ClickCare Café

Evidence-Based Analysis of Healthcare Costs -- and The Role of Telemedicine

Posted by Lawrence Kerr on Wed, Mar 28, 2018 @ 06:00 AM


The most common questions that we get about iClickCare are related to cost and ROI.  What is the return on investment of telemedicine? Can doing healthcare collaboration bring additional income into the organization? Will iClickCare help us cut costs? (To which we answer: the ROI is excellent; definitely; and for sure.)

It makes sense, given the cost pressures that providers, practices, and hospital systems face these days. So much of what we do boils down to cutting costs or increasing income for the institutions that we work for.

This focus on costs makes sense in a lot of ways. But it is also a shame, given the profound impacts of using telemedicine for healthcare collaboration that go far beyond cost savings. Ultimately, for us, iClickCare is about good medicine, not just good economics. We find that healthcare providers, who do telemedicine and do healthcare collaboration, experience less burnout, better outcomes, AND increased income and decreased costs. It simply goes back to providing the best care that we possibly can for our patients: a principle we all learned in medical school.

That said, we were intrigued by a recent study that gets deep into healthcare costs in the US — with some surprising conclusions. Fierce Healthcare elaborates on the study by Papanicolas et al., which was published in the Journal of the American Medical Association last week. It's an exploration that lends some good science to the conversation around costs.

There are fascinating findings, some of which debunk drivers of healthcare that we tend to take as “obvious” causes of high costs. Conventional wisdom says, "Sure, medicine in the US is more expensive than in other places, but outcomes are better, and the costs generally come from use of high-tech interventions and pro specialists." 

The reality is more complicated than that. In 2016, the US spent 17.8% of its GDP on healthcare. That's significantly higher than in the 10 other high income countries (United Kingdom, Canada, Germany, Australia, Japan, Sweden, France, the Netherlands, Switzerland, and Denmark) that the study looks at. Expenditures in those countries range from 9.6% (Australia) to 12.4% (Switzerland). And, sadly, life expectancy (perhaps a proxy for outcomes, or perhaps not) is lower in the US than it is in the rest of these high-income countries.

The first focus of the study was the source of these high costs. As the study authors report, “Administrative costs of care (activities relating to planning, regulating, and managing health systems and services) accounted for 8% in the US vs a range of 1% to 3% in the other countries.” It turns out that it is precisely these administrative costs, alongside pharmaceutical costs, that account for the total cost difference in the US relative to the other countries -- not costly specialists or expensive procedures. 

The study certainly raises important questions about value. And the conversation around evidence-based approaches to costs is hugely important. It's certainly detrimental to our field that we often don't tend to apply the same amount of rigor to analyses of costs and drivers as we do to the content of our medical practices. Ultimately, cost concerns drive the context in which healthcare providers work, so it's crucial that we understand these costs accurately.

But there are no easy answers. Why do we spend more on administrative costs of care? Is it because we're failing at care coordination and healthcare collaboration or is it for another reason? Why is our life expectancy lower? Is it because of poor outcomes relative to the other countries, or does our heterogenous country have different starting points than these other countries (as just one example of an additional explanatory factor.) 

While fascinating and helpful, the study certainly doesn't give us simple conclusions. It's an important conversation to be having, but it's also important not to jump to knee-jerk responses that don't really support us in moving forward.

As healthcare providers, most of what we can control is just in our patient-by-patient decisions, trying to improve care, bringing down the time that we spend playing phone tag or coordinating care, and improving outcomes. And ultimately, that may make the biggest difference of all.


Get an honest review of one of the most cost-effective telemedicine approaches available, here:


ClickCare Quick Guide to Hybrid Store-and-Forward

Tags: telemedicine technology, healthcare collaboration software, cost effectiveness

 The Provider Shortage Mistake Your Hospital is Making

Posted by Lawrence Kerr on Thu, Mar 22, 2018 @ 06:00 AM


Many healthcare providers feel undervalued, unappreciated, and overworked.

(“Yeah,” I can hear you saying, “Name one provider that doesn’t feel that way!”)

I know that for many providers, it feels like their work is disposable, that it’s not valuable, and that they’re a cog in the wheel.

