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Time to update your Web site? | |||
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When the Web site for Bristol Park Medical Group in suburban Los Angeles debuted in 1999, it was like most practice Web sites back then—basically just an advertisement. Not any longer. First the 80-doctor primary care group amassed an online library of patient education material. Next came communication tools that allowed patients to request appointments and prescription refills and to ask clinical questions. These are a convenience for patients and mean fewer phone calls for the office. "We have 5,000 patients who use these services, and they love it," says internist and medical director Mark Schafer. Just this year, Bristol Park introduced two more Web site tools. The "Personal Health Tracker" lets patients review their history of preventive health screenings and receive reminders when one is due. And consulting specialists can now log on and read portions of a patient's medical chart. If you want your Web site to be more than an electronic brochure, you've got to catch up to the likes of Bristol Park. True, medicine is nowhere near the banking, brokerage, or retail industries in terms of Internet services, but practice Web sites are nevertheless improving patient care and streamlining office operations. And it's not just large groups that are reaping the benefits of this technology. At three-doctor Northern Virginia Family Practice Associates in Alexandria, 95 percent of new patients register online at the group's Web site, shortening their first visit and providing the practice with legible information in advance. FP Patrick Tokarz adds that 10 percent of his established patients complete an online symptom assessment form before making an appointment. "It helps us know whether we should schedule the appointment right away, and for how long," he says. Of course, the state of the medical practice Web site art continues to evolve. The next big thing will be a personal health record that's available through a practice Web site. Someday it could be a patient's point of entrance into the national health information network envisioned by President Bush. Whether you want to create a practice Web site, or upgrade what you already have, you need to know what makes a Web site a hardworking extension of your office. We've surveyed the medical wing of the Web to give you answers. Be sure to include this core content It's hard to imagine a medical office without exam rooms or a receptionist counter. An online office also has its own key elements, outlined in navigation buttons on the Web site's home page. Labels for this content may vary, but they follow along these lines: About us. This section is where you describe the mission and history of your practice. Physician profiles . Don't just paste in your CV. Explain in a few paragraphs what makes you tick as a clinician and person. Include a photo, says Steve Malik, CEO of Medfusion, a healthcare Web site firm in Raleigh, NC. "Patients will choose a doctor they can see over one they can't see." Some practices also include a section that displays photos, titles, and short job descriptions of staff members. That section serves a dual purpose: it lets patients differentiate people in the office and makes the staff feel good that you recognize them as the integral part of the practice that they are. Our services. Highlight common conditions that you treat, as well as ancillary procedures such as Botox injections and nutritional counseling. "Web pages about services receive lots of visitors," notes Malik. Insurance and fees. List the insurance plans you participate in and tell patients how you expect them to pay their portion of bills. Office hours and location. Besides providing these basics, insert a link to MapQuest.com to provide directions. Patient education. Roughly 30 million adults make the Internet their primary source of health information, according to New York-based Manhattan Re-search, which studies healthcare information technology. So why not let them do this legwork at your Web site? Tip: Label patient education material as such, not with vague terms such as "Links" or "Resources." Frequently asked questions. "FAQs are some of the most heavily visited pages," says Steve Malik. Wondering what to post? Poll staffers on the questions they hear most frequently, and then write up your responses. At Northern Virginia Family Practice Associates, FAQs include "Can I see you even if you do not participate with my health insurance?" and "What is a PA?" Contact us Include an e-mail address for nonclinical messages. Online services. Secure messaging (more on this later) lets patients request prescription refills, referrals, and appointments, ask nonurgent clinical questions, and pay bills. Many sites assign a navigation button to each service. Online forms. Whatever forms patients fill out in the office can be posted on your site, either as a document they submit electronically or as one they print out and bring to the office. Go beyond links and homegrown articles On the first physician Web sites that emerged in the late 1990s, patient education consisted mostly of articles written by doctors in the practice and hyperlinks to authoritative sites such as the National Institutes of Health (www.nih.gov). This model is still a sound approach, but articles with your own byline will also add a personal touch to the site. Links put a world of knowledge at a patient's fingertips—and cost you nothing. However, don't get lazy and list links in willy-nilly fashion without explaining to patients why they're important. The Web site for Concorde Medical Group (www.concordemed.com) in New York City organizes a couple of dozen links under topics ranging from diabetes mellitus to antibiotic prophylaxis, and includes a brief commentary on many. While they're valuable, links and homegrown articles can be problematic. Not everybody has time to write—or update—their own material. And links whisk patients off your Web site and put them on somebody else's. Novice Web surfers could get lost in the process. The wave of the future is patient education material from trusted sources that's automatically posted at your site. Patients don't have to go elsewhere to read an article about, say, wound care. The source organization freshens the site with new and updated information, meaning less work for you. A small practice working with a local Web designer might find this strategy unaffordable. Licensing patient education material can cost big bucks, and you'll have to pay the Web designer extra to integrate it into your site. However, price is less of an obstacle when doctors turn to companies specializing in practice Web sites. The major ones (see "Who should create your Web site?") automatically incorporate patient education materials from outside sources. Medem, for example, taps into handouts produced by its