Perfect prescription: Handhelds help doctors give best treatment
San Francisco Business Times - by Brendan Doherty
When Dr. Joseph Goldberg makes the rounds, he brings along his assistant.
The assistant can't make coffee or answer the phone, but it can easily handle his schedule, track prescription drug interactions and fax prescriptions to the pharmacy. It tells him the side effects for drugs, negative interactions between drugs and reminds him of everything he did in the clinic for a patient.
Goldberg's assistant is software -- written for his Palm Pilot.
"It helps with the understanding of the handwriting," said the 68-year-old internist and teacher of cardiology at UCSF Medical Center.
"There are some medications with very similar names like Celebrex and Celexa, and they do different things. (Celebrex is for depression and Celexa is for arthritis.) I can catch this before there is a problem, and it helps everyone make sure the patient gets the right one."
But Goldberg's prescription for his colleagues is software developed by Mountain View-based ePhysician for handheld devices.
Annually, the number of medical errors run in the hundreds of thousands in the United States. A recent study by the American Medical Association and the Center for Medicare and Medicaid found that every year, physicians, as a group, leave $25 billion in services and material charges uncollected. Physician expenses rose 44 percent last year, while revenues dropped 3 percent.
For between $100 to $500 plus $100 per month to connect their handhelds to the computer network, Goldberg and other physicians can check each drug's profile for potential side effects and for counteractions with the patient's existing medication. Ephysician, a 35-employee private company, is among several Palm-based software developers that are putting desk references, drug formularies for insurance companies, and billing software on handhelds.
Goldberg believes that the individual investment of $100 per month for the service is well worth the efficiencies gained from electronic prescription writing and billing.
"The pharmacy knows it's my prescription when it gets there," said Goldberg. "I use it to show the patients exactly what the side effects and choices for medication are. They won't come with me to look it up in a book, but with this, I can bring it to them."
Goldberg was among the first physicians to beta-test the software in 2000.
Another company, ePocrates Inc., a San Carlos-based software developer, is producing Palm-based drug formularies and physician support programs. The formularies are produced with the help of insurance companies. Formularies are ways for HMOs to control prescription costs, preferring certain drugs over others. When a doctor inadvertently prescribes a drug not on a patient's HMO formulary, the cost for the patient is substantial.
With the Palm-based programs, the patient's plan information and the drugs they can afford from their HMO, come along as part of the physician's diagnosis, usable in the outpatient or inpatient clinic.
Getting doctors to adopt technology hasn't been easy. There are cost issues, as well as more serious issues surrounding security of patient records and information. This may be what pushes doctors to adopt the easy-to-use and inexpensive Palm-based programs.
Ephysician allows doctors, with a couple taps of the stylus, to capture all the services they render for patients rather than leaving it to their memories when later filling out an invoice.
"This improves the coding and the likelihood and timeliness of the billing, by making it instantaneous," said Stuart Weisman, president and CEO of ePhysician. "The Palms are now where personal computers were in the 1980s. There are more and better things to come."
One of those things is better clinical information and better prescription writing. Epocrates' free downloadable databases for physicians may sound like old dot-com economics, but the company has found a terrific audience of physicians -- 200,000 of them. Physicians can participate in marketing surveys for which pharmaceutical or other companies gladly pay physicians and ePocrates. Epocrates creates the network and charges for messages. Physicians can opt out of the surveys, but not the intermittent network messages, and use the software for free anyway.
Epocrates is also developing reference materials like the A-Z of Interactions, a $50 medical dictionary that will be carried on a Palm. Among the early adopters of the Palm-based medical software was Stanford University Medical Center. The Stanford Library purchased 250 Palms for med students last year. Already, the users report that the service has become invaluable as a clinical tool.
"It's invaluable," said Shannon Moffet, a third-year medical student. "We normally have to carry all of these huge references, but this let us drop off some of the heaviest books."
Brendan Doherty covers health care and biotechnology for the San Francisco Business Times.
Latest News |
Most Viewed Stories |
Most Emailed Stories |