In reality, however, healthcare providers are in short supply and of extreme value to hospitals. In fact, the cost of replacing a physician is estimated to be $500,000 to $1 million. And Fierce Healthcare reports that the provider shortage is bad and getting worse. They quote Bill Haylon, CEO of Leaders for Today as saying, “The findings tell us is that there simply isn’t enough qualified talent to go around and that frustration levels are rising."

So you would think that the healthcare system, in particular major hospitals, would be "all hands on deck" to retain their healthcare providers and to leverage their time and expertise.

In reality, my observation is that hospitals simply aren't doing enough to retain their providers. In 2014, 54% of U.S. physicians reported burnout, much of their frustration coming from ever-increasing clerical loads. Of course, physicians with symptoms of burnout are more likely to report having made a major medical error in the past 3 months and to receive lower patient-satisfaction scores. Many, perhaps most, feel under-appreciated, under-supported, and overworked.

Further, most medical practices and hospital systems are not leveraging their providers' time with hybrid store-and-forward telemedicine or healthcare collaboration. The pressure on providers to perform at the highest levels, with no mistakes, is high. But the tools provided to support care coordination or healthcare collaboration -- which can reduce workload, and decreased mistakes, while easing burnout -- are inadequate. 

We believe that the key challenge here is for us to connect the dots. We need to connect the dots between hiring challenges that hospital administrators face... and burnout... and the lack of healthcare collaboration tools that can significantly leverage providers time, and ease burnout. Ultimately, the right tools -- like healthcare collaboration using iClickCare Hybrid Store-and-Forward® -- can make the challenges around the provider shortage much less severe.

To learn more about how to start a program at your hospital, download our free guide: 

ClickCare Quick Guide to Hybrid Store-and-Forward

Tags: healthcare provider burnout, provider burnout, healthcare collaboration software

A Definitive Guide to Healthcare Collaboration

Posted by Lawrence Kerr on Wed, Mar 14, 2018 @ 07:40 AM

HC 3.png


Introduction to this Review:

They say that the more things change, the more things stay the same. And in medicine, that's especially true.

Recent years have brought pay-for-performance systems, focus on metrics like length of stay and readmissions, and demands of care coordination and meaningful use. In turn, all of these pressures mean that healthcare collaboration is critical to surviving in today's medical landscape But, of course, the more things change, they more they stay the same. Healthcare collaboration has always been the best way to provide excellent care to our patients. So it's one of those times when the "practical thing" is also the right thing to do.

As two doctors who founded a telemedicine-based healthcare collaboration platform, we're deeply passionate about healthcare collaboration. In fact, it might just be our life's work. So this page is meant to be your "cheat sheet" to healthcare collaboration. Use it as you wish: as a review, as a checklist, as an introduction. No matter how you use it, remember that beyond technology, beyond telemedicine -- the main thing is treating our patients in the ways we would want to be cared for. And it turns out that's good medicine, good business, and good work.


Table of Contents: 


“What we have here is a failure to communicate”
1967 Cool Hand Luke, Strother Martin, Captain and Paul Newman, Luke.

What is Healthcare Collaboration?

Healthcare collaboration is simply a team, working together, as professionals, on behalf of a patient. The goal is rapid, simple, documented, interactive presentation and discourse of information pertinent to a particular health need. When appropriate, the patient is part of the team. 
Of course, healthcare collaboration is not dependent on any one kind of technology. Providers doing healthcare collaboration may use technology but it's a tool, not the purpose. It's not dependent on any one kind of expertise, either. Providers doing healthcare collaboration can bring multiple kinds of experience and expertise, from across the continuum of care. It is the sharing of expertise that brings out the best medical care, irrespective how it was done. 

The classic principles of good medical care have always involved a team approach to complex diagnosis and treatment, as well as complex psychosocial overlays to physiologic and anatomic problems. This is not foreign to us as medical providers.

In school, we used study groups to help us learn. In labs, we had partners. If you were a medical doctor, you had rounds, grand rounds and morning report. If you were a surgeon, you had morbidity and mortality conferences. If you were a Physician's Assistant or Nurse Practitioner or Aide or nurse, you certainly had the same structure and hopefully were invited to be part of the above. With the changes in medicine, the need for these supports has increase, but most of the supports themselves have disappeared.