constituent medical societies. Medfusion, an IT partner of the American Academy of Family Physicians, stocks Web sites for FPs with AAFP self-care charts and handouts. RelayHealth relies on a company called MediMedia USA for patient content. And Omedix offers more than 5,000 articles from Healthwise, a nonprofit organization that supplies educational material to health plans, disease management companies, hospitals, employers, and group practices. Go for secure messaging and data sharing If you're going to communicate with patients online, you shouldn't rely on ordinary—and vulnerable—e-mail. You'll need "secure messaging," the same technology used by your bank for online services. Messages are encrypted and stored in a Web server behind a firewall. To send or retrieve a message, you must first enter a user ID and password. Any competent Web designer can build in secure messaging. It's also a standard feature of Web sites from Medem, Medfusion, Omedix, RelayHealth, and other companies that put practices online. If you have an existing Web site, it's possible to plug in secure-messaging tools from these companies. The Web site of Bristol Park Medical Group, for instance, incorporates secure messaging from RelayHealth. In addition to communication channels, third-generation Web sites include selected clinical data. Lab results were the first bits of the medical chart to go online. Now there's a push to add patient health records, or PHRs, that may include patient-supplied information, clinical data, or both. Medem and RelayHealth sites come with a PHR that patients fill in themselves, which raises the question of whether they'll do so faithfully and accurately. However, such PHRs don't have to be stuck in the do-it-yourself mode. Medem and RelayHealth both recently announced that Sure-Scripts, a company that electronically connects pharmacies to physician practices, would begin transmitting medication histories to individual PHRs. The two rivals also are moving to integrate clinical data from EHRs into their PHRs. Some practices already boast Web sites with PHRs that are extracted from their electronic health record system. Patients at Group Health Cooperative, a nonprofit healthcare system based in Seattle, can go online and view lab results, medication and problem lists, and other sections of the group's EHR. And patient education is woven into their cyber-experience. A patient can click on diabetes in his problem list and read articles from Healthwise on that disease. "This allows them to review what they've talked about with me in the exam room," says internist John Kaschko. This option is starting to come within reach of small practices, as well. Last August, EHR vendor Misys Healthcare Systems, in partnership with Medfusion, began offering customers a discounted practice site with secure messaging. What's niftier, though, is that the Medfusion-authored site meshes with the 8.0 version of the Misys EHR program, now in beta testing. This will allow practices using that version to send patients a secure message containing their "Continuity of Care Record," a standardized summary of the medical chart containing such elements as medication and problem lists, immunizations, and family histories. A patient can then print a copy of his CCR or import it into a PHR from Medfusion that's built into the Web site. One Misys customer that's opted for this Web site is nine-doctor Carolina Internal Medicine Associates in Asheville, NC. It expects to switch to the new 8.0 version of the EHR program this spring. "Our goal is to let a patient download his CCR so he can share it with other doctors and keep track of things himself," says internist Ken Kubitschek. "The more knowledge a patient has, the better the compliance, and the better the outcomes."
Who should create your Web site? You may have a strong do-it-yourself streak, but don't try to build a practice Web site from scratch. Sure, you can buy design software like FrontPage or Dreamweaver for a few hundred dollars and clack away on a keyboard past midnight; but unless you've studied graphic design, you could end up with an amateurish-looking and confusing site that drives away patients. Then there's the science of engineering the site to score high with search engines. You've got better things to do with your time. Hiring a pro is the smart way to go. But you'll want an established company—not a moonlighting relative—that you can count on to update the site and keep it in good working order (for more on this, read "Tune up your website" in the April 7 issue. Like physicians, Web design shops consist of generalists and specialists. The generalists, which include advertising and marketing agencies, can give you a beautiful site with the secure-messaging tools that are de rigueur these days. However, a firm that works for a hotel one day and a florist the next may lack a deep understanding of how a virtual office can improve patient care and reduce your staff's workload. In contrast, companies that specialize in physician Web sites already know fine points, like routing online appointment requests just to schedulers and refill requests just to nurses. Their sites come stocked with patient education material that you can customize. They may offer connectivity with EHR and practice management software programs. And discounts may be available for members of organized medicine. Here are four leading physician-Web site specialists and the prices they charge to create a site. All offer secure messaging. Medem (www.medem.com). Web sites cost $195 per doctor per year for members of the AMA and specialty and state medical societies that partner with this company. Other doctors pay $295. Sites are created cookie-cutter style, using a variety of templates and color schemes. Hosting and maintenance are included in the charge. RelayHealth (www.relayhealth.com). This pioneer in secure messaging charges $75 per doctor per month for a Web site with a standard design, customizable content, and interactive tools. Group practices qualify for discounts, and hosting and maintenance are included in the charge. Medfusion (www.medfusion.net). Customized sites for a solo practice begin at roughly $2,800, plus $1,250 for each additional doctor. Medfusion charges $50 a month for hosting, and another $50 per month for a Web site editing program that lets a practice make as many changes as it wants. Members of the AAFP and Medical Group Management Association receive a minimum 10 percent discount. Omedix (www.omedix.com). Prices range from roughly $2,300 for entry-level sites to $7,500 for highly customized sites with advanced features like animated patient education. Omedix has extensive experience developing sites for cardiologists and orthopedic surgeons. Hosting and maintenance charges for a solo practice are $75 a month, a figure that includes limited updates of content. Omedix offers an editing program like Medfusion, but it costs substantially more. |
