"Social Media has the potential to empower, engage, and educate patients and physicians alike. The environment has evolved beyond the simple information-retrieval capabilities of ‘Web 1.0’ to the newer ‘Web 2.0’ concept, which allows users of these social media platforms to expand certain aspects of the doctor-patient relationship well beyond the exam-room door," she wrote.
Practice strategies should facilitate awareness and management of online reputation. Professional and privacy concerns should be heeded.
Dr. Travers reported having no conflicts of interest.
Finding the Right EHR System
Electronic health records are among the hottest of hot-button issues when it comes to incorporating the latest technology into practice.
"Few issues in dermatology practice management evoke as much emotion as the topic of the use of electronic health records (EHRs)," according to Dr. Mark D. Kaufmann of the department of dermatology at Mount Sinai School of Medicine in New York, and his coauthor.
EHR systems were originally developed for primary care physicians, but the unique aspects of dermatology require a specialty-specific system.
The American Recovery and Reinvestment Act of 2009 has created incentives for adoption of EHRs. To meet the Centers for Medicare and Medicaid definition of "meaningful use," EHRS must include documentation of problem lists and active diagnoses, e-prescribing, and order entry with drug-drug interaction checks to help facilitate their use (Sem. Cut. Med. Surg. 2012;31:160-2).
"Regardless of these interventions, many practitioners are still hesitant to implement the programs. To be useful, additional dermatology-specific ER criteria must be met. This is because of the field’s broad coverage of both surgical and medical care, heavy reliance on clinical photos and diagrams, and close interaction with other specialists," they wrote.
"Consequently, EHRs that include a drawing tool function, the capability to upload and annotate files and photos, and easily interface with specialists would be most beneficial," they added.
In the long run, the advantage of a complete EHR system will outweigh the disadvantages – as long as the EHR system being used is the right one.
In addition to the basic templates and functions of a standard program, some other important EHR features for dermatologists are:
• Anatomic drawing templates – rather than typed, lengthy descriptions of anatomic locations – with full anterior and posterior views along with a close-up of the face (with anterior and lateral views), hands (with dorsal and palmar views), feet (with dorsal and plantar views), and the ear.
• Easy and accurate accessibility to biopsy results. For private dermatologists who outsource biopsies to stand-alone companies, an EHR system that provides results electronically is of great benefit.
• The ability to upload, de-identify, annotate, and attach clinical images to a patient’s record, with accessibility to the images by any physician at the institution. For specialists not in the same center, the ability to print or securely e-mail the images and annotated anatomic templates also would be helpful for correctly identifying sites of interest and for aiding in diagnosis.
• The ability to include information about distinct data, such as skin cancer type, location, size, pathology reports, date of biopsy, number of layers, and closure types. A system that collects and incorporates this data into the patient’s medical record is integral to practice efficiency.
An effective EHR system would be easy to use by all staff members and effortlessly annotated. With new tablet technology that can be easily transported to and from patient rooms, a system should allow for direct download.
With the new tablet technology, the Apple iPad and Samsung Galaxy (among others) can be integrated ino the office. EHRs can be downloaded directly onto the tablets, which can be easily transported to and from patient rooms," they wrote.
Given the current incentives – and looming disincentives – now is the time to make the switch from paper-based practices to EHRs, according to the authors. "Although initial adoption may be slow, practices will more than likely increase their efficiency in the long run," they noted.
Dr. Kaufmann reported receiving stock options from Modernizing Medicine as a member of its medical advisory board. He is chairman of the American Academy of Dermatology’s EHR Implementation Task Force, for which he receives no compensation. His colleague, Dr. Shraddha Desai, reported having no disclosures.