Currently, information technology is the lens through which this simple principle is seen. That has not always been the case. The concept and assumptions are timeless. Current or historical, they use the same classic principles.  One professional has a question for another. Sometimes a simple answer is all that is needed. At other times, a discussion is needed to add judgment and experience. And still at other times, discussion is needed over time.

However, the concept has been warped by technology and by the lens through which we view the technology. We have become more “connected” but in fact we are more isolated.  A text message has room for only data or for feelings, but not both. The phrase, “I am worried about” wastes 16 characters of message space. By its elimination, it also eliminates offers of support and enhances isolation.

Many, almost too numerous to count, words are used to label the use of technology in healthcare.  For example, this thorough analysis from Ziegler,  a speciality investment bank report.  

Many descriptors are used: telemedicine, mHealth, eHealth, telehealth, synchronous, asynchronous, video store and forward, secure text, secure email, telephone call, care management, personalized health, home monitoring, telecardiology, teleneurology, telestroke, teleER, telepsychiatry, telenursing and more. They overlap.


Why is Healthcare Collaboration Necessary?

Certainly, collaboration is not always necessary. It should not just be another healthcare product but rather an assist when an extra hand is needed. But when it is necessary, it is necessary for a variety of reasons:

1. As much expertise as each of us has, we need to realize that “No one of us is as smart as all of us."

2. The amount of knowledge has exploded. No one of us can master all of it. 

3. Healthcare is complex with ambiguity, uncertainty, and a blend of too much data and incomplete data. 

4. In serving the patient, often called providing healthcare, the provider, can be lonely. Burnout, job changes and suicide rates attest to that. 

5. The patient needs access to the right care, at the right time, in the right place, as close to home as possible. 

6. Those who follow behind need education. Medical education is the least effective that it has ever been from the time of the Flexnor report of the early 20th century. 

7. Data alone is useless without interpretation. Can you interpret high normal on lab and anatomic normal on an X-Ray, always? Weeding through an EMR is both exhausting and time consuming, only allows review of data, and can be supported by extensive reading. Our expertise is needed -- and, often, the expertise of multiple people is what's needed.


What Attitude is Necessary?

Artificial intelligence will become an aide. Emotional intelligence will become a necessity.

The demands of today's medical systems mean that we work in our own silo and rarely collaborate. We have academic specialties (stroke, cardiology, neurology, etc.) and relate to only one part of the body, not to the patient as a holistic being.

So medical providers who do healthcare collaboration tend to have a unique attitude. In our work with thousands of providers in telemedicine and collaboration, we've found the following attitudes to be crucial:

1.  Yearning to do better and belief that we can do more.

2.  Sense of responsibility beyond “the job."

3.  Respect for all colleagues regardless of role, from support to ultra-specialist.

4.  Enjoyment of interaction and of being a vibrant part of a community.

5.  Recognition of the whole, rather than fixation on the part.

6.  Acceptance of the limitations of one’s self or of one’s colleagues.

7.  Attitude towards technology as a friend not an as enemy.

8.  Understanding that the patient is the boss, not the administration nor the government.

9.  Recognition that the patient is a person, not a widget to move down the assembly line.

10.  Sense of satisfaction from being part of the whole that is bigger than oneself.

11.  Desire and ability to abstract, prioritize, and communicate a question and an answer.

12. Respect for the value of coordination and at times, for compromise.


Who Benefits from Healthcare Collaboration?

Healthcare collaboration, even when done on a limited scale, has so many benefits that it's almost difficult to enumerate them.

Some of the benefits of healthcare collaboration include:

1.  The patient by receiving the best care, at the best time, in the best place.

2. The healthcare system by benefiting from efficient and coordinated care.

3.  The taxpayer who is not the victim of waste from an inefficient system.

4.  The more healthy society by having more healthy members.

5.  The payor by paying for care that is less wasteful, more accurate and more preventative.

6.  The provider by having a satisfying and supportive work environment.

7.  The family who understands, who supports, and who is free of needless burden.

8.  The student who is healthy enough to learn well and to stay in school as much as possible.

9.   The educator who gains a rich experience for review to share with others.


Who DOES NOT Benefit From Healthcare Collaboration

Of course, we all resist change sometimes. And we're all busy and selfish at other times. But we find that the benefits of healthcare collaboration tend to be so significant and so immediate, that very few providers don't benefit. 

