For my first blog post of 2014, I thought I would start the year off by discussing how important it is to stay abreast with technology today and how it relates to our profession and even our practice. I have only been in practice for nine years now and I cannot believe how much change has occurred. Technology has completely redefined the way we not only practice but more importantly the way we keep up with medicine.
We were only beginning to use computers in our clinics while I was in school and computers were an adjunct but not necessary. I remember how we used to take turns photocopying journal articles at residency programs so we could all have our own copies to read and study. Personal digital assistants were becoming popular in the form of the Palm Pilot but were only as good as the information you put into them. Smart phones were yet to be and if you were lucky enough to have a cell phone, it was more of a "cool" thing but not really necessary. Pagers were really the only form of contacting a physician immediately.
Let us see how each new device and technology has changed what we do daily.
Electronic medical records. While this has become a mandatory way to keep records, you can still avoid it by accepting a lower rate of Medicare reimbursement for each year.1 Why would you do this? You would be surprised that I hear some of my senior colleagues boasting about how they will not make the change. While this change may seem cumbersome and frustrating, there are many benefits that go along with it other than just following Medicare's guidelines.
As an example, our society is gradually moving away from any type of paper records and data storage industries free up more real estate space in your office. For the past six years, I have not utilized any paper charts in my office and therefore the need for storage of these folders is irrelevant. I have access to any of my patients’ records at any given time whether I am in the office, at home, at the hospital or at a satellite office. Many of today's electronic medical records allow us to follow protocols and standard of care without the need for memory recall, allowing us to focus on the patient's problems and concerns. Pharmacies with databases of medications are built into these electronic records, allowing doctors to write prescriptions and send them immediately with ease.
The bottom line is: if you are not utilizing electronic medical records, your patients will begin to realize this and think that you are behind the times in your practice.
Smart phones. If you are not utilizing a smartphone in your practice setting today, your ability to communicate will be greatly hindered. Although it seems rudimentary, by prolonging communication processes, we waste valuable time, which will interfere with our ability to see more patients.
I currently practice at two office settings and two wound centers. Now combine this with outpatient surgeries, hospital rounds and consults. Any time left for communication to my staff could be frustrating. However, 95 percent of our communication happens via text messages and emails, which frees up my time and ability to see more patients. Many times, I can handle a 10-minute phone call with text messages, which take up no more than 30 seconds to a minute.
If you go a step beyond this, you can even have the hospitals communicate with you via text messaging, sending consults instantly without the need to take time to write them down or type them into your phone. It is even possible to share images with smart phones, which allows physicians to communicate about pathologies such as an infection or abscess or cellulitis, making a conversation regarding the patient more relevant. Sometimes seeing an image of a patient's foot from an ER physician can solve a problem without the need to admit the patient.
A smart phone can even function as a scanner when you are in the hospital. I no longer have to carry around folded-up demographic sheets or notes from the chart as I image these with an app on my phone, which creates a PDF file that I can email to my office staff. The staff have the demographics and billing information to enter in the computer before I even leave the hospital floor.
Tablets. When Apple introduced the iPad three and a half years ago, it changed the way I read periodicals. I have not picked up a hardcopy medical journal now for over three years and I can without a doubt say that I have read far many more journals now than I ever have. Gone are the days of printing out a reference list, taking it to the hospital or university library and finding the journals. The associations that I belong and subscribe to place their journals online, which I then read through the corresponding website.
I am fortunate enough to belong to a teaching institute so I utilize www.sciencedirect.com  to access periodicals that the institute subscribes to. Here I obtain countless PDF articles to read at any given time. If the article is not available there, then a simple email to our wonderful librarian is all that I need to have her obtain the article and email it to me. This often happens within 24 hours.
Now comes the fun part. Once the articles are on my iPad, I have access to them at any given time. Accordingly, when I have a few minutes before a meeting or if I am somewhere outside of my office setting and I want to read, I have access to my entire periodical library. I am partial to Apple and the iPad, but I am sure one can do the same on most tablets.
Another fascinating concept the tablets have enabled me to do is immediately show my patients and their family intraoperative and postoperative photographs. I get a nurse circulator to use my iPhone to take the picture in the operating room and the images sync to my iPad. Large high-definition images are instantly at my fingertips to show the family and explain immediately following the surgery exactly what I did. Pictures are often worth a thousand words to our patients.
Technology isn't always just about getting that new gadget. It is about advancing your ability to communicate and learn. It can allow you to advance your knowledge at a rate that was once not even dreamt. We are just scratching the surface with what these devices are going to allow us to do. Video conferencing and sharing medical opinions will soon be instantaneous and worldwide.
1. Available at http://www.healthit.gov/providers-professionals/faqs/are-there-penalties...  .