Besides detailing 5 stages in the process—which can take place over a period as short as 3 days, he claims—he also suggests a somatic cause for this fatal psychological decline. The brain’s frontal-subcortical circuit (critical to goal-direction and hence, motivation) may undergo a malfunction or change, he proposes. This change severely impairs the person’s capacity to live, leading to psychogenic death.

The Responses to the Price Hike for Nitrofurantoin

When Nostrum Laboratories implemented a price hike of over 400% for its liquid preparation of nitrofurantoin last August, strong reactions were predictable. The antibiotic in question went from costing $474.75 to $2,392 a bottle. Soon after the Nostrum CEO’s explanations for the hike—which included citing a “moral requirement to sell the product at the highest price”—responses flowed in, including from US FDA commissioner Scott Gottlieb:

1/2 Regarding @FT story today @bydavidcrow; there’s no moral imperative to price gouge and take advantage of patients. FDA will continue to promote competition so speculators and those with no regard to public health consequences can’t take advantage of patients who need medicine

— Scott Gottlieb, M.D. (@SGottliebFDA) September 11, 2018

Both the Infectious Diseases Society of American and The HIV Medicine Association have also issued condemnatory statements, calling it reflective of “opportunistic greed in its most indefensible form”.

The incident has parallels in the 2015 Turing price hike for Darapram under the leadership of Turing’s then-CEO, Martin Shkreli. Turing raised Darapram’s price by a factor of 56 (from $13.50 to $750 per pill).

Improvements in Cryptosporidium Research and Vaccine Development

The microscopic Cryptosporidium parasite has long been a problem for researchers. Developing drugs and vaccines for its treatment has been difficult because its oocysts (the infectious form of the parasite found in a host’s small intestine) could not be produced in controlled conditions. Even oocysts grown in host animals were difficult to preserve for long-term use and study because they tended to lose their infectious quality following cryopreservation.

Recent discoveries involving oocyst bleaching and vitrification have changed that. Researchers can now produce uniformly cryopreserved oocytes for study and distribution to the various labs dedicated to finding a vaccine for the enteric sickness caused by Cryptosporidium.

The Discovery of Three New Types of Neurons in the Inner Ear

Researchers at Sweden’s Karolinska Institutet have just discovered that one of the 2 neuron types in the inner ear is actually composed of 3 different neuron types itself. This means that there are at least 3 different pathways to the central auditory system, not one. The discovery may pave the way for an improved understanding of the way the auditory system functions, as well as better therapies for those with hearing impairments.

Dr. Francois Lallemand, the leader of the group doing the research, has also noted that their discovery may eventually “lead to the development of better auditory aids such as cochlear implants”. Since the newly identified neuron types seem to be involved in decoding sound volume, those studying hearing disorders like hyperacusis may gain the most fresh insight.

The post Monthly Roundup: The Best Medical News for October 2018 appeared first on SeriousMD Blog.

How does that work out for a clinic in the Philippines? Let’s say for now that each appointment nets you ₱PHP 300 in revenue and you get 13 patients per day.

These are modest figures, but we might as well start with them. No-show rates vary all around the world. Generally speaking, practices will see anywhere from 20-40% no-show rates in their schedules.

Now assume a no-show rate of 30%. In this scenario, you would be losing around ₱7,200 a week just from no-shows. That’s up to ₱374,400 a year.

That is how no-shows represent potentially millions—if not billions—of pesos lost yearly by healthcare. Even in the US, they cost clinics as much as $150 billion. It’s not hard to see how the costs mount:

• After a patient misses an appointment, you now have an unproductive block of time in your day.
• The resources you spent on preparing for the appointment (medical supplies, staff labor, time retrieving and reviewing his files, etc.) have been wasted.
• The patient who missed the appointment could have gotten worse, which means more medical costs for him in the future.

But this goes beyond you and that one patient. It even affects your other patients, some of whom might be in greater need of care. Usually, you can’t fill in a no-show’s appointment slot promptly with a replacement. That represents lost hours that could have been spent helping others who require urgent attention.

Fortunately, healthcare professionals and the tech sector are working together to solve this. Medical workers are learning to use—and in some cases, even develop—new tools and practices that can help reduce no-shows.

Efficacy rates vary, of course, and techniques may not be applicable to all clinics. However, implementation may still be the better course than otherwise, as we shall see below.

Techniques Used to Drop No–Show Rates

A lot of solutions have been proposed and attempted for the no-show problem. Some have been positive (in terms of encouraging patient presence through reminders) and others have been negative or punitive (in terms of discouraging patient absence through penalty).