Ultimately, only the following people tend to resist healthcare collaboration so much that they never benefit:

1.  The egotist who is no longer the narcissistic center of attention

2.  The medical center wanting to survive because of control of the catchment area

3.  The entrenched regulator who resists change (within government or within a system)

4.  The adherent to a zero sum game where one wins only at the expense of another’s loss


What Equipment Is Necessary?

Little equipment or special technology is necessary to be collaborative. That said, there are a few technological tools that can make healthcare collaboration much simpler and more practical in today's medical system.

A secure system that ensures patient privacy.

In the United States, this is described as HIPAA compliant. In Europe, it's European Union General Data Protection Regulation; in Mexico, the Federal Data Protection Act; in Canada, it's PIPEDA. Countries throughout the world have similar examples.

Software is needed to make the devices, mobile or stationary, protect patient privacy and ensure that the entire system is compliant.

The ability to share images and videos.

Rich information allows good evaluation, so text is usually insufficient. A photo of a rash, a video of gait, or an audio clip of speech can be crucial to good collaboration and diagnosis.

At times, live video conferencing is important, especially when a consultation is direct from provider to consumer, but this is not really an example of collaboration. Further, when relationships need to be developed or when voice and face are easier than typing, the live video is important.

Limited peripherals.

When equipment (often called peripherals) is needed to obtain data such as an endoscopy, then specialized equipment is important. Realize though, that once the data obtained, it can be shared by a healthcare collaboration system.

Internet Connection.

An internet connection, slow or fast, is necessary if modern technology is going to be leveraged. However, stopping a colleague in the hall or on a telephone call is also healthcare collaboration. But one might not be in the hall at the right time or able to take on the phenomenal burden of telephone tag -- which is why it can be helpful to have a technology tool to help with the coordination and communication.

Specifically, the components of the needed equipment include:

1.  The desire and need to collaborate

2.  Connectivity

3.  Secure, comprehensive software platform (asynchronous, store-and-forward)

4.  Secure video-conferencing system (on occasion)

5.  Policy and procedures

6.  A system that is easy to use, always on, always available (for instance, a smartphone)


What About Policy And Procedures?

Seven main components need to be in place. They need not be complex, but should be tended to to ensure compliance:

1.  Reimbursement policy and procedures.

2.  Privacy procedures consistent with HIPAA.

3.  Bring Your Own Device (BYOD) policy.

4.  Patient permission policy.

5.  Policy about access to records with change in employment.

6.  Electronic orders.

7.  Delineation of responsibility.


What Is Needed From Leadership?

Of course, there are many leaders in every healthcare community. Aides, family members, nurses, doctors, administrators, and specialists are all leaders at different times and in different ways. But many times, medical providers get stuck in their efforts to collaborate because they don't have the support they need from "official" leaders -- department heads, hospital administrators, and the like. Medical providers can also be buoyed and championed by forward-thinking hospital administrators (of which there are many), something we've certainly seen and experienced over and over again. 

Medical leadership can offer the following to support healthcare collaboration efforts:

1.  Acceptance of something new and willingness to change

2.  Commitment to making healthcare collaboration work

3.  Encouragement and enforcement of use

4.  Strong support of implementation

5.  An empowering attitude

6.  High level understanding of workflow and its challenges

7.  Broad view of ROI and the changing reimbursement landscape.

8. Pride in accomplishing improvement over operational status quo.

9. Trust in downstream integrity

10. Willingness to make a decision (take a risk) before others in the industry


What are Examples Of Good Healthcare Collaboration?

Despite what skeptics may say, there is excellent healthcare collaboration happening all around the country, every single day. We see so many examples of incredible collaboration, including:

1.  School-based healthcare.

2.  Connected health.

3.  Cleft and Craniofacial Teams.

4.  Rehabilitation teams.

5.  Developmental teams.

6.  Clinical-pathological conferences.

7.  Tumor Boards where clinicians, researchers and lab colleagues discuss cancer care.

8.  Burn centers where intensity varies from ultra-acute to chronic care.

9.  Space medicine where many need to tackle the unknown at the limits of mankind’s habit.

10.  Transplant medicine where molecular biology works with surgical skill and pharmacology.

11.  WWII Valley Forge Hand Center where multiple specialists came freely and shared in care.

12.  WWI Harold Gillies Facial Reconstruction team where devastating facial injuries met artist and surgeon.


What are Examples of Poor Healthcare Collaboration?

