Gabriel Perna

Recent surveys show that everyone, even older patients, uses the Internet to access healthcare information and discover providers. As a result, a nicely-designed website has never been more important for practices.

“This is the new phone book,” said Derek Kosiorek, at the time the principal with the Medical Group Management Association’s (MGMA's) consulting arm. “Websites are your new front door. This is the first impression people will get of you.”

Kosiorek shared some tips with attendees at an MGMA conference on building the ideal website to attract potential patients. Here are a few of them.

Tips for building your practice’s website

Editor's Note: This slideshow originally appeared in article format on Physicians Practice in 2015. 

Slideshows

Planning on building an engaging website to attract patients? Here are nine tips that should get you started.

Welcome to Practice Rounds, our weekly column exploring what's being covered in the larger world of health care.

Surgeon General Makes Opioid-related Recommendation

The U.S. Surgeon General this week issued an advisory recommending that more Americans carry an opioid reversing drug, naloxone. The drug, sold under the brand name Narcan, can restore normal breathing if someone has overdosed on opioids. Jerome Adams, MD, says knowing how to use naloxone and having it available can save someone's life. "Despite evidence of the effectiveness of naloxone in reducing opioid overdose deaths, awareness of the drug’s benefits and its possession and use among patients, prescribers, community bystanders, and even first responders in some areas remains limited," Adams wrote in 

health venture between JP Morgan, Amazon, and Berkshire Hathaway

 - until now. In a letter to shareholders, JP Morgan CEO Jamie Dimon laid out a few initial plans for the venture. According to 

, Dimon said the group will aim to align incentives among doctors, insurers, and patients; reduce fraud and waste; increase access to telemedicine and better wellness programs for employees; and look into the cost of end-of-life care. Dimon said in the letter the venture will use big data, virtual tech, and customer engagement to achieve these goals. He said the venture will start small and operate on a long timeline.

The Department of Health and Human Services (HHS) and its Office of the National Coordinator for Health IT (ONC) jointly released a new resource for individuals, patients, and caregivers to more easily access their health information. HHS says the resource supports a goal in the 21st Century Cures Act empowering patients and improving patients’ access to their EHR via the 

recently announced MyHealthEData initiative.

 “This guide will help answer some of the questions that patients may have when asking for their health information," National Coordinator for Health IT Don Rucker, MD,  said in a statement.

Direct-to-Consumer Advertising of Medications is Wrong

"Since patients cannot purchase drugs without a prescription, nor do they have the depth of knowledge to understand the process of drug selection, I wish there were no direct to consumer ads for drugs."

Melissa Young, MD, Endocrinologist, Freehold, N.J.

Articles

The U.S. Surgeon General issued an advisory recommending more Americans carry the opioid reversing drug naloxone.

Surgeon General Makes Opioid-Related Recommendation 

After a year of running his own practice, it became clear to Brett Swenson, MD, a primary-care physician, that a traditional outpatient clinic wasn't for him.

"I was seeing 25 patients per day - which is pretty typical for a doctor in a primary-care practice…my visits were down to 15 minutes per patient, [and] half of the time [I was documenting]. I wasn't getting to know patients like [I wanted to]…my practice continued to grow and it was successful based on the definition of a traditional primary-care practice, but it had become factory medicine," Swenson said at the annual Healthcare Information and Management Systems Society (HIMSS) Conference, held recently in Las Vegas. 

Swenson says he hadn't gone to medical school to practice medicine like this. So he set out to open a concierge practice, which would allow him to focus on quality and value-based care.

"Value, for me, was achieved with happy and healthy patients, that's the value I wanted to deliver," he said.

Once he left behind factory medicine for value, he needed to adopt tech solutions that would help him adjust to a patient-focused practice, especially when it came to communication. One of the draws of concierge medicine is constant interaction between practice and patient. That's where chatbot came into play.

"Chatbot is a computer program designed to simulate conversation with human users, especially over the internet. The goal of the chatbot was to meet the criteria set by the patients - responsiveness, communication, and better outcomes. That's what the chatbot could deliver," he said.

Swenson's concierge practice, Swenson Premier Care in Scottsdale, Ariz., rolled out the chatbot technology in three phases. The first phase was patient-initiated communication, whereby they used the technology to schedule appointments and get medication refills. Instead of calling the clinic, patients could securely text through the chatbot system and make those arrangements.

