Facebook for Physicians

I came across an interesting posting by Tej Deol MD, a Canadian trained doctor and expatriate now living in Singapore.  He had recently attended a conference put on AdvaMed, a Washington-based lobbying group representing the medical device industry. In this posting, he comments on one of the conference sessions that covered the area of "social collaboration" in the medical community, and suggests that the push is driven by the powers that be really to facilitate the goal of usage data gathering.

That word "collaboration" seems to be popping its head up over and over again. It was just a couple of weeks ago, that Canada Health Infoway's CEO, Richard Alvarez used that term to describe what he felt was lacking in Canadian Healthcare to ensure EMR uptake and success.

It seems that in the US, there are a growing number of social networking companies who are specifically catering to the medical space. Companies like Sermo, WebMD, MedPage, MedConnect, Epocrates, Proximity, QuantiaMD and others. Sermo bills itself as "the largest online physician community in the US.... Sermo is a real-time meeting place where physicians get help with everything from patient care to practice management. They’ve described it as “therapeutic,” a “virtual water cooler” and “vital to my everyday practice.”


(Taken from Sermo slide presentation)

Most of us have trouble thinking of physicians as getting online to start conferring with colleagues during the day. But it makes sense. It's got to be coming to healthcare. It's starting to happen everywhere else.

Recently, while exploring an opportunity in the retagging and contextualization of medical research, I learned an important lesson about healthcare delivery - namely, that physicians, on the whole, are more likely to discuss patient cases and treatment with their colleagues than they are to start pouring through research. There's just too much of it, and the answers can't be gleaned from the abstracts alone. It's assumed that one would "hear" about the most important research anyway. Conferring with a fellow doctor, on the phone, over dinner or on the golf course is easier, dependable, and therefore safer ("conventional wisdom").

As we witness the shift from the paper-based medical practice to the EMR-based practice, and usher in the new generation of Facebook-literate, Blackberry-texting medical graduates, one can only assume that the conferring will continue amongst healthcare professionals, but most of it will be online. "Collaboration"will ultimately be at the kernel of the medical practice... Collaboration with colleagues, patients, medical suppliers, research publishers, and indeed with the entire patient healthcare delivery chain.  It's a good thing.  I think like all good things, it will take time to evolve into its most positive iteration.

I only hope that the new order of collaborative physicians maintain a higher standard for social etiquette than the rest of us do with our smartphones when collaborating.  If not, I pray that my own doctor doesn't receive that long-awaited text message in the midst of my next prostate exam.

The EMR Challenge... Collaboration!




Collaboration is key to successful EMR adoption

 I note the words of Richard Alvarez, president and CEO of Canada Health Infoway in today's Globe and Mail newspaper.

When asked why there wasn't faster uptake of Electronic Medical Records by Canadians, Mr. Alvarez replied:  “I would say it's not technology or money that's lacking but a culture of collaboration. Once you have that – ... anything is possible.”

That got me thinking...  He may be on to something there.  While I've always assumed that similar to when any new technology is introduced, the Technology Adoption Curve  applies.  There are going to be the "Early Adopters" followed by the "Early Majority", "Late Majority", and then, "The Laggards" (also referred to by some as "The Skeptics".  And it would appear by the statistics of late, that we're well into the Early Majority stage in Canada.  And the pace of moving from one stage to the next with respect to EMR is not totally unexpected, to me anyway.  We are, after all, a pretty conservative country, and we do like to think a little longer before making wide-sweeping changes.



However, I believe that Mr. Alvarez is really on to something when he suggests that a "culture of collaboration" is missing.




The Technology Adoption Curve & EMR



As a company that works to facilitate medical record storage for retiring, relocating and deceased physicians, RSRS also facilitates the transfer or medical records to the patients and/or to a new doctor.  It never ceases to amaze me how many doctors are still a little reluctant to relinquish copies of the records, to their patients, let alone to new doctors.  There seems to be a tendency to want to safeguard the information, and release it only as an edited summary.  The reason given is often something along the lines of:  "They don't need to see this or that..".  It's only when these physicians are reminded that the patient has a legal right to view the entire record, and in fact, is the legal owner of the information (not the paper though), that the physician reluctantly agrees.



Is it a fear of possible misdiagnosis?  Omission?  Wrong protocol?  I'm not really sure, and admittedly this issue comes up less with the younger doctors who have understood from day one that the records they keep are subject to inspection by a multitude of other authorized parties, not the least of which is their accrediting College of Physicians.

Collaboration is a necessity - certainly when it comes to health.  Physicians learn from other physicians.  They also learn from their patients, who are in the best position to communicate historical issues not immediately available in their medical records.  The patient really needs to have full access to their healthcare picture.  They don't need to understand it all, but they do need to be able to access it, and any good EMR system should have this accommodated.

I believe that the faster that the new breed of EMR's facilitate a safe environment of collaboration for both physician and patient alike, the sooner we move well into the "Late Majority" adoption phase for EMR's.