There have also been some false starts and failures along the way as medical providers have tried to do healthcare collaboration and failed, or as people have willfully ignore the opportunity to work together altogether. For instance: 

1.  Development of anesthesia where fight over ownership slowed adoption.

2.  Semmelweis’s prevention of puerperal fever which was demeaned by the establishment.

3.  Banning of reconstructive breast implants because of a single approach to the complex.

4.  Patenting of medical advances such as cataract procedures.

5.  Various centers based on self promotion, look to the billboards and TV for the list.


How Do I Implement A Healthcare Collaboration Program?

If you're a medical provider or a healthcare administrator and you're interested in starting a healthcare collaboration program, then we are thrilled to help in any way we can. We've seen thousands of programs implemented and found some key steps to help you along the way. 

Keep in mind:

1.  Consider starting at a hotspot with fewer than 30-50 people involved.

2.  Plan and purchase for build out within 45 to 90 days to enable the network effect.

3.  Build collaborative networks based on already trusted colleagues.

4.  Continue support after introduction.

5.  Use train-the-trainer approaches so that there may always be local expertise.

6.  Budget less than one hour exposure for each participant to keep things simple.

7.  Allow self study and for medical providers to work at their own location and timing (as with hybrid store-and-forward technology.)


Key Outcomes of Healthcare Collaboration

There are many reasons to prioritize healthcare collaboration in your practice, hospital, or workday. Chief among them is the satisfaction, decreased burnout symptoms, and overall joy that providers tend to get from working together on cases.

But you'll notice a lot of other benefits as well, and the following overview of the key benefits may be a helpful outline for you as you share the potential of healthcare collaboration with colleagues... or even to be used as a checklist for assessing progress and results.

I. Cost

A.  Avoid duplication

1. Tests

2. Procedures

3. Sorting out of complications (i.e. reddened IV sites

4. Order and ranking of testing done with expert guidance

5. Avoid referral to wrong place

B.  Efficiency

1. Throughput in Emergency Department

2. Throughput in Operating Room

3. Shorter Length of Stay

4. Faster communication among unit or team members

5. Shorter work time (store-and-forward)

6. Change of diagnosis and testing from “shotgun” to precision

7. Imaging and Lab results easily placed into appropriate clinical history 

C.  Income

1. Larger catchment area can be served

2. Increasingly billable services

3. Value-based care

II.  Quality

A.  Safety

1.  Handoff errors reduced or eliminated

2. Reference and saving of more informal communication

3. Inappropriate, but still dangerous, testing, reduced

4. Rapid secure communication of environmental or infectious events

5. The potential for understanding trends with AI analysis of conversations

B.  Provider employee support and satisfaction

1.  Decrease burnout of isolation

2. Increase educational opportunities

3. Remove nagging doubt

4. Increase satisfaction of job well done by short and long term follow-up

5. More rapid on-boarding based on case review and store-and-forward methods

C.  Public health

1.  Increase communication across entire community of providers

2. Allow on-site care of patients by first responders

3. Better triage in disasters

4. Population health analysis

III.  Patient

A.  Patient understands thought process behind advice

B. Patient appreciates effort on their behalf

C. Patient can be part of the process (part of the solution, not the problem)

D. Patient avoids time off from work or school for self for some follow-up

E. Patient avoids time off from work or school while caring for child or parent

F. Patient avoids repeated history as thread of conversation unfolds




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Tags: healthcare collaboration software, medical collaboration tool, hippa secure healthcare collaboration

The VA's New Approach to Healthcare IT is Surprising -- But Useful

Posted by Lawrence Kerr on Tue, Feb 14, 2017 @ 06:04 AM

vaapproachtoit.jpgThe VA's operational, managerial, and technological struggles have made nationwide news in recent months and years.

But the Department of Veteran Affairs is working on a new approach to scheduling, EHR interoperability, and billing.

