PracticalDermatology

The concept of snake oil is as old as time. While charlatans peddling lotions and potions that promise miracle cures can be easy to spot, “digital snake oil” isn’t always immediately recognizable—and can be quite costly to an unsuspecting practice or practitioner.

“From ineffective electronic health records (EHR), to an explosion of direct-to-consumer digital health products, to apps of mixed quality, this is the digital snake oil of the early 21st century,” said James Madara, Executive Vice President and CEO of the American Medical Association at the group’s 2016 annual meeting.¹

Electronic Health Records (EHRs)

We all know the drill by now: EHRs were supposed to reduce paperwork, medical errors and administrative burdens, cut costs, and improve the quality of care. This has not yet proved to be the case. In fact, use of EHRs is resulting in lower doctor satisfaction and higher rates of burnout, according to a study in the July 2016 issue of Mayo Clinic Proceedings.²

Verdict:EHRs probably will improve healthcare at some point, but current models lack the interoperability that is needed for EHRs to truly live up to their lofty goals. If you haven’t bought into a system yet, take a deep breath and wait and see what the next generation looks like.

Patient Portals

Patient portals were thought to be the holy grail of patient engagement. Portals are secure online website that gives patients 24-hour access to personal health information from anywhere with an Internet connection.

Verdict: So far, patient portals have failed to be widely adopted. Adopting or developing such portals can be expensive for practices and healthcare systems. Office staff and patients aren’t excited about having new ways to communicate in addition to calls, in-person visits, and emails. Instead of adopting a portal, adopt a wait-and-see attitude.

Teledermatology

Certain apps can and do help manage and triage patients. And teledermatology does have a role in improving access to dermatologists, especially in underserved areas.

Verdict: Many thought teledermatology would replace office visits, but it hasn’t happened, nor will it. Dermatitis and acne are most likely to be cared for by teledermatologists. In-person visits are more likely to be for skin cancers and mole checks. Consider how teledermatology can help your patients and practice before jumping in head first.

Google Glass

Google Glass promised to revolutionize healthcare (not to mention life in general) when it was first launched in 2013. The main lure was the fact that it is hands-free.

Verdict: New research suggests that Glass may have a role in the OR. In a recent study,³ nine resident and attending plastic surgeons at Georgetown University used Glass for cosmetic and reconstructive surgery procedures. Surgeons gave Glass high ratings for comfort and overall satisfaction. The ability to capture images and video using voice-activated control was rated “good.” They reported difficulties with reviewing images during surgery. One-third of the surgeons found Glass to be distracting or that it required awkward positions in order to take pictures. Media reports suggest that Glass is undergoing a comprehensive redesign so stay tuned.

Social Media

I think we can all agree that social media is here to stay. The exact role that it should have in promoting a practice or procedures, however, is less clear. It can be a slippery slope.

Verdict: If social media makes sense for your practice, make sure staff members receive HIPAA training and are aware of their obligation to maintain patient privacy. Be wary of new sites such as SnapChat, which allows people to send pictures and videos that only last a few seconds before disappearing. Anything you do on social media can come back to haunt you and SnapChat is no exception. Tread carefully here. n

Mark D. Kaufmann, MD is an associate Clinical Professor of dermatology at the Icahn School of Medicine at Mount Sinai in New York City.

1. American Medical Association. http://www.ama-assn.org/ama/pub/news/speeches/2016-06-11-madara-annual-address.page

2. Shanafelt TD, et al. “Relationship Between Clerical Burden and Characteristics of the Electronic Environment With Physician Burnout and Professional Satisfaction.” (2016). Mayo Clinic Proceedings. DOI: http://dx.doi.org/10.1016/j.mayocp.2016.05.007 |

3. Sinkin JC, et al. “Google Glass in the Operating Room: The Plastic Surgeon’s Perspective.” (2016). Plastic & Reconstructive Surgery 138; 1:p 298–302.