Advanced Communication Technologies

Overview and Potential Uses

Alan Brookstone, MDMarch 29, 2008

Background

Family physician – Closed practice June 30, 2007 Partner – The ClearView Group August 2007 National

Physician Advisory – Canada Health Infoway Founder of CanadianEMR – National EMR service for Physicians

Provincial BC College of Physicians and Surgeons BC Ministry of Health IEHR project BC Provincial Privacy Working Group

Regional Vancouver Costal Health eHealth Steering Committee VCH Primary Care IT strategy Privacy Working Group PUG strategy

Local Richmond Hospital strategies

Question

How do we do our jobs more efficiently, accurately, enjoyably when we work in an EMR based practice setting?

The Answer will not The Answer will not Arrive through Divine Arrive through Divine

InterventionIntervention

Advanced Communication Technologies?

Used to support Communication Collaboration

Can facilitate groups or person-to-person Some are in wide scale use today

eMail Instant messaging Video-conferencing (e.g. Skype) Cell phones Blackberries etc.

Traditional Web-based Tools

Bulletin boards – Useful but static Blogs – Useful, provide interactivity. Not

real-time Wikis – Also interactive – you can edit and

contribute. Not real time

Potential Benefits

Presence (you know an individual’s status - provides context – away, available etc.)

Interactive communications Real time Allow an immediate response

Can use technologies simultaneously Can switch between different technologies Desktop and/or mobile

Potential Risks

Disruptive to workflow Cost and complexity Is it really needed?

Technical Support

Level of support - specific extent of technical assistance in the total range of assistance that is provided by an information technology product (such as a software product) to its customers.

Some companies name their levels of support basic and advanced.

Others call them level 1, level 2, and level 3, or

Level A, level B, and level C

Support

Typically, when a software user calls for technical assistance, a level 1 technician tries to answer all questions, which might include help with simple problems or general "how-to" questions.

If the question is more complex, the user is passed on to the level 2 technician. e.g. advanced features and possible product bugs or failures.

If the level 2 technician cannot help the caller, a level 3 technician may be consulted either by the customer or by the level 2 technician. Research and investigation may be required - takes time.

Some companies offer certain levels of support only on a fee basis.

Support

You are having difficulty with a certain feature in your EMR

Can’t answer question from the in-built ‘Help’ feature

Who would you call or email? Best bet: product/technical support

Scenarios

Best – question is answered immediately and you get back to work

Worst – you are escalated through higher levels of support. Your question is unanswered

Ultimate worst – “Sorry, please contact your hardware or network supplier. This is not a software problem”…. Right!

Costly and Frustrating Satisfaction level is reduced

What are the Alternatives?

Advanced communications technologies Such as:

Instant messaging

Could be used by physicians And especially medical office staff

Example

STATUS

OTHERS ONLINE

ACTION

Opportunities

What if you had a chat application that: Was secure (running on a private or encrypted

network) Provided access to: Company technical support (within hours of

operation) Users of the product who could indicate

Size of practice, specialty and location Status (online, away) Role (mentor, user etc.)

Create virtual user groups

Advantages

Technology already exists and is in regular use by millions of users

Efficient Non-intrusive Real time Appropriate Leverages user experience appropriately Cheaper for practice Cheaper for vendor

Other Opportunities

Why stop at an ‘Instant Messaging’ application?

Video-conferencing (You have to have a camera) Can have additional advantages Launch-pad to other tools It all starts with….

Putting it into Context

Just an extra tool Can help resolve issues and questions more

quickly Must not be intrusive Could result in abuse (needs rules – just

like telephone use in the office) Could prepare practices for other advanced

technologies Tele-medicine Distance monitoring

Thank You