Since the VA is an extreme case in terms of the problems they're facing, resources available, and unique constraints given their governmental status, their approach to these changes is surprising -- and potentially a good model for other hospital systems.As Fierce Healthcare reports, "Lawmakers continued to criticize VA officials for using decades-old legacy systems, drawing comparisons to the overwhelming costs required to maintain an old car."

We tend to trust that despite all of the VA's challenges, the vast majority of administrators and healthcare providers are doing their absolute best to improve care at VA hospitals, within the constraints they have. A recent article reports that they are making a fairly dramatic shift in how they approach their IT and their purchasing. As Fierce Healthcare reports, the VA is "considering commercial products and moving data to the cloud instead of spending money building customized in-house systems."

So does that shift have anything to teach the rest of us who are also trying to improve our systems, while cutting costs, and improving performance? We think so.

There are three great ways to improve performance and adaptability while not increasing costs, as the VA is beginning to find:

Don't build everything custom.
As David Powner, director of IT management issues at the Government Accountability Office said, "Buying instead of building is the way to go." There is a growing community of products available for the healthcare system, iClickCare being just one of them. Are they all perfect? Of course not. But if you keep a shrewd eye on HIPAA compliance and a high prioritization on ease of use, you often more easily find an off-the-shelf product that will meet your needs than building from scratch.

Use the cloud.
The VA says they're looking more to cloud-based software, and that certainly makes sense to us. iClickCare has always been cloud-based because it allows us to be constantly updating the software as needs change, technology improves, and our offerings evolves. It means that with a single subscription, you get cutting edge technology -- without your team needing to use time or resources to update it yourselves.

Don't over-invest in hardware.
The Government Accountability Office has estimated that a large portion of the VA's budget has been going to maintain systems that are more than 50 years old. Wasteful? Definitely? Dumb? Probably not. This type of expenditure often comes from having a lot of hardware that would be impossible to update but expensive to replace. This isn't just the VA's problem, though, it's every hospital system's challenge when they've overinvested in hardware, rather than investing in software, systems, and people. As we've shared in other posts, hardware is often the least cost-effective, least innovative way to pursue telemedicine -- and this concept applies to other Healthcare IT as well.


We look forward to seeing the VA evolve and grow in coming years, and we hope that this shift toward modernizing their approach to IT is the sign of more great things to come. 


If you're curious how iClickCare works to limit your hardware expenditures and keep you HIPAA safe, click here to learn more:

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Tags: telemedicine, healthcare collaboration software

What Donkeys Know About Healthcare Collaboration

Posted by Lawrence Kerr on Wed, Dec 28, 2016 @ 02:17 PM

4f42iqlrjf4-timothy-muza.jpgHarrison is an autistic preteen. He has good days and bad days. And his parents have certainly been on a journey of learning to live with, and be parents to, him.

He has a secret weapon when it comes to autism, though -- and that's his donkeys. Harrison, it turns out, has been riding and racing burros since he was 3 years old. According to his father Hal, Harrison has a special relationship with the donkeys. And that special relationship has something significant to teach us about healthcare collaboration.One of the original inspirations for iClickCare came from the work I did on our Craniofacial Team. As a surgeon of significant facial deformities like cleft palates, I found that it literally took a village to support and "cure" a child with a cleft palate. It took speech therapists, teachers, dentists, surgeons, pediatricians, and more. So I set up a monthly time when the whole team -- across the continuum of care -- would get together to discuss our pending cases. The patients we cared for in the Craniofacial Team thrived in every way. And that feeling of true healthcare collaboration for the whole patient is what guided us to start iClickCare -- we wanted to make it easy and fast for all healthcare providers to have that kind of experience.

Although it makes a lot of common sense, this kind of team approach is rare in medicine. Why? As scientists, it's common for us to focus on the "active ingredient" in healthcare. We prize the surgery. We prize the antibiotic. We prize the super-specialist.

But my experience on the Craniofacial Team demonstrated, again and again, that it is the whole treatment, for the whole patient, that matters - not just the "active ingredient."

The autistic boy's burro racing impacts him as much or more as his regimen of therapy does. The teacher's careful work around speech and reading matters for the cleft palate patient just as his occupational therapist's work does, just as his surgeon's work does.

