In building an electronic medical home for Internal Medicine Primary Care patients over the last 2 decades in two different states, it is fun to see how technology has progressed. I was one of the last classes in residency at The Mayo Clinic in Rochester Minnesota to use paper charts and a conveyor belt chart delivery system which at its peak was state of the art (believe it or not that was as “recent”as 1996). My first IM practice at Diagnostic Clinic in Largo Florida (during the “pol, physician online email” days) used an in house MS DOS system with rudimentary lab interfaces and dictated notes transcribed into the database. As we transitioned to our current practice in Pueblo Colorado in 2005, we began with a national EHR platform and have watched it grow to the point where the platform itself, the patient portal, the hubs, interfaces, registries and supplemental “add on” platforms have reached the point where the convenience of digital portability has caught up to the demands of pace and need for efficiency encountered in day to day practice.
Enter today where what’s new is old again. As video visits are being touted by the CPCI (CMS’ comprehensive primary care initiative) as a next step in patient centered care occurring within medical homes, WeCounsel has built a secure and convenient way to link with patients in this manner. And there we have it, the new becoming old with the potential again for house calls, which is exactly what it feels like when participating in a WeCounsel video visit. As the platform is intuitive enough to allow medicare patients to connect digitally with their physician, care can be extended in new ways. We (Sangre de Cristo Internal medicine, sdcim.com) primarily use this tool as a way to augment home health visits, having a home health nurse “couch side” with the patient to help transition through the visit with vital signs, concerns requiring visualization (edema, skin lesions et. al.) and building a care coordination process that is more robust than standard after the fact telephone communication. We have also used the tool for primary care psych f/u in patients needing continuity while being in and out of our geographical area.
All this to say that technology has now gone from “whiz bang” back to old school practical. I greatly thank all the tech geniuses out there that have put primary care back on the cutting edge map of managing patient populations with innovative tools such as WeCounsel.