EHR Insights

We live in an increasingly connected and technology-dependent world. As information technology has proliferated, it has changed the way we communicate with one another, as well as our expectations of how, where, and when we can consume information and get things done. This is as true in an aesthetic office as it is in other healthcare settings or in our daily social lives. Working in the aesthetic space creates specific challenges and opportunities around leveraging technology within the workflow.

To start, information technology impacts where your patients are coming from and how they get to you. About a decade ago, practices were commonly enlisting third-party “portal” sites that served as registries of contact information about cosmetic practices. These generally required paying fees to be listed or even a per-lead referral fee to those registries. In our current era of social media, however, many of these are now obsolete or not the best use of online marketing dollars to identify and target patients. Savvy practices work with their website teams as part of a more comprehensive online content strategy that leverages original video and educational content along with third-party products like virtual educational brochures from professional societies (like ASPS and AAD), medical animation videos, blogs, YouTube channels, virtual office tours, etc. These of course all interlink with the practice's social media presence on Facebook, Twitter, LinkedIn, Google+, and other sites. Smart practices use Google AdWords and other campaign tools side by side with client management and marketing tools in their office practice management software to identify who is searching for their services and direct targeted content toward them. Some web developer services offer a completely integrated suite of social media, online content development, website maintenance, photo archiving, blogging, and other services to present your best face (and those of your great patient results) forward.

Fine, so the patient has contacted you online or called the office for an appointment. Offering communication portals for patients to enter intake information can potentially reduce wait times in your front office and allow more efficient use of the physician's and staff's (as well as the patient's) time. This is another opportunity for marketing, by delivering details about how your practice differentiates itself from others through downloadable materials. You may save on mailing expenses and office supplies by moving more of this content to the digital domain. Many of us cannot remember the last time we read a newspaper in hardcopy, since we have become increasingly accustomed to receiving and consuming content on screens. Obviously, there are caveats to communicating with patients online: practices should explore HIPAA-compliant tools to replace gardenvariety email and texting, which work essentially the same way but in a more protected fashion.

The technology process flow now turns to practice management. In addition to obtaining basic demographics and contact information, this is an opportunity to further understand and engage customers. Some practices use informative “scripts,” taking a cue from telemarketing and call centers in how to tease out a prospective client's pain points and needs. Properly recording this in a way that is searchable and archivable in a practice management system is important, as that may be the primary location where you can go to identify who needs to be remarketed to for their three-month Botox reminder or a quarterly special on skincare products. Practice Management (PM) systems designed for the aesthetic space often include reminder and reporting tools to help you figure out what kind of business you did for which patients and when, which is critical to developing recurring streams of patient volume and revenue.

Frequently, an electronic heath records (EHR) system is the next part of this information chain. While government incentives and penalties may not resonate for fully elective, cash-pay aesthetic practices, there are still ample reasons to consider implementing an EHR system into the workflow. The EHR system may potentially interface with the practice management system, allowing tracking of cash charges by procedure and allowing streamlining of documentation for commonly performed services through smart data tools that are more dynamic than static templates. Inventory modules might interface directly to the PM system, the EHR system, or both, depending on your needs. A smart financial manager in a practice can query these systems to understand how much of what types of products and supplies are used for each line item of service in the practice. Perhaps by leveraging these tools well, you may decide to change your pricing for certain procedures to improve profitability, or find cost reduction strategies to optimize the use of your staff and real estate. For example: do you really need a large waiting room? Maybe that space is better served housing a laser or body sculpting device that can earn revenue while a patient is on your premises, rather than buffering patients in a holding area that is not revenue-generating. EHR system tools can also be used in the informed consent process, providing information as well as electronic signature capability for patients to sign on an iPad in the waiting or exam room. Many EHR systems, as well as physician peer social networks like Doximity, have built in virtual fax tools to help reduce paper in the office and allow secure faxing via Internet rather than conventional faxing. This may permit a more direct filing of information in the correct patient's digital chart and speed the process of communication with colleagues.

Tools like AppleTV and GoogleTV can allow you to illustrate and educate patients in the examination room from a tablet device with an EHR system or other patient education tool (TouchMD, Canfield Mirror, Understand.com, etc.) while broadcasting onto large wallmounted screens for an interactive, digital experience that can go a long way to reinforcing your brand as a state-of-the-art practice with a personalized touch. EHR systems in the cloud or with remote VPN login capability can permit you to later review your consultations and complete documentation in the comfort of other locations. For example, as a practicing surgeon, I am often called by patients at night when I am out to dinner or at an event. The ability to access the highlights of the medical record and enter a note in my iPhone is indispensible to providing round-the-clock care and documenting it appropriately while it is fresh in my mind. I no longer need to stay late at the office charting on paper or taking a risk by transporting charts in a car to finish my notes now that I am an avid user of an EMR system. Moreover, the content I generate by drawing on my iPad—describing breast lift incisions and the relevant anatomy with diagrams, or illustrating on a patient's photo taken on the fly using the iPad—can be shared with the patient to be consumed at home to reinforce my commitment to fully educating and informing patients of their surgical options and my recommendations. I am thoroughly convinced that such tools have helped improve my closing rate and enhanced the decision for patients to select me among other highly qualified plastic surgeons with whom they may have consulted.

Another important part of the aesthetic workflow is, of course, photo management and before-and-after galleries. These can be archived within an EHR system, a medical photo management tool, or other display tools, in addition to hard copy catalogues. Be careful when labeling these photos with any identifiable private health information, and ensure that if you keep these in a digital form, you use a tool that is meant for medical photo archiving. We have all heard stories of physicians being held liable for photos placed online with personally identifiable information attached. Do your homework here. Some tools allow you to publish prospective and actual results for the patient to consume at home, which can further your patient engagement.

Finally, we are all acutely aware of the importance of maintaining a consistent online reputation. This brings me to tools like review sites (RealSelf, Real Patient Ratings, Yelp!, HealthGrades, and others) as well as reputation management services (Medical Justice, for instance). The review sites tend to serve both as pre-consultation marketing channels (answering questions on RealSelf, for example) as well as patient reviews of their experiences. Properly leveraged, these can allow immediate added value from your consumers helping to increase your online presence, which can improve your website's Google search positioning. In addition, you can cite your positive reviews on your own site, contributing to an immersive brand management approach. Understand that search engines see where reviews originate, so be sure your patients are doing this of their own accord (no harm in encouraging them, naturally), preferably from their own devices, to optimize your results.

I'll close by returning to the subject of social media and content consumption: building a solid aesthetic brand and a successful practice also means creating a desire among existing and prospective patients to be part of the “private club” of your followers. You can leverage your Facebook, Twitter, and other social media feeds to encourage almost a “cult of personality” around who you are as an aesthetic surgeon, dermatologist, or other cosmetic provider. The tools are there for you to master.

Tim A. Sayed, MD, FACS is Medical Director, EMA Plastic Surgery™ and EMA Cosmetic™ at Modernizing Medicine. He is also an Executive Committee Member of HIMSS EHR Association.