So what it is that Harrison, the donkeys, and the Craniofacial Team teach us about healthcare collaboration?

They teach us that the whole patient, and each person's contribution to that whole patient matters. They teach us that it's not just the "active ingredient" in the medicine that always makes the difference. 

It's easy to get started with iClickCare for your medical team. Try it here:

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Tags: telemedicine, medical collaboration, healthcare collaboration software

Running is Good for Mental Health -- and a Reason to do Telemedicine

Posted by Lawrence Kerr on Wed, Dec 07, 2016 @ 10:46 AM

runningpic.jpgThe most common argument against telemedicine-based healthcare collaboration is that it's simply not worth the time.

With so many pressures on a provider's time, it's easy to say "I would do it, but all the must-haves get in the way."

But a recent study is one more challenge to this notion -- a piece reviewing recent studies on running and its impact on mental health.Ultimately, providers do telemedicine-based medical collaboration because they know that treating a patient is about treating the whole person -- not just conducting some kind of medical transaction. Treating a patient as a team isn't a "nice to have" -- it is simply more effective than treating a patient as an individual provider, in a silo so t speak.

Collaboration is about saying, "I know a lot about this patient, but I wonder if my colleague (with his different expertise) has a different viewpoint" and "My job is to treat this patient to the best of my ability, given all the people and resources available to me."  This also implies not tripping up the other providers' plans and medications, including those of the school system and social workers in some cases.

This is something we all know, but it is so easy to forget. A recent New York Times article reminded me of the value of this whole-patient approach to health. The article looks at the significant effects of running and its impact on depression. For instance, men and women with the lowest physical fitness are 75% more likely to have a diagnosis of depression. Running seems to be able to alleviate symptoms of depression in the same ways (although not always to the same degree) as medication and therapy do. 

Sure, you say, exercise is the miracle drug. But what does this have to do with healthcare collaboration?

The proven impact of running on mental health is proof that we have to treat the whole patient in order to treat the patient well. It's a great example that patients are more than just their condition, and even things that seem unrelated -- like running and mental health -- may well impact each other. When we are "siloed" as providers, when we don't collaborate, we are less likely to help patients in a holistic way. Just treating the immediate condition is not always treating the patient well.

As an individual provider, we often don't have all the information we need to treat the whole patient. The cardiologist might not know that the patient's depression is contributing to noncompliance in taking his or her medicatiion. And the physical therapist might be able to use iClickCare to mention that the patient used to be a runner, and exericise could be a great tool for helping with heart health, ease their depression, and improve compliance. That's why it's so crucial to treat the patient as a team -- the team enables us to treat the whole patient.

Using telemedicine for medical collaboration doesn't have to be time-consuming. But it can be life changing for those you treat. And it can make your practice a lot more satisfying. 


Learn more about using iClickCare to easily and securely connect with other medical providers today:

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Tags: telemedicine, medical collaboration, healthcare collaboration software

The Greatest Healthcare Collaborations of All Time

Posted by Lawrence Kerr on Fri, Mar 25, 2016 @ 07:30 AM



Our friends at Hubspot have a unique outlook on the world of business, and often have interesting insights for the medical world. Matthew Kane lists 7 creative collaborations, which are an interesting starting point for thinking about what it means to collaborate effectively with colleagues.

For instance, Kane identifies these classic collaborators:

  • Andy Warhol and Jean-Michel Basquiat
  • Paul McCartney and John Lennon
  • F. Scott Fitzgerald and Zelda Fitzgerald
  • Harry, Albert, Samuel, and Jack Warner
  • Ed Catmull, Steve Jobs, John Lassete
  • Steven Spielberg and John Williams
  • Helmut Krone, Julian Koenig, and William Bernbach

We love these as a starting point. Obviously, these folks are “creatives” and in a different field. But they solved problems in new ways, different ways, bold ways, and creative ways by being collaborative. And the truth is that we see medical teams acting equally collaborative and equally creative -- every day. For instance, just last week a major study looked at the way the "soft innovation" of full-time care teams for a given condition had blockbuster results.

