Cleveland, MD: Doctor's Orders
The Advantage is Automation
Achieving these advancements in patient care and office management is simple with a Macintosh. Dr. Cleveland runs his entire office using just three fast, affordable Macintosh computers. An iMac G5 with a 20-inch screen functions as the server for the EMR. A 17-inch iMac G5 runs MacPractice billing software, and does double duty as the front office reception computer. And a 15-inch G4 PowerBook, which he uses to enter patient data into the EMR, accompanies Dr. Cleveland throughout the office. All the computers are linked to a wireless Airport Extreme network, as is a Brother 6050N networked printer.
One of the attractions of using a Mac is the range of software that works with it. Dr. Cleveland gets the most from his Mac, and improves his practice, by using Apple productivity software designed to work seamlessly with every Macintosh. From marketing his practice to voice recognition software that make short work of dictation chores, to imaging software, email and offsite storage on iDisk, everything Dr. Cleveland needs to run his practice is available on the Macintosh.
Dr. Cleveland markets his medical practice using iWork and Keynote, the presentation software designed specifically to work on the Mac. “I used to use PowerPoint, but I find Keynote much easier to use,” Dr. Cleveland reports. “I set my backgrounds and just drag and drop my content right into Keynote. When I make a presentation to an insurance company on work injuries, I’ll drag in QuickTime videos, JPEGs, extracts from the literature. I just drag and drop in the images, then click and scale them to fit.”
When it comes to communicating with other doctors, Dr. Cleveland uses iListen speech recognition software from MacSpeech that enables him to dictate text, then edit and format it using spoken commands. “I use this primarily to dictate letters of referral to consulting doctors or specialists,” he says.
Dr. Cleveland uses his .Mac Internet account to host his website, send emails with .Mac mail and store worker’s compensation forms on his iDisk account, which provides 1 gigabyte of storage, accessible from anywhere on the Internet on Apple’s secure servers.
“Worker’s Comp generates a lot of forms,” Dr. Cleveland notes. Instead of filling up his computer with forms, he says, “I download these as PDFs, and store them on iDisk. I can modify the PDFs to include our office information. That way I only have to enter patient information on the form. Forms stored in iDisk are easy to find, and easy to access.”
To review x-rays, MRIs and CAT scans Dr. Cleveland relies on OsiriX and iPhoto. “When the results of an MRI scan come back, we might get 250 images on a single disc. We’ll scan through the MRI images to find the ones that best show clinical details and store them in the patient EMR. I’ll use iPhoto to review the images, choose the image that best shows the most detail and any abnormality, adjust the brightness and contrast and enter it into the EMR. The image becomes a reference for future treatment.”
Security, Reliability, Availability
Dr. Cleveland backs up all his office records and patient data on two Lacie 250 gigabyte backup hard drives set up to automatically duplicate his data. Once a week he uses iDVD to burn a DVD of all his records which he stores offsite, for an added measure of security.
“I want to be sure my data is secure and available,” Dr. Cleveland says.
The unseen cost of an electronic medical system is the reliability of the system it is running on. That’s one of the main reasons Dr. Cleveland chose the Mac. A long time Macintosh owner, Dr. Cleveland reports, “The Macintosh system is unbelievably reliable. In 22 years my Macs have never gone down. None of my computers, and I’ve owned 20 over the years, has ever come to a halt because of hardware problems.”
Running an EMR and Practice Management software on the Macintosh has proven to be “a very cost effective way to set up a medical practice,” Dr. Cleveland says. And you don’t need an IT person to set it up. “I set it up myself. I’m a hands-on guy. I like to know everything works.”
To provide better patient care, Dr. Cleveland supplements each office visit with instructions for follow-up care. “For back pain, I’ve already written exact instructions for my patients to follow, accompanied by a scanned in series of stretching exercises. I print out instructions and they are sent wirelessly to a printer. I send a note to my assistant to schedule an appointment, which she receives on her iMac. I tell my patient, ‘See you in three weeks’. And my patient walks out the door with instructions on care, a prescription, and a reminder to schedule a follow up visit. And within the hour the system will generate a letter to the patient thanking them and inviting them to call back with any questions.”