This list excludes methods such as double-booking or waiting lists for last-minute appointments. This is because those would fall under techniques for mitigating no-show costs, not lowering no-show rates via prevention.

Finally, note that the methods below aren’t necessarily exclusive. Indeed, a fair number of practices use combined systems.

Text Reminders

This is one of the most popular methods at present for no-show prevention. This may be due to the following reasons:

1. Text messaging systems are often present in modern practice management software.
2. Text messaging is easy to set up, even without using a system integrated into the clinic’s practice management software.
3. Most patients have regular access to cellphones.

The third item is particularly strong in recommending text reminders for Philippine clinics. While not all Filipinos yet know how to use email or bother to check it regularly, many of them do read text messages. A 2017 survey showed that 8 out of 10 check their mobile phones first thing after waking up.

For this reason, we used text messaging as the method for our own study. 15 doctors participated, using text reminders to reduce patient no-show rates. Patients would receive 1 SMS notification the day before their scheduled appointment. In order to be counted in the total appointments completed by the physician for the day, each patient had to be marked in that physician’s queue as “finished”.

An example of a text reminder sent by the SeriousMD app.

The doctors tested the notification system for 2 months. The control data for the experiment was taken from the 2 months prior to those. The average sample size for both groups was 3,000 patients (for every 2 months), granting an aggregated sample size of 6,000 for the study.

To ensure compliance with data protection laws, all patients also consented to receiving notifications upon registering in the SeriousMD system. All were given a way to opt out of notifications too.

The data was separated within each group for weekday patients and weekend ones. Weekday patients came on days from Monday to Thursday; weekend ones, Friday to Saturday. Note that there were about twice as many patients on weekends as on weekdays.

The results showed marked improvements in attendance, as may be seen in the table above. This generally agrees with most of the other studies on text messaging for improving patient attendance.

Voice Reminders

There are two general types of voice reminders:

1. one is the standard or manual phone call, which is performed at the moment of contact over the phone;
2. the second is the recorded voice message, which may be spoken before the moment of contact and is simply delivered as a saved recording.

Voice reminders bear some similarity to text reminders but require more time and effort to arrange. Text reminder creation can be largely automated. By comparison, most voice reminders have to be created individually. This makes them less desirable as a no-show reduction technique for clinics where staff hours are especially precious.

They may have their virtues, however. Voice notification systems are often seen as very effective. A meta-analysis of relevant studies published in 2016 actually found them better at improving patient attendance when compared to text notices. An older review (from 2011) came to the same conclusion, with manual phone calls showing better results than automated text reminders (39% vs. 29%).

There are hybrid models being developed as well. A 2011 study compared interactive voice response systems to traditional nurse phone calls in reducing nonattendance and ill-preparation. The results showed both methods to be equally effective.

Interactive voice messaging allows prerecorded systems to deliver an almost personal experience for patients… but may cost a lot to put in place.

Interactive voice systems may be a new twist on the voice reminder that could pay off. Still, as they still require more effort to create than their text alternatives, they remain lower on the list of options for most clinics.

Email Reminders

Email reminders may technically be the cheapest-to-implement of all the methods in this list. The two negative methods listed later in this list have potential costs associated with them, by comparison. As for text and voice reminders, you typically have to cover their costs in a phone service plan. Email, on the other hand, can be more or less free.

As mentioned earlier, email doesn’t have the same reach SMS does in the Philippines. Still, numbers are improving. The Asia Digital Marketing Yearbook showed that as many as 34% of the population were going online daily by 2012, with the top activity for users being email.

SeriousMD actually has email broadcasts (and SMS broadcasts) too. The cheapness of the medium is a definite consideration for many doctors. The relative ease of use can may be another (copy+paste and typing may be even easier than for SMS, although an option to have recurring reminders is actually built into the SeriousMD system for convenience).

Whether or not email can be effective at averting no-shows is still up in the air. Not a lot of studies have been conducted on it. One rare study did show some promising results, though: in a sample of 73 patients sent emails about their appointments, 22 professed to have known about those appointments only from the emails. This suggests that email can still be a good preventative for no-show patients.

Patient–Dropping or Termination

This is one of the punitive methods mentioned before. It refers to the practice of removing patients from your clientele as a response to repetitive no-shows by those patients.

This is not a common method for reducing no-shows. In fact, there are hardly practices in the Philippines that do it. You are more likely to find some overseas, but even there it’s rare.

