Ambulatory Mobile Apps

[Trish Oschmann]

Good Morning,

https://www.nextgen.com/Community/VirtualOffice/DemoLogin.aspx

http://himssvirtual.org/20120426_VF_PrivacySecurity/education.asp?s... (Ref2)

http://www.medical.siemens.com/webapp/wcs/stores/servlet/ProductDis...   (Ref1)

http://www.medical.siemens.com/webapp/wcs/stores/servlet/ProductDis...

These combine to make for a very interesting discussion.  NextGen did an excellent job on their mobile device demo video which walks you through a doctor patient mobile interaction.  Apparently Siemens and NextGen are working together on this product portfolio (Ref 1).

Several things crossed my mind while watching and listening.  Perhaps the education offered by HIMSS will satisfy some of my questions and no doubt create others. (Ref 2)  They are offering several discussions pertaining to mobile interaction privacy that may or may not apply to my questions here.

Definitely I am curious about the workflow of talking to the patient before viewing a chart or doing an identity confirmation. Clearly you can have a discussion with a doctor today and they will call in a script for you based on that verbal interaction.  The volume of these interactions will increase due to the ease and reliability of these interactions.  We need processes built into the workflow that create a secure and precise foundation for practice.

In the demo video, the doctor selects the patient from a patient list after she hangs up.  Isn't it possible that the doctor has both the mother and daughter in her patient list? There was no confirmation of birth date, etc. We certainly don't want the doctors to rely on memory or worse, scrap paper, to transfer the answer to identity confirmations, back into the software post discussion. Doctors also need the benefit of full closure so they can move on to other tasks.  Perhaps an “open” job report linked to an incoming call list, that isn’t a total nuisance, would be in order.  Siemens has software that schedules work flows, surely with a little tweaking they can pull in the code if they haven’t already done so.

Perhaps a speakerphone (of course I think no speakerphone would pass HIPPA/privacy regulations) "like" switch would allow the software to run in the background while the call is taken, allowing the doctor to locate the patient and confirm identity before any diagnosis or recommendations are made. 

Also, I trust there is a patient "history" file of "called in" prescriptions. This seems like a shrewd thing to track from both the doctor’s side and the pharmacy’s side.

How are the doctors going to receive these calls to begin with?  Typically one calls in through an answering service.  If the call is outgoing from the phone, that may address my first concern, if the patient list is preloaded in the mobile's address book. I can't imagine a doctor giving out a cell phone number for open use by patients, unless of course that billing feature mentioned at the end of the demo, can bill out a consult on all calls. 

I can see it now ...Doctors working call-in centers.  Actually it's not too far fetched ...drop in the glucose monitor to the patient's cell phone and have the “read” transmit like text to the doc's phone.  There will be an app for that!

All the best!

Trish Oschmann