iPad Pros for Primary Care Resident Physicians

Thank you to all who donated last year.  This enabled us to provide iPad Pros to each of 12 new physicians in our Community and Family Medicine Program at Truman Medical Center – Lakewood.  This was so successful that we’re repeating this fundraiser again on May 16, 2017.

The UMKC Family Medicine Residency is one of the most comprehensive family medicine programs in the country as well as one of the largest. With 36 residents and two fellowships, over the past 20 years, we have had more graduates than any mid-west residency. Our mission is to provide an unequaled opportunity to be a successful family medicine physician in a variety of practice environments. Truman Medical Center – Lakewood is the home base for this program. Truman Medical Centers, Missouri’s only safety net hospital is committed to providing care for our most needy people and training tomorrow’s workforce.  Your contribution to this project plays a role in attracting the best and brightest new physicians into our program.

Last year’s beneficiaries are now graduating into their 2^nd year of their Family Practice residency taking their iPad Pros with them.  These devices allow them to manage their patient’s records wherever they are using Cerner’s native iOS version of PowerChart Electronic Health Record with its built-in Dragon Medical voice recognition system.

Special Fundraising Event

Last year Dr. Timothy Neufeld, Dr. Paul Terranova and I walked and played 72 holes at the Nicklaus Club of LionsGate.  This was so much fun we’re going to repeat this event on Tuesday, May 16 and adding at least one other participant, Paul MacCready.  This year’s goal is $20,000 (roughly $300 per hole).   Stay tuned to my Facebook (www.facebook.com/vorand), and Twitter (@dvoran) feeds on 5/16 to follow us.

You can help us reach our goal by going online and making your Tax-Free donation to Truman Medical Center Charitable Foundation’s Advanced Technology and Equipment Fund (see instructions below).

How to Contribute

By Computer

1. Point your browser to Truman Medical Center’s Charitable Foundation donation page:   https://app.mobilecause.com/f/v6x/n
2. Select the amount of your donation
3. Complete the process conveniently and securely

On your mobile phone

1. Send a text to 41444 putting the word “FPTech17” in the body of the text
2. Follow the donation link that will be returned after sending the text
3. Enter the amount and payment information

By Check

1. Make the check out to TMC Charitable Foundation 
2. Specify FPTech17 on the check
3. Mail to: TMC Charitable Foundation
   2310 Holmes Road, Suite 735
   Kansas City, MO 64108

A Short List of Technologies Changing My Practice

Was asked for a short list of what technologies have made a difference in my practice over the last year and I rapidly jotted down the following:

Large screen devices

• Our clinic started with small notebook computers primarily designed for the physician and nurses to carry from room to room.  Severaly years ago it became apparent that we often needed to share what was on those screens with patients (primarily diagnostic imaging and lab results).  The hand-held devices didn’t cut it.
• We moved to 19″ regular monitors and after some experimentation ditched the notebooks and took the minimal added time to log into inexpensive autologon desktops and increased the size of the monitors to 21″ swivel devices
• Now have gone to 24″ HP All-In-One touchscreen devices for nurses and patient rooms because we discovered productivity is proportional to screen real estate and the added dimensions of the touch screen enabled us to include patient input into the documentation process in the exam room

Photos and videos

• Having a current patient photo on every page view of the chart (usually in banner bar) reduces errors of performing actions on the wrong patient, reduces the need to dig for information (pictures jar our memories in ways names cannot)
• Having pictures of rashes, wounds, deformities provides more information for downstream readers than any amount of words
• Including videos of tremors, gaits, movements improves diagnoses
• Provides excellent teaching tool
• Has dramatically decreased the amount of descriptive text and time to completion of notes without sacrificing information
• Enables visit-to-visit comparison that is just not possible with text

Electronic Messaging, especially with patients

• Asynchronous messaging reduces interruptions for both the clinician and the patient and is more efficient than voice.  Patient’s complaints are in their own words eliminating the need for redundant recording of the interaction
• Improves communication without adding cost and dramatically reduces time spent on the phone. Secure messaging enables electronic transfer of patient information to outside physicians in need of that information when normal record transfer mechanisms are not available

ePrescribe

• Especially the External History has the potential to change the conversation (discovers those who have not filled prescriptions as well as those that are doctor shopping)
• Also having access to the medications covered by specific plans and the co-pay for those medications is what I call REAL DECISION SUPPORT … now if only we could get the same push for covered services

Point of Care use

• Improves timeliness and also accuracy of the interaction
• Increases the perception of time spent with the patient
• Increases confidence and satisfaction

Patient Access to chart, especially visit notes

• Improves the accuracy, integrity and timeliness of the notes
• Try to review and write the note (even though I’m using 100% template driven documentation in the clinic) with the patient as the next reader and editor of the note.  Takes a little more time but forces me to be judicious and accurate in my documentation which I’m convinced improves patient care

Interfaces and connections … Health Information Exchanges

• The power of an EHR increases logarithmically with the number of systems to which it is connected
• HIE connections have the potential to increase productivity (see new patients in the same time as established patients)  and why they are not catching on is beyond my comprehension as they enable a clinic to schedule and see new patients in the same time slots as established patients by dramatically reducing the amount of de novo data entry required to make medical decisions

There are many more technologies and infrastructure changes that are positively impacting health care but these are the ones that came to mind as fast as I could type them.

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