There are myriad reasons for this. Perhaps the most salient is that most consider it a drastic option. It could have serious consequences for the patient and his health (especially if circumstances make your practice the most easily accessible one for him).

It can even have legal circumstances for you. If you choose to terminate a patient from your roster in the middle of his treatment, for instance, that might ostensibly count as patient abandonment. This means you may well need to have a legally-defensible policy for it ahead of time.

Another thing to consider when terminating patients is the manner in which you carry it out. A very polite and clearly worded letter is generally advisable. Anything less inoffensive (or blatantly emotional) could bring on very serious problems.

An extreme (if overseas) example of the possible trouble less-than-politic patient dismissal can bring on a doctor is in the Gallogly-Stipe incident from 2017. In this incident, a doctor came under investigation as well as public criticism following a flare-up with a patient that was caught on camera.

Of concern too is the possibility that the doctor above may have violated state law in essentially refusing treatment of the patient.

Monetary Penalties

Making patients pay for not showing up is another controversial resort. It is still unusual even in the US, in fact: not even a decade has passed by since Medicare began accepting such penalty payments. Some clinics attribute lowered no-show rates to it, nevertheless: one such practice, charging $50 per penalty, claims to have seen nonattendance down from nearly 200 to 44 per month.

Penalty prices vary. The US’s National Institute of Health claims it to often be around $35 to $50. Numbers are not yet available for the Philippines; we ourselves found no clinics imposing such penalties yet in the country.

Penalties aren’t always applied for each nonattendance either. Some clinics only impose them after two instances of nonattendance for a patient.

Efficacy of Techniques

More controlled studies comparing more of the techniques to each other are still needed. With what data is available now, however, it would seem that voice notifications and text notifications are the most effective. Both have been shown to reduce no-show incidences in various cases.

Voice reminders tend to post better no-show reduction rates than text reminders. Part of this may be due to most voice notifications still being made manually: patients thus get to interact with a living person in a direct phone call, which signifies greater social and personal investment.

Further, manual voice reminders are often handled by clinic receptionists and secretaries. This makes it feasible for the patients to reschedule appointments during the call itself.

However, voice reminders tend to have low contact rates. Text reminders have far better ones (30% to 60% vs. 97% to 99%). When contact rates are not considered a factor, text reminders appear to be the better option. At least one study showed even email to be preferable to voice reminders in that sense, with 5.9% of recipients still failing to show up (vs. 4.4% for text reminder recipients and 9.4% for phone call recipients).

The punitive or negative methods of reduction are actually the most difficult to study. So few clinics use them that reduction rates can’t yet be properly measured.

Final Notes and Recommendations

Different no-show reduction techniques have different rates of efficacy; combining them may be a good way to reap greater benefits. Many clinics are now turning to combined reminder systems, for example, such as text reminders supported by voice notifications. This may be a good way of improving no-show reduction rates as it would raise the chances of contact.

The problem with this would be the cost of implementation. Not all practices can afford to institute two notification systems in one go. When this is the case, one shall have to do. The choice of which to use shall depend on the practice’s resources again: if sufficient manpower is available for it, voice notifications may be advisable, given their high efficacy when contact is achieved. Otherwise, text notifications are very likely preferable.

As for the punitive methods of no-show reduction, they may well have their place too. But for most practices, it may be best to consider them an absolute last resort. Certain situations may also render them problematic to execute, based on legal strictures.

There are alternatives. For instance, practices might send patients a notice drawing attention to their nonattendance and requesting them to call and cancel appointments in advance instead. Supportive techniques, such as the creation of a list of patients willing to come in for impromptu appointments, might also be of worth.

The post How Practices Can Easily Reduce No-shows by Over 35% appeared first on SeriousMD Blog.

1. Combining formerly disparate systems can save time when accessing them.
2. Using a single software solution for different processes lowers the costs of staff training.
3. Staff collaboration is easier as information does not have to be manually merged across different sources.
4. Inventory management becomes easier across the board.
5. Accounting becomes faster with all financials on a single resource.
6. You can generate your own reports on demand and make use of those analytics as needed.

ERP is therefore something that can benefit many a business—including, of course, medical practices. This is why we built it into SeriousMD.

In our app, you can more or less divide ERP into the following categories:

1. Catalog Management
2. Reports
3. Inventory
4. Billing Practices

Here we shall show you the basics of each category when using the SeriousMD ERP.