Usage in this phase was low, said Swenson, who noted behavior change can be hard and most patients still called the clinic for those services. Also, because it was not yet integrated with the EHR, there was still manual work to be done in the back end by his staff.

Instead of having patients use the chatbot service on their own, phase two involved the clinic initiating communication with the patient. The clinic focused on patients receiving preventive care, such as a flu vaccine. In this phase, the tech was still not integrated into the EHR and the process of finding patients eligible for the vaccine had to be done manually.

"We had to generate two files….the first was a list of phone numbers for patients who needed flu shots, the second was a file with timeslots available for [them] to get the flu vaccination. Once we compiled those files, we sent out a text [inviting them to get the shot]," he said. While the response rate was much higher, the lack of integration forced a lot of extra work on the staff.

The final phase, which started in February, aims to solve that problem, as Swenson's concierge practice recently rolled out the chatbot with EHR integration. Meaning every appointment made through the technology goes right into the EHR's practice management suite. Moreover, it's easier to identify patients who may need those shots. They've expanded this capability to focus on patients who need their annual physical.

Swenson's advises other practices looking to adopt this tech that EHR integration will make life much easier. Also ensure the process is compliant with HIPAA regulations. On the operations side, he recommends reaching out to patients in manageable chunks, starting with 500 per physician. As health care goes from volume to value, Swenson sees chatbot as a viable way to help practices make this move. 

"The systems we've been using are better designed for factory-designed medicine. They're designed for the convenience of the clinic rather than the patient," he said, noting the failures of portals and phone calls. "That's where chatbot can be beneficial. It gives the patient 24/7 access. They use a text interface, which they use for everything else in life, so why not health care? And it's interactive with the patient. And it can be designed to provide those nudges we need for preventive care."

A concierge doc shares his experiences with using chatbot technology as a way to provide patients more value.

How Chatbots can Aid Value-based Care Initiatives


The Trump administration saw another major shakeup as President Trump relieved David Shulkin, MD, as Secretary of Veterans Affairs (VA), replacing him with White House physician, Rear Adm., Ronny Jackson, MD. In a widespread op-ed to 

, Shulkin said he was fired because he was against the privatization of the VA, a move favored by advocates from the administration. Shulkin, a rare holdover from the Obama administration, entered the VA as Under Secretary of the Veterans Affairs for Health in 2015. In early 2017, Trump nominated him to the top spot at the VA and he was unanimously confirmed shortly after.

Jackson has served the past three administrations as White House physician. While Jackson has a deep background in medicine, 

 reports that he has no experience in management . The VA employs 360,000 people and has a budget of $186 billion. It's tasked with providing care to more than 9 million veterans each year.


The convergence of retail and insurers may continue as Walmart is in early stage talks to buy health insurer, Humana, 

. According to the report, the deal is in preliminary talks and there is no certainty that it will happen  or what form it could take. Analysts suggest Walmart may be interested in Humana for its foothold with senior citizens, the insurer is the second-largest provider of Medicare Advantage plans. Last year, CVS bought Aetna for $69 million in a major case of an insurer and a retail giant coming together. Both Walmart and Humana's stocks traded up upon news of the proposed deal.
 


Apple announced this week that 39 health systems across the U.S. are making patients' medical records available on the iPhone. The list of health systems and academic medical centers participating includes Johns Hopkins Medicine, Geisinger Health System, NYU Langone Health, and Stanford Medicine, among others. Through these systems, patients will be able to automatically access their records through the Health app. Medical record access through the iPhone was previously only available to patients who had signed up to test a pre-release version, 

"Has the joy of medicine been lost? No, it has been drowned out by the sea of systematization. While I may feel some degree of burnout sitting at my desk ticking check boxes, every time I enter an exam room and sit in front of a patient, I remember why I became a doctor. These patients have no one else. If I wasn’t here, they would be swept away in the waves of our dysfunctional system."
Linda Girgis, MD, family medicine physician, South River, N.J.

President Trump relieved David Shulkin, MD, as Secretary of Veterans Affairs (VA), replacing him with White House physician, Rear Adm., Ronny Jackson, MD.