Staff training; Patients' Internet usage; E-books; Prescription drugs
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You've put a technology training program in place that's designed to convert even the most timid, resistant staffer into an enthusiastic computer user. Everything's proceeding according to plan. But be alert: Your staff may include a Luddite primed to sabotage computer training with a barrage of negative comments: "I'll never learn this stuff." "The old system worked better." "Did an idiot design this?"
Before you put the offender in front of a firing squad, remember that you catch more flies with honey. Let the carper feel that her concerns are valid. Ask for her advice. Convince her that she's indispensable to the implementation process.
At the same time, be sure all the doctors in the practice express faith in the new computer system and present a united front to the staff. One nay-saying doctor, and your Luddite won't need as much courage to spark a revolt in the ranks.
Be careful, though, to avoid Pollyannaish optimism. I once told the staff of a four-doctor practice to commit themselves to a new practice management system for six months. "Then we'll evaluate it," I said. "If it's not meeting our needs, we'll pull the system." That kind of honesty breeds cooperation. And we needed cooperation because the receptionist was a potential saboteur who didn't want to give up her hard-copy appointment book. I knew we'd succeeded when she kicked off our six-month checkpoint meeting by threatening to quit the practice if we went back to the appointment book.
But the best success story is that of my mother, who worked for a solo lawyer. She started out fearing her computer, but became so adept at its use that when her boss added a partner, he didn't need to hire an extra staffer or outsource the added dictation. My mom could handle it all.
In the hands of properly trained employees, computer technology does boost productivity.
Rosemarie NelsonComputer consultant/Syracuse, NY
A flock of companies such as Healinx, Salu, and McKessonHBOC tout the merits of communicating with your patients through secure online channels. However, patients' Internet usage isn't uniform from state to state. For example, 53 percent of Virginians surf the Web, according to Cambridge, MA-based Forrester Research. In contrast, only 28 percent of their neighbors in West Virginia belong to the modem generation.
Internet usage also varies widely by race. In Florida, 75 percent of Asian-Americans are online, compared with 53 percent of Hispanic-Americans, 42 percent of Caucasians, and 26 percent of African-Americans. Forrester analyst Ekaterina Walsh says this "digital divide" stems mostly from income disparity.
Bartleby.com (www.bartleby.com), a New York-based Internet publisher, has put the 20th edition of Gray's Anatomy online. You can click on headings in the table of contents or type in a term (how about the zonule of Zinn?) to conduct a search. Bartleby.com also publishes everything from the King James Bible to the poetry of Oscar Wilde.
If your patients have to pay out-of-pocket for their medications, pull out a prescription pad and write down www.destinationrx.com. At that Web site, they can type in the name of a medication and learn which Internet drugstore offers the lowest price.
The price spreads among e-pharmacies can be dramatic. Let's say you want 90 10-mg tablets of Lipitor. A company called International Pharmaceutical Services (www.internationalpharmacy.com), which charged $195.11 in early January, was at the high end. The lowest price was $151.65, from drugstore.com (www.drugstore.com). Once you find the best deal, DestinationRx allows you to jump to the Web page of that Internet drugstore to consummate the transaction.
DestinationRx can also be useful for patients whose insurance companies pick up the tab for medications. The Web site reveals whether a particular drug is listed in an insurer's formulary.
One-fifth of all telemedicine activity occurs in prisons, according to a survey by the Association of Telehealth Service Providers and Telemedicine Today magazine. By connecting inmates to caregivers electronically, correctional facilities are spared the expenseand hazardsof transporting prisoners to doctors' offices and hospitals.
Robert Lowes. Computer Consult. Medical Economics 2001;3:23.