Catalog Management

The Catalog is where you can list your services and their prices for quick accounting later. Having them here means you can bill patients for them in just a few taps. No need to enter item, package, or service names or prices individually. Just choose them from the list you saved and you are good to go.

To start, access the Catalog tab. You need to go to the Billing module on the app for it.

Here, you can add items as well as search for and sort them based on type (services, items, or packages). You can choose to add descriptions for entries besides adding their standard retail prices (SRPs).

Note that you may also add different entries for the same thing but with varying prices based on the HMO, as in the image above. To see the entries for just one of those HMOs, you can use the drop-down filter box, as in the picture below.

The app also keeps track of which patients were billed entries in the catalog. Clicking on a particular entry (say, the “consult” service, as in the image below) will yield a detail page for it. You can then choose between the HMO Rates and Sales tabs on that page to see more information.

Reports

Now say you want an even more detailed history of your transactions. All you have to do is go the Reports tab (still in the Billing module).

Here, you will find filters that let you sort entries according to your needs, whether based on the report type, clinic, time period, or even HMO.

This puts key business figures right at your fingertips. You would be surprised how many practice owners cannot tell you how much profit they made in the past year. With SeriousMD reports, you can always answer that question in a flash.

Inventory

You can also use the app to keep track of your practice’s inventory. The Inventory tab is still under Billing and is divided into the Stocks and Transaction lists. It has filters too for advanced sorting, as well as quicksearch. It also lets you sort items by location/clinic. It even has reminders. This makes it simpler than ever to know what is going in and out of which clinics.

Adding items to it is as easy as clicking on the “plus” sign at the top right, next to the print icon. Then, simply fill out the fields (seen below).

Billing Practices

As for billing itself, you can do it right from a patient’s page. Simply choose the “Manage Billing” option.

This should take you to the Billing module’s page/records for that particular patient.

Here, you can add a bill for that patient. Note that you can actually consult your catalog on the same page (the section on the right), to make adding items easier.

Clicking a bill will take you to a detail page. You can check items to make sure everything is correct and also save bills without settling them (for those who let patients pay later). If you do save the bill without settling it immediately, all you need to do is return to the page later and click on the billing item again to access it.

Say your patient pays the bill immediately, though. You can save the bill and settle it in a flash using the module. You can also note the method of settlement, for recording purposes.

After a bill has been settled, it gets moved to the History tab in the Billing module. You can access this in two ways. First, via the patient’s page, as below:

Or you can access it from the main Billing module’s History tab (which means without having a patient selected, so you will see all entries for all patients and clinics there).

Note, finally, that the billing practice on SeriousMD allows you to only void or reissue entries once they have been committed. Why? Simple: so you have a reliable audit trail.

This should cover the basics of ERP usage on SeriousMD for now. This is only the beginning, though: we’re actually working on more, like tracking HMO receivables through the app.

For now, give the items we listed above a try. You do not need to take on all of them at once: the beauty of SeriousMD’s design is that you can choose what to use and not have to worry about the rest until you decide to include it. Remember, if you need more help with the app, just consult our FAQs. For those interested, you can also schedule time with us to learn more about the app.

The post ERP 101 for Doctors on SeriousMD appeared first on SeriousMD Blog.

Hence the question: with benefits so uncertain, why should an already-pressed-for-time physician still bother with social media?

For one, because the future of social media itself is not uncertain. The networks that make up this part of the online world are still expanding, having leapt from a userbase of 0.97 billion in 2010 to 2.46 billion in 2017. By 2020, the estimate has it reaching 2.95 billion—which means about a third of the globe’s population.

What of the Philippines? The number of social network users in 2017 was 38.87 million; by 2020, it will be 47.33 million.

Those are only user numbers. By actual usage hours, we even lead the world (at least, according to 2017 data). Filipinos spend an average of 4 hours and 17 minutes a day on social networks. The closest contenders, Brazilians, spend only 3 hours and 43 minutes a day on it. Americans spend only 2 hours and 6 seconds.

The Digital in 2017 report shows us at the top of social media usage internationally.

Even more interesting is this: 2017’s Philippine Trust Index revealed that Filipinos who do have online access tend to trust social media more than traditional media now. 9 out of 10 trust the former, while only 7 out of 10 trust the latter.

All of this indicates that social media is a serious portion of Filipinos’ online worlds. Many of them use it; many of them trust it. And as far as we can see, it looks like even more of them will be using and trusting it in the future.

Any Filipino building an online presence—and that should include most doctors now—would therefore be unwise to ignore its current and potential power.

