How to Build Your Own 21st Century Practice

When physicians talk in the hallway or the elevator about a patient issue, a referral, or other physician communication, it is commonly referred to as a "cubside consult." In his recent article

When physicians talk in the hallway or the elevator about a patient issue, a referral, or other physician communication, it is commonly referred to as a “curbside consult.” In his recent article, “Airport Confidential: You Have the Right to Remain Silent,” Eric Tangalos, MD reviewed the need for discretion and privacy protection when discussing patient information in public spaces and on cell phones. Add to this the growing use of virtual communications tools, such as e-mail, text messaging, and other Web technologies, and the risk of a significant breach of patient privacy increases exponentially.

Having it All

New Web-based technologies such as VoIP or Internet telephony, instant messaging, and social networking are no longer limited to the Net Generation, which has been immersed in technology since birth. Now, these tools are being increasingly incorporated into the daily lives of people of all ages and profiles. As a result, these technologies are also rapidly working their way further into the healthcare delivery process. Good or bad, unlimited access to health information through robust health portals and a growing reliance on instant communication has also fostered a demand for faster, more direct communication with doctors and healthcare providers.

One physician in Brooklyn has created an interesting new practice model, based on the premise that patients want greater access to their doctors and greater freedom in how they communicate with them. Offering concierge-style service, (see our article for more on this), he makes house calls, and doesn’t even have an office or staff. To communicate with patients, he uses an Apple iPhone and standard Google mail and instant messaging (IM). With his practice centered on familiar, personalized service bolstered by Web-based communications, he is, in essence, the 21st century equivalent to the “old country doctor.”

Back to Reality

This model of patient access and open communication is admirable, with many aspects that should be actively considered by all physician practices. However, the desire for real-time online communications must be reconciled with patient privacy and the ramifications of a breach. For example, classic e-mail and IM programs are not encrypted and unsecure. In fact, most user agreements stipulate that e-mail files are public, giving e-mail providers the right to manipulate them in any number of ways. This is not to suggest that open communication with patients and other medical professionals is bad or that online tools cannot be used. However, a safe and secure physician-oriented solution must offer powerful tools designed to help medical professionals communicate more effectively by providing secure access to each other.

Weigh Your Options

Offering online collaboration tools that create a secure mechanism for medical professionals to stay linked with patients, partners, colleagues, and friends, a new service developed by CurbsideMD is gaining traction among medical professionals.

Many physicians cringe when they hear the terms “online community” or “social networking.” After all, they say, I’m not trading music files or pictures. It is no surprise that survey after survey shows that most physicians do not value—and therefore, are not using social networking.

But, what is the real purpose of an online community? It is to connect people with like interests and needs and give them the opportunity to exchange ideas and solutions. This has evolved from FaceBook and MySpace targeted at the Net Generation to business-oriented tools, such as LinkedIn. But what does a similar solution look like for physicians?

Curbside Communities™, a professional social network, is built on a framework of user trust and invitation, but includes encrypted chat and messaging functions, as well as discussion forums and other tools to make connecting and communicating with physicians easy, secure, and convenient. It is shaped to meet medical industry-specific requirements, such as patient privacy, topic-specific discussion areas, call escalation based on caller and call reason, and the ability of affiliated staff to use some of the tools easily and appropriately.

Curbside Communities™ also provide exposure to enabling technologies designed to help medical practices improve capabilities and revenue. Perhaps the technology with the greatest potential to make a significant impact is a secure smartphone. With secure e-mail and IM, next-generation phones bring all the communication benefits of the Web to your fingertips, while uncoupling you from the office—and the fear of privacy breeches.

To this end, Curbside MD is developing a program with the California Medical Association (CMA) and a variety of county medical associations to seed more than 11,000 resident physicians with next-generation smart phones. Now, it’s easy to imagine thousands of 21st century doctors with the ability to walk out of a patient visit, open their smartphones, and instantly send a secure message to a colleague for a consult or the pharmacy to submit a prescription.

Saving Grace

It is a brave new world out there for physicians. A bit scary at times, when you consider patient privacy and HIPAA compliance, but one where emerging technologies offer physicians new opportunities to improve patient communication and care, enhance practice efficiency, and boost revenue. Now that is technology offering a solution we can all get behind.

Pronoy Saha, Business and Product Strategy, CurbsideMD, can be contacted directly at

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