In healthcare, some of the most important innovations of our history have been created by teams: 

  • Banting and Best (discoverers of insulin)
  • Watson and Crick (DNA)
  • Flexner and Flexner (memory)
  • The patient and the doctor
  • Marie and Pierre Curie (Curie said, “My husband and I were so closely united by our affection and our common work that we passed nearly all of our time together.”)
  • Blalock and Taussig (Blalock Taussig shunt for congental heart disease with the African American lab assistant who really did the work)
  • Debakey and Tarvik (artificial heart)

Of course, everone in medicine knows the thrill of teaming up a diagnostic problem, sharing woes or joys, or learning together. But these days, these exciting and illuminating moments of healthcare collaboration have become fewer and farther between. iClickCare is one way to bring them back to your practice -- without time or hassle -- but you can do it pretty simply, by walking down the hall or looking across your desk.


We looked for stores of medical collaboration around the world and here's what we found: 


ClickCare Quick Guide to Medical Collaboration

Tags: medical collaboration, medical collaboration software, good medicine, healthcare collaboration, healthcare collaboration software

What a Patient's Family Photos Have to do With Telemedicine

Posted by Lawrence Kerr on Fri, Dec 18, 2015 @ 08:30 AM



Not so long ago, people with facial deformities were not treated as people. As babies, they were sometimes left to die. As adults, they were assumed to be inept, unintelligent, and even unfeeling.

Of course, we now understand that a facial deformity is a condition that a person has -- not a condition that defines a person.

But sometimes in the crush of technology that medicine strains under, I worry that we've somehow gone backwards. These days, we're often reduced to seeing patients in 6-minute windows, entering data in EMRs by ourselves in a windowless room, rarely finding time to chat with other doctors, and receiving weekly productivity reports. So often, these days, we're just processing conditions, not helping people with conditions.

To be quite honest, iClickCare is sometimes criticized as not being an efficient enough tool at processing conditions. Despite its ability to save institutions significant amounts of money and improve results, folks are often critical of how it fits into the assembly line that medicine can become.

My answer? It doesn't really fit into the assembly line. Telemedicine generally, healthcare collaboration generally, and iClickCare in particular, fit into an efficient, thoughtful, caring, low-cost model of telemedicine that is decidedly not an assembly line. It's a conversation. It's an exploration. It's caring for people with medical conditions, not processing conditions evermore impersonally. Besides, the assembly line is not showing itself to be efficient or effective.

That's why Dr. Mikkael Sekeres's article about how his patients' family photos impact him, really impacted me. Dr. Sekeres shared that in taking a moment to look at the family photos on the wall of a patient's hospital room, he says, "I get to appreciate my patients from the time before they were sick and I can also see what they are trying to return to."

This is not a bleeding heart sentiment. If you don't know who your patients are and what they are trying to return to, you cannot treat them effectively. You can treat them -- well, and efficiently. But you can't treat them with the knowledge of how an extra day in the hospital affects their job. You can't delay surgery by a day so the high school swimmer can still swim in the state competition. You can't involve a young child's teacher in the telemedicine conversation about her speech development.

Your tools must support you in treating people -- not processing conditions:

  • People are more than their treatment.
    Healthcare collaboration is crucial and it must be rich conversations among healthcare providers, involving pictures, words, and videos -- not a text form with a single question and answer.
  • People have homes and jobs and families that are key to their health.
    That's why healthcare providers need to coordinate and collaborate with each other, across distance and on their schedule, so that patients don't have to trek from appointment to appointment with little benefit.
  • People have multiple facets of care and many caregivers and healthcare providers.
    For good care to happen, it's not about the opinion of an expert. It is about people across the continuum of care collaborating on a single case.
  • People have pasts and futures.
    That's why healthcare providers need to be able to refer back to past cases with ease -- using them to inform what the patient is facing now.

Especially this time of year, we are so grateful for our loved ones and are conscious of the health we have -- never to be taken for granted. We're also grateful for the many healthcare providers we know are equally conscious of the "non-medical" aspects of care that we hope to receive if and when we need care ourselves.


We put together a free ebook on hybrid store-and-forward telemedicine. You can download it here:

ClickCare Quick Guide to Hybrid Store-and-Forward

Tags: telemedicine, medical collaboration, hybrid store and forward medical collaboration, healthcare collaboration, healthcare collaboration software

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