Posting for Your Practice

Patients can (and, if they happen to be millennials, often do) look you up online nowadays. Your social media accounts will obviously be among the references that show up. Some patients even recommend doctors to others now by sending them links to their doctors’ sites or social media accounts. Depending on what people see, they might be more or less inclined to choosing you as their doctor.

Having a presentable, well-managed social media account can be a help in that respect. As Internet access increases in the country, so does the import of your online identity. Your social media account can become a vital part of that (professional) footprint.

Now the question: How can you build an online trail that leads more patients to your practice using social media?

1. Get on the biggest social media network(s).

For most, that means Facebook, YouTube, Instagram, Twitter, and LinkedIn. Realistically, though, a lot of doctors will not have the time or inclination to manage accounts on all these. There are workarounds:

1. Assign social media account management to one of your staff as a minor duty.
2. Use only one social media account/network and focus your attention on it.

If you choose the latter option, Facebook is the best, being by far the most popular social networking site for Filipinos. But then, just about every network has its strengths.

Twitter is brilliant if you need a way to quickly push out short, sweet updates or lead people to other links/information you think can help them. LinkedIn is great if your main concern is with becoming better-established (this may be a goal for younger doctors hoping to be gain credibility).

That may tempt you to create accounts on all of them from the get-go. But remember: having a single, curated social media account is better than having multiple poorly handled ones on different networks. Remember to connect with your colleagues by looking for relevant network groups like these, by the way. This brings us to the next item in the list.

2. Use it to build a positive reputation and relationships within the medical community.

Not every Filipino doctor is on social media yet… and some might even say most of them are not (yet!). But this actually works for you.

The Philippine medical community on the Web is still fairly young as online communities go. At this stage, newcomers can more quickly get to know others and establish themselves as part of “the core” of the community.

Building relationships with fellow physicians is one of the best things you can do to make your practice more visible. We already said it before in our piece on how to get more patients online: referrals represent a significant portion of practices’ business. And like most professionals, doctors tend to refer those they know.

Having your social media accounts linked to those of other doctors can also garner attention online. Some physicians already have thriving social media accounts with a fair number of followers.

These followers are all potential patients. They could even be your potential patients if your specialty happens to be something not yet covered by physician the patients are already following.

Look at Dr. Philip Tan Gatue’s Twitter follower count, for example. That is a big potential audience… or even patients.

So to make it short: interact. Ask. Exchange knowledge. The idea is to contribute something to the dialogue and thus make yourself a memorable part of the group.

It may help to focus specifically on what may yield the most benefit to everyone, by the way. People will be more attracted to you if you make the conversation more about health/medicine (roughly synonymous with the greater good here) than yourself.

Difficult to put it better than this.

3. Schedule your social media.

Social media is not your main job, obviously, which means you should not let it take over your days. Yet you still want to invest enough effort into it that it can make a difference.

Now the key to any effective social media strategy is to find a way to organize it. Since you obviously do not want it to take up more time than you can spare, try to schedule it. Set aside a time of day or week for your social media activities.

Some people schedule a weekly block of time for social media management like this.

This makes things a little easier on your followers (they know when to check for your latest content). It also makes it easier for you to remember to do it if it is a regular thing.

Do not get too uptight about it if you miss a day or so between updates, though. There is little point in giving yourself undue stress about “being on time” with posts when they are actually meant to make things better for your practice (eventually) instead of worse.

4. Get into the habit of posting multimedia items.

This is one of the most effective ways of grabbing people’s attention. Most doctors’ social media accounts obviously run on medically informative posts. The most effective ones (in terms of patient engagement and eyeballs) tend to be those with multimedia elements. That means using pictures, sound, or even video where you can.

Look at the more popular doctors on social media and take your cues from them. Dr. Kevin Pho (159K followers on Twitter, 100K+ subscribers on his blog) posts a photo with just about every Tweet he puts out, for example. The same for Dr. Mike Sevilla and Dr. Zubin Damania.

Damania’s Twitter may be interesting for younger doctors & audiences given its “hip” presentation.

Remember that you do have to abide by the basic rules of patient privacy whenever you post, though. Do not post pictures that reveal patients’ faces or identities, at least not sans their signed consent. Do not discuss patients’ conditions with such specifics as might allow others to identify them. This includes replies you might make to people’s messages on your social media accounts, by the way.

In the same vein, make it clear to your patients from the start what your own boundaries are. Most doctors will not want to perform a health consultation online for reasons obvious to them… but not necessarily to their patients.

