Digital Communication in Medical Practice (eBook)

Nancy B. Finn is President of Communication Resources, a consulting organization that helps small business and start-up companies communicate more effectively with customers, prospects and business, a published author and an adjunct faculty member at Bentley College in Massachusetts.William F. Bria, MD is Chief Medical Information Officer at Shiners Hospital for Children and President of the Association of Medical Directors of Information Systems.

Foreword 6
Enabling the Complexity of Communication in Health Care 6
Series Preface 8
Acknowledgments 10
Contents 13
A Visit to the Doctor: Three Scenarios 17
Scenario #1 17
Scenario #2 18
Scenario #3 18
eHealth and Patient Safety 23
Medical Error: Woe is Me Woe is You
Keeping Patients Safe 25
The eHealth Triangle / The eHealth Professional 27
The eHospital 29
Case Study: The VA has HIT Covered 29
Case Study: The Dana Farber Cancer Institute 30
Reducing Errors in the Emergency Department 31
Case Study: The Dashboard at BIDMC 31
ePatients 32
eHealth Around the World 33
Europe 33
Asia 34
Key Points 35
References and Notes 36
New Health Care Models 37
Continuous Available Information on Every Patient 38
EHR in the Hospital Setting 40
Driving the Adoption of the EHR in Small Group and Solo Practices 40
Case Study: Group Health Cooperative 41
Installation, Implementation, and Impediments 42
EHR Early Adopters Around the World 44
Health Information Exchange and Compatibility 45
Regional Health Information Organizations Information Exchange 46
Case Study: The Indiana Network for Patient Care and Indiana Health Information Exchange 47
Case Study: The Taconic Health Information Network and Community 48
Santa Barbara Country Care Data Exchange (SBCCDE) 49
Computer Physician Order Entry 50
Personal Health Records 51
Case Study: EMC Corporation 54
Key Points 55
References and Notes 56
Communication 58
The Media, the Message, and the Internet 58
The Telephone 59
Smart Phones and PDAs 60
Electronic Mail 61
Obstacles to Email Use 62
Email Benefits 63
Email Guidelines 64
Portals 65
Case Study: Kaiser Permanente 66
The eVisit 67
Case Study: Medem 69
Case Study: Relay Health 69
Key Points 71
References and Notes 72
Telemedicine 73
Why Telemedicine? 73
Telemedicine Technologies and Infrastructure 74
Obstacles 75
Cost 75
Reimbursement Policies 76
Licensing of Medical Professionals 77
Cultural Barriers 78
Standards 78
Telemonitoring and Home Healthcare 78
Telemedicine for Patients in Remote Areas 80
Case Study: Hayes Medical Center 80
Case Study: St. Alexius Telecare Network of North Dakota 81
Telerehabilitation 82
Speech and Language Therapy 82
Physical Therapy 83
Mental Health Services 83
Telehospice: Death with Dignity 84
Telemedicine around the World 84
The eICU: Remote Monitoring for Intensive Care 84
Key Points 85
References and Notes 86
Information Access: Information Overload 88
Healthcare Finds the Internet 88
Information Access Telecare Network of North Dakota 89
Information Overload 90
Resources for Physicians and Patients 93
Institutional Web Sites 97
Professional Organizations 97
Online Resources for Cancer 97
Online Resources for Cardiac and Lung Disease 98
Online Resources for Diabetes and Kidney Disease 98
Online Resources for HIV 99
Online Resources for Ordering Drugs 99
Key Points 101
References and Notes 102
Keeping Health Information Away from Prying Eyes 103
Medical Information is no Longer Private 104
Privacy Issues Concern Physicians and Patients 105
Protecting Data with a Secure Network 106
US Federal Regulations Regarding Privacy (HIPAA) 108
The European Union on Privacy 111
The Internet 111
Email 111
Case Study: CVS 114
Key Points 116
References and Notes 117
Medicating Your Patients 118
Medication Error 118
Electronic Prescribing (E-Prescribing) 119
Patient Information and Collaborative Drug Therapy 122
Hospital Policies 123
Confusion in the Naming of Drugs 124
Adherence 126
Online Pharmacies 127
Direct-to-Consumer Advertising 129
Resources for Safe Healthcare and Medication Advice 129
Key Points 130
References and Notes 131
All About Money 132
How We Measure Healthcare Costs 132
The Underinsured and the Uninsured 134
Controlling Health Expenses with Information Technology 137
Consumer-Directed Health Plans (CDHP) 138
Health Reimbursement Accounts (HRA) 139
Health Savings Accounts (HSA) 139
Pay-for-Performance (P4P) 140
Key Points 141
References and Notes 142
The Quality Quotient 143
A Broken System 144
Why Quality is so Hard to Achieve 145
Health Information Technology 145
Evidence-Based Healthcare Delivery 147
Quality Initiatives Require Change 148
Lessons Learned 150
Resources 150
Key Points 156
References and Notes 157
Heathcare 2020 158
A Portrait 158
Devices and Enablers 161
The Practice of Medicine in Healthcare 2020 165
Key Points 167
References and Notes 168
Glossary 169
Index 176