PracticalDermatology

Mobile technology is quickly reshaping how we live and interact. In the world of medicine, it is changing how we practice. With mobile technology, clinicians can consult research, send prescriptions electronically, and coordinate important clinical and practice information. And that is just the tip of the iceberg. Now that Electronic Health Records (EHRs) hold a greater presence in healthcare, the benefits of utilizing mobile technologies—such as smart phone and tablets—have grown more apparent. Given the built-in potential for these technologies to expedite various processes, several EHR companies have innovated new avenues for meeting the government's Meaningful Use standard, as well as various other uses.

To shed light on current and future possibilities regarding mobile technology and EHRs, I spoke with Christina Majeed, Vice President of Business Development, New Products, and Technologies at NexTech, and Michael Sherling, MD, Chief Medical Officer of Modernizing Medicine, who each offered reflections on how their respective companies are adapting to the changing conditions of technology and offering unique advantages to physicians. The following Q&A recounts their feedback.What are your general impressions on the current utility of mobile technology in the daily operation of EHR TEchnology?

Dr. Sherling: Modernizing Medicine's dermatology clients have been using our Electronic Medical Assistant™ (EMA) application since 2010 and have been extremely satisfied. Since EMA is a native iPad app—accessed through the iTunes App store, not a browser—its performance is lightening fast. Multiple users can be logged into the same patient at the same time on an iPad and simultaneously complete parts of a patient's history, exam findings, and diagnoses. But to really streamline documentation, the developers of EMA focused on user experience. The EMA app has clean lines, effective use of color, and zoomable body images so that dermatologists can denote exactly where the patient's lesions and rashes are. With a few touches of your finger on the iPad, your note, requisition forms, patient counseling sheets, and superbill are done.

Mobile devices like the iPad enable the dermatologist to document in real time within the exam room and without breaking eye contact with the patient for more than a second. Since these devices can be carried from room to room, start-up costs are lower and each room doesn't need to be outfitted with a more expensive computer system. Having been the first dermatology specific EMR with a native iPad app, Modernizing Medicine's EMA is the market leader and innovator in mobile touch technology.

Ms. Majeed: Mobile technology is taking a more prominent role in the daily operations of practices as it relates to Electronic Health Records and providing better patient care. EHRs and mobile technology have a direct relationship and effect on one another. As they both start to gain more market traction and penetration, the features and robustness of both will continue to increase, creating more efficiency as it relates to the daily operations and patient care of a dermatology medical practice.

Can you explain how your platform enables physicians to harness other external technologies?

Ms. Majeed: The NexTech platform allows dermatologists to have a robust system that has seen success for 15 years, ranging from some of the largest medical practices in the country to the one-doctor practice. The option of having a server in one's practice or having a server hosted off site is one of the aspects that has allowed NexTech practices to see flexibility and success with the platform. In addition, the NexTech EHR can be used “out of the box” because it leverages the collective wisdom of the largest dermatology user base in the industry. In addition, NexTech EHR also provides the user customization flexibility for each NexTech dermatologist to very easily customize their templates as they like.

Dr. Sherling: Scheduling and billing are critical steps around the patient visit and EMA Dermatology interfaces with over 400 practice management systems—allowing any dermatologist in private or academic practice the ability to use the most efficient and dermatology-specific system on the market without having to bear switching costs.

order for a patient to make it from check-in to checkout in the most efficient manner possible, office flow has to run smoothly. Modernizing Medicine has developed a technology called OfficeFlow that tracks patients in real time from check-in to waiting room to exam room to checkout. At each step in the process, doctors can visualize the elapsed time to know where the bottlenecks are in his or her workflow. Replacing existing physical call buttons, doctors can also use a virtual call button with directives so that a medical assistant can set up biopsies, come into the room as a chaperone, or take a patient to phototherapy. While medical assistants and front staff are not, strictlyspeaking, technology, nothing runs without them and so using our platform to harness the efficiency of these physician “externalities” is one of the most important things we have done to improve office workflow.

How do the advancing photographic features of tablets and mobile technologies benefit physicians? how can these be synced with EHRs?

Dr. Sherling: A picture in dermatology really is worth a thousand words. Modernizing Medicine has therefore made sure that physicians don't have to take an extra moment of their day for the most important part of their exam to be recorded. EMA Dermatology has native apps for both the iPhone and the iPad. Photos of 5-megapixel resolutions can be easily captured. But unlike other products, images can be mapped and labeled with the patient name, diagnosis, location, and date without uploading, appending, or renaming the photo. In other words, the doctor just has to take the picture of the lesion and he or she is done.

EMA Dermatology also has leading interfaces with 3Gen so that dermatoscopic images go directly into the chart and are annotated without any extra effort on the physician's part.

Ms. Majeed: The advancing photographic features of tablets and mobile technologies allow for the immediate capture and documentation of a patient image. With the NexTech EHR iPad app, the patient image can be automatically captured, stored, retrieved, and edited within the patient chart all on the iPad. The same automation is used within NexTech EHR using high-resolution wireless digital cameras.

What kind of avenues Will Develop in the future that will benefit physicians who use tablets/mobile technologies?

Ms. Majeed: We see value in continuing to innovate and develop new products and EHR functionality that allows dermatologists to leverage the latest functionality on mobile hardware (i.e., the iPad, tablets, etc.) while harmonizing their unique needs of image integration, and voice recognition with quick yet detailed documentation, while optimizing patient flow for the most efficient use of provider time.

Dr. Sherling: Mobile has been and always will be our core focus. Having front-line physicians guiding our development means that we will always be on the cutting edge of what physicians need. Making EMA faster and enabling physicians to be more productive is our guiding tenet. Improved decision support tools are also in the development pipeline and we will have some very exciting surprises in store for dermatologists that will revolutionize the way a chart is visually consumed in the near future.