To avoid issues like that, lay it all out from the get-go: what is fine, what is not, what they can ask you or discuss with you, and where to go for more (your clinic’s formal contact info, for instance).

This should cover your first forays into social media for your practice. We’ll be talking more in the future about this and other ways to make the online world work for you, but for now, you might want to get started by giving us a holler on our own social media accounts (FB / Twitter). We look forward to seeing all of you on the network!

The post How to Get More Visibility for Your Practice Using Social Media appeared first on SeriousMD Blog.

The frank truth is that many patients are already seeking their physicians online. Two decades ago, most doctors still got their business the old way: via direct referrals and recommendations. But now that both accessing the Web and getting on it are so easy, things have changed.

The smart doctor can take advantage of these changes instead of being run over by them. And make no mistake: some will be run over. People will continue to need medical care through the Internet age and beyond, yes. But where they turn to get that care is the question.

Doctors need to adapt to the new ways people look for them. We’re going to be discussing this at greater length in later articles, but for now, we can start simple and limit it to 5 steps.

The goal: to get more patients using the Web

As for the methods:

Establish an authentic, verified online presence.

Obviously, you should start with your own website. Every practice should have an official website that shows its authenticity to online users. It can also be a first point of discovery for people actually looking for clinics matching its traits (location, physician specialties, etc.).

You have to be doing some SEO (search engine optimization) for this to work, though. And it tends to be best to have your own domain name, since it really adds to the impression that you are not only “established” but an “authority”.

The next step is to get on sites like Yelp and Google. The idea is to put your practice in a place where people online typically look for services like yours. People who need you will be more likely to find you that way.

Google still tends to be the first port of call for surfers seeking a service

Being on SeriousMD’s directory also helps. We give you a free online profile page. This is a place where patients can find you and book time with you. We optimize the page ourselves and all you do is add information. So you hardly do a thing, yet get maximum visibility. It becomes public as soon as we verify your identity manually.

Your profile page also shows your clinics and hours at the bottom.

Other doctors are capitalizing on their profile pages already: they give unique URLs to their patients and use it as a business card to promote their business and online interviews.

You should also get on social media. But that deserves its own item.

Get on social media.

This does not mean becoming superglued to your smartphone, by the way. It just means starting to use social media a little more to benefit you. And not just any social media, but the right social media. What does that mean?

If you are like most medical professionals, then you are generally pressed for time as a resource. You will find it hard to manage a lot of social media accounts: say ones that run the gamut of all the current networks.

So the wiser course would be to focus your efforts on the channels likeliest to yield returns. To identify them, you may have to do some market research. Talk to your patients or run a quick survey of them and their families. Find out which social media networks they use most. These may be the ones you should be focusing on first since they are the ones likeliest to give you what you need.

Usually, that means Facebook, Twitter, and LinkedIn. These are places where you can show your expertise to others: both colleagues and patients seeking information. Having your own business page on all of these also makes your practice more discoverable online.

Some doctors’ Twitter accounts are very successful.

Some social networks (like Facebook) also give you a channel for patient reviews. That leads us to our next item.

Make use of the marketing potential in patient testimonials.

Patient testimonials are great online resources for any business. They tell others your practice is real and (assuming a good review) worth visiting. Of course, if they are negative, they can have the opposite effect, so some management may be in order.

You might ask who really believes in online reviews anyway. More and more people, actually. BrightLocal’s Consumer Review Survey demonstrated this in the past when the percentage of persons who trust online reviews was shown to grow from 2011 to 2013. By 2013, it was already at 79% of their survey. By 2017, it had reached 85%.

Encouraging patients to drop reviews of their experiences at your clinic can benefit you. If your practice has a Facebook page, you can encourage them to leave testimonials like this. We are actually going to be adding a review feature for SeriousMD users’ profile pages soon, by the way.

Reviews pages like this can be good for your business.

If you do a good job at your practice, there is no reason to believe most reviews should be positive. Do not bank on that, though. To be safe, you should also have a management protocol in place for the negative ones. For instance, you should have someone on staff who replies to them in a polite manner.

Take care not to reply with a lot of detail. You still want to respect patient privacy rights. Try to avoid mentioning the patient’s name, complaint, or other details in the response. Generalities are the best policy here.

If you get a negative review detailing issues with your practice, for example, just say the following:

1. You are sorry the experience was unpleasant for them.
2. Your staff have a continued commitment to service quality.
3. Give contact details for your practice if they need to talk more about it.

Run a blog.

The blog should be distinct from your practice’s official website. The blog can be more personal, obviously, although you should still refrain from making public any personal information about patients on it.

