Savak "Sev" Teymoorian, MD, MBA, focuses his blog on the latest glaucoma medications, treatment strategies and surgical advances.

BLOG: Doctor, when you’re ready, your requested patient feedback from Mrs. Smith is available

The forces controlling how medicine is practiced are pushing doctors to see more patients in less time. Compounding this time crunch is the growing pool of information that needs to be discussed between the patient and the entire health care staff. There are two solutions to this problem. First, providers can increase the number of work hours while keeping patient volume the same in order to create more time for each encounter. The reality, though, is that time is a limited resource, and there is only so much that can be delegated to non-physician staff. The second option involves thinking outside the box to find a more efficient use of time between doctors and patients. This can be done by separating when the time is spent from both sides for this interaction by not requiring this time to occur at the same period temporally. Fortunately, the ability to do this is not just a theory but can be achieved with current technology.

A solution we use

MDbackline is a computer-based program that allows for high-yield interaction between doctors and patients. It provides an electronic communication where both patient and provider can access pertinent information about patient care. Patients receive individualized education about their specific disease along with recommended care that is relevant to them. In exchange, providers obtain critical information about how patients are doing with their disease and responding to the treatment prescribed.

How it works

This process centers on a few focused questions that are answered by patients online after their office encounter. The responses given are used to create automated educational content in both written and video form that is recommended back to the patient. The result is high-level patient care that is distinct for each patient but with minimal extra time commitment from the physician and staff. In my practice I have found it allows for better and individualized patient care while doing so in an efficient manner. As an extra benefit, it could be used to fulfill CMS Meaningful Use requirements given its patient interaction. There are several modules within the MDbackline package, but are there are three in particular I find very useful: glaucoma, dry eyes, and pre- and post-surgical care.

1. Glaucoma. I am excited to see the increasing options we have to provide pharmacological care for glaucoma patients since the introduction of pilocarpine. However, each medication has what feels like an exponentially long list of side effects. Especially with greater than 50% of glaucoma patients requiring more than one class of medication, there is no way to cover all the side effects for each medication I might recommended. In practice I review the most important and common side effects directly with patients and then integrate use of the glaucoma module from MDbackline to complement the rest. I let patients know that I would like to provide an educational tool that would benefit both them and myself, and which they can do on their own time later when it is convenient to them. Just like doctors, I find more and more patients are time sensitive in their ability to get medical care, and they appreciate this is something they can do later on when they are better able to fit it in their schedule.

When the patient leaves the exam room, MDbackline is activated to send the patient an email that appears to come from me to their address on file. This provides patients the sense of individualized care while also reassuring them it is not a phishing scam. The timing of when this email is delivered is adjusted based on physician preference. Later on when the patient is ready, and in a HIPAA-compliant manner, the patient uses the personalized email to access MDbackline and its features.

The program starts with an introduction and guides patients through a short list of high-yield questions related to their glaucoma care and treatment. Their responses generate a unique set of patient education that is offered and also asks a few more pertinent questions. For example, the patient is asked at the beginning to check off what glaucoma medications they are using. The selected medicines then trigger some specific questions such as possible side effects to the beta-blocker class of medication if, for instance, timolol or a combination drop with timolol as a component is picked. If a patient then responds back positive with a side effect, especially a possible serious one, MDbackline sends a report to me with a highlighted warning. This signals to me and my staff to contact the patient to discuss this particular issue. This serves two purposes as it shows patients are aware of these side effects and also relays this valuable information to me such as confirming they are using the medications I prescribed and in the right doses. Other useful services provided are videos of common issues for glaucoma patients including how to instill eye drops.

2. Dry eyes. The next module I use is the one for dry eyes. This naturally comes in handy as the glaucoma drops can exacerbate the dryness. In much the same way as the glaucoma module, high-yield questions are asked and patient responses are used to provide unique recommendations.

3. Pre- and post - surgical care . Similar to the prior modules, the pre- and post-surgical care section allows patients to review surgical material including information about the surgery and frequently asked questions. In the module we use in my multispecialty practice, the doctor performing the surgery is the featured speaker on the video links. This provides an additional personal touch for the patient.

The end results

Most of the time I find that patients get the answers they want to their common questions in these three areas from MDbackline. This avoid the inconvenience for both the patient and our staff to communicate in real time. MDbackline provides that information at the right pace and length requested by patients. It also signals to me when I need to intervene back with the patient.

As providers, we want to provide the best care as possible for all of our patients. The time has come to use the technology around us to provide the level of care we wish to achieve. Creative services like MDbackline allow for such advancement in patient care in this evolving environment of medical practice.

Disclosure: Teymoorian reports he is a consultant for MDbackline.