So what should you be publishing? Preferably something both useful and informative… and obviously, related to medicine.

A lot of doctors run blogs where they post knowledge about their specialties. We even made a list of some of the most successful ones in the Philippines. As you can see from those examples, blogging helps them in more than a few ways.

1. It builds authority as people (both laymen and colleagues) look up their answers to medical questions.
2. It promotes engagement within the online medical community (which we will cover in the last item in this list).
3. If done regularly enough, it also makes their blogs and names more discoverable to search engines.

You do not have to restrict yourself to written posts for your blog, by the way. Why not do YouTube videos? Or do image posts? Just look at Dr. Willie Ong’s videos on Facebook, for example. Just look at the stats for one of his videos below:

You can even come up with something interactive like a webinar or live session with people who have questions about your specialty. UP Med does some great webinars, if you want to see what we mean.

Cultivate relationships with other doctors online.

Referrals make up a large part of any practice’s business. Being a reliable diagnostician, returning results promptly to the referring physician, and the like are all crucial in getting more of them. But relationships are important too.

Doctors tend to refer patients to other doctors whom they already know. Building relationships and turning acquaintances into friends online is thus a good way to socially invest in your practice’s future. Read other doctors’ posts, reply to updates on their social media accounts, and so on. Become part of the growing online medical community and you may find yourself reaping its rewards before long.

Even just sharing this article or discussing it with others on the Web can be a good start. Go ahead and tell your colleagues online what you think! Or get on Twitter / Facebook and say it to all of us there!

The post 5 Ways for Doctors to Get More Patients Online appeared first on SeriousMD Blog.

We already covered this in greater depth, both for the March results and in our review of the best medical schools in the country. To check the latest results, refer to this PDF file.

As for the schools’ performances for these results, here they are:

The overall passing rate in the table above includes the schools’ passing rates for test repeaters.

Below are also the top 10 examinees for the September 9 exams:

Share the news with others in the community on Twitter / Facebook!

The post Philippine Physician Licensure Exam Results: September 2017 appeared first on SeriousMD Blog.

That’s changed now.

Now, you can perform an ultrasound right from a patient’s bedside at their home. You can get EKG tests done even while on a bus. Thanks to advances in portable technology, physicians nowadays have their pick of handy devices to bring with them on out-of-clinic visits.

As you might have guessed by now, we at SeriousMD are big believers in mobile medicine. It’s a big part of our dream to make healthcare better and more accessible for Filipinos.

Take the basic portable device we believe just about every mobile doctor should have by now: the iPad / tablet computer. With an iPad, you can use an EHR like SeriousMD to access and even create patient files outside of your office. It’s certainly better than having to bring a physical copy of your files when you go out. You can even scribble on it as you would on paper!

Devices like the iPad Pro make mobile medicine easier than ever before.

Portable tech brings new convenience to an out-of-office doctor’s task. So we encourage doctors to give a try to devices like the 10 we’ve listed below. You just might find something that makes your job as a mobile physician even easier.

A Pocket-Sized Ultrasound Imaging Device

Gadgets like the Vscan let you perform ultrasound imaging on-the-go.

Gone are the days when ultrasound devices took up as much space as a hotel cart. Now, you can actually have one that fits in your pocket.

Consider, for example, the Vscan series of devices from GE Healthcare. Each of the Vscans is about the size of your average smartphone, making portable echoscopy a reality for traveling physicians. The line even boasts a two-transducer (dual probe) model.

The Vscan devices aren’t alone, of course. MobiSante has the SP1 System, for example, which is just about the same size and has much the same capabilities. Whatever the differences between it and the Vscan gadgets, the point is that doctors have more choices than ever before for these sorts of devices now.

A Portable EKG Device

The AliveCor Kardia works with your smartphone as an EKG device.

Arguably the best example is the AliveCor Kardia. Technically, its meant for use by patients who need to monitor their cardiovascular health. There’s no reason a traveling doctor can’t use it for his own consultations, though.

The Kardia Mobile is an FDA-approved device that fits in your pocket and delivers EKG data to your smartphone. All a patient has to do is put his fingers on the Mobile’s pads. If you have the Kardia app on your smartphone, the data should be available for readout in as little as 30 seconds.

There are also smart bandages now that let patients and their physicians keep an eye on their heart rhythms in real-time, by the way. An example is the Vital Connect patch, which uploads patient data to the cloud so that doctors can look out for danger signals.

An Infrared Thermometer

Infrared thermometer in use.

What’s wrong with the traditional mercury thermometers, you might ask? Or even the new ones with digital readouts? Nothing, really, except that they can be a little challenging to use when dealing with patients who won’t stop moving.

Infrared thermometers are probably more useful for doctors in the pediatric specialties. Still, they do offer a nice solution when your patient simply isn’t cooperating… particularly in out-of-clinic settings where the doctor doesn’t have much control over the environment. That means there may be more potential sources of agitation for the patient.

There are a lot of brands offering infrared thermometer models nowadays, so finding one shouldn’t be a problem. A little tip that might come in handy, though: the laser is a marker for the general area where temperature is being measured, not the point being measured itself.

In other words, the actual area of temperature measurement is usually somewhere around the laser—either above, beside, or below it, depending on the gadget in question. Ask the manufacturer of your device to get a precise answer. Otherwise, opt for a two-laser thermometer: this tells you the area of measurement more clearly because it would be the space between the two laser points.

A Smart Glucose Meter

The Dario portable glucose meter being used with a smartphone.

This could come in handy when you need to learn a patient’s blood sugar levels in a flash. While standard hospital glucose meters are smaller than ever these days, there are also options that let you use your smartphone as one. They typically involve installment of an accompanying app and connection of a small device to your smartphone, but the end result is still a more portable system than the average hospital one.

There are a lot of smart glucose meters available nowadays, from iHealth’s Wireless Gluco-Monitoring System to Dario. When choosing one, though, you may want to consider the cost of the strips and having them shipped to your location.

A Portable Speech-to-Text Transcriber

MModal Fluency Direct for Practices lets doctors dictate notes more efficiently.

This is for doctors who wear down their fingers with typing or writing down notes after patient examinations. There are any number of speech recognition devices for this purpose now, naturally, but possibly one of the best comes from M*Modal. Their Fluency Direct solution isn’t just tailored to work with EHRs but also sports features like computer-supplied immediate feedback that helps a physician improve his documentation’s quality.

A Smart Scale

The Qardiobase is a modern scale capable of giving you a lot of information.

You might argue that this is less of a portable device than the others and you’d be right. But if your out-of-clinic-appointments require full checkups, you’ll need a scale in your bag anyway. So, why not go with one as well-rounded as the latest wireless offerings on the market? For example, the QardioBase is a good-looking smart scale that pairs up with an app to deliver a ton of data. Think things like weight, BMI, fat composition, water composition, bone composition, and muscle composition.

A Sanitizing Wand

The Verilux sanitizing wand in use.

It might not take the place of your traditional disinfectants (like alcohol), but it could come in handy nevertheless. Sanitizing wands like Verilux’s blast surfaces with UV rays to kill up to 99.9% of bacteria. That makes them pretty good alternatives to liquid disinfectants when you’re working with fabric surfaces and the like.

A Digital Stethoscope

This digital stethoscope comes from ThinkLabs.

Technically, the traditional stethoscope still works just fine… but if you do feel like it’s time for an upgrade, you might consider a digital device instead. Rechargeable devices like the Thinklabs One Digital Stethoscope and the 3M Littmann Electronic Stethoscopes allow you to do things like record patient tracks, send audio data remotely, eliminate the majority of ambient noise, and even use multiple filters.

A Portable Blood Testing Device

This is the NBM200 blood testing device.

These still won’t be as informative as traditional laboratory tests, but portable gadgets do exist now that let you measure several blood parameters on-the-go. A great example is the NBM 200 series from OrSense. Not only are the systems small enough to pack in your average bag, but they also use non-invasive testing technology to find data including hemoglobin levels, calculated hematocrit, oxygen saturation, low perfusion oximetry, and so on.

A Handheld Vein Viewing System

The AccuVein AV400 in use.

Ever wished you had a clearer sense of where all the veins where just under someone’s skin? Here’s the answer for that. The AccuVein AV400 is a gadget that lets you see a real-time map of a patient’s veins on his skin—and can do it with center line accuracy to the width of a human hair. It’s rechargeable, permanently aligned, and weighs less than 10 ounces. It also makes venipuncture easier than ever, potentially saving you time on the job.

And that makes the list of portable devices we think physicians should have this year. Do you think we left out anything vital? Tell us in the comments below! Otherwise, if you want to help other doctors become more mobile in their work, you may want to share this post with them on social media (Twitter / Facebook).

The post The Top 10 Portable Gadgets for Doctors in 2017 appeared first on SeriousMD Blog.