¶ Day 16 of the EMR transition and learning to streamline workflows
Hey guys, Don here, welcome to Podiatry Practice Mastery. We're helping you get to the $1,000,000 mark and beyond. So I am on day number I'm counting down here day #16 of my EMR transition. I think by day 30 it's going to be pretty great getting better. I am still kind of figuring out how to document and I'm I'm leaving earlier. So basically I'm finding there's a little bit more time for my staff to to do the notes. So I'm I'm trying to do my notes
the following day. In the past, I used to always finish from the same day, but just cuz I have some extra time during the day, I don't want to stay late. So I'm trying to get out at an earlier time. So that's, that's one thing that I'm kind of doing. I've, I've learned today in the EMR, I learned how to schedule surgery. So within the EMR, there's like
¶ Setting up surgery scheduling with detailed equipment protocols
the surgery scheduling thing for my scheduler. And basically, though I think I've mentioned this before, but what I do is all, all the surgeries that I do, I have them all written in a Google doc with kind of what's needed, the equipment, the time, everything that's needed. And, and I, and I give them to my scribe.
And then when he schedules the surgery, he just copies and pastes that in there and just adds and what like, which we're doing for like arthroplasty or arthrodesis or a bunionectomy or something like that. And more importantly, the things that aren't on that list, I refer out to someone else.
¶ Referring out complex surgeries beyond comfort levels
And I and I, this took a while. I haven't talked about this for a while, but there are certain surgeries I just don't feel comfortable doing and I don't do a lot of them. So I send them out. So if they're not on my list, then I'll then I'll send them out. And that, that's been a good reminder for me of not trying to go beyond my kind of my ability levels of things that I feel comfortable, comfortable doing. I also learned about what else was this? I, I learned how to get messages
from patients in the portal. I've learned how to kind of like sign documents using an iPad. So that's the only reason I use an iPad right now. And I'm, I'm still, we also learned a lot of things come in electronically through faxes or through these like connections that are made. And then I've learned how to like process those documents and have them go and then write results on them. So it's basically when like pathology results comes or LFTS
or things like that. I've been learning how to do that. So for the day, I'm going to go over these, these kind of I'm going to go over 12 patients. I had more, but the other ones I'll go over the following day just because I didn't finish their notes.
¶ Managing bunions, hammertoes, fractures, and fungal nails
First was a 75 year old female. She had a bunion. I did X-rays. She had some hammer toes that are painful to the tips as well. So I did the office visit and and the calluses, she needed them trimmed. I did them. I gave her Crest pads, recommended anatomic shoes and if it doesn't get better, kind of come back for the for the next. She has a very large bunion. She would benefit from a lapidus and and hammer toe repair, but they wanted to try some some non
surgical treatment. So that's kind of what I recommended for her. Next was a 53 year old man. He was for an orthotic follow up after six weeks doing good. So no need for a follow up for him. Next was a 54 year old female. She failed Lamisil and she almost, I don't know if she failed Diflucan, but she has this like 1/4 toenail that's kind of still thick and it's a little bit curved. So I think it could be more from the curvature of the nail and hitting on the shoe more so than
fungus. So after failing Trabenafen and Diflucan, I don't really feel like that could offer her pulling it off or just kind of living with it and she's opted to just kind of try to live with it. Next was a 65 year old female. She had a fifth met fracture. I've been seeing her. I saw her initially 3 times. I think we did 3 or 4 focused only shock waves. This is a really bad fracture. It was like there's a big gap where it was it it could very easily been been fixed.
She opted for non surgical treatment at at three months now she's finally getting out of the Cam boot and she's doing better. There's still a little gapping in there and so I'm going to see her back in another two months. And next was a a patient that had carry flex. So I've been having a lot of carry flexes come in this days. She's a 57 year old female to brided 2 nails that were thickened and I put on carry flex. Next was a 62 year old female.
This was that competitive skier. So she's she Oh, I'm sorry, this is a sorry, this is a different one. I did the see the competitive skier that fifth met osteotomy she's #5 out of 6 she's a competitive skier like water
¶ Addressing kissing corns and educating patients with online resources
skier. She's doing much better feeling better. Next was a sorry it was just kissing corns between the 4th and 5th toes recommended lamb's wool. I have a page specifically on kissing corns on on our website like a web page and this can do a castellani paint and lamb's wool and ginger Violet, all that stuff to dry it up. But really I explained to her and I showed her on the X-ray she has the 2 bones that are
hitting again. So I recommend an arthroplasty of the 5th toe to take care of that. So she's going to let me know if she wants that. Next was a 55 year old female for a fungus and recommended the kit trabenafin and LFTS. Next was a 20 year old male for left fifth met fracture, kind of an avulsion fracture. Gave him a tall Cam boot to reduce the pole from the peroneals. Next was a 55 year old up. Sorry, 24 year old orthotic follow up doing well. 65 year old orthotic follow up doing well.
And then an 80 year old arthritic ankle #2 out of 6 with shockwave. That's not to help with the arthritis, it's to help with the bone marrow edema around it. So that was the day. There were more, I just didn't finish those notes, but it was, it was a good day. I'm getting better at shock waves, getting better at the notes. Murali is doing a great job. It just, it seems like it, it, it, it kind of like your wait, wait, wait and then hurry up. That's what it's been like
¶ Training staff to adapt during EMR integration and scheduling updates
because it's the staff are kind of learning. We're also going through a lot of staff training. We have many new staff that are kind of coming in trying to train them, trying to get them up to up to par with with treating things. So, but things are things are going well. I'm going to keep writing on my positive focus until I get to day 30 here. So some of the positive things I learned to do the surgical orders, ingrown notes are a little bit easier.
There's some protocols for that. The portal is working well and we have this new online scheduling we've never had before for new and and established patients.
¶ Launching online scheduling and integrating urgent care strategies
So on our website I put a link that says like schedule online and we're finding that patients are using that. And we are, I'm working on a with my SEO people. They're going to make a web page for an urgent care, urgent care foot and ankle kind of web page slash custom blog articles to push to it. And the thought would be is to use this and then the scheduler, you can schedule by whoever like
the first available appointment. And I'm going to make another scheduler that it won't be they can't pick the doctor. It'll just have like the first available so they can pick an appointment and come in right away. And this would be in on this. I kind of put in the I'm putting in the things that we're already getting from the urgent cares that they see them and then they come to see us. So like the fractures, the gouts, the ingrown toenails, the
ankle sprains, things like that. So I'm trying to compete with the urgent care with this, with this web page.
¶ Using Clara for chat-based patient communication and appointment booking
This is something that it's not quite up and done yet. But if you want to go to our website and see this new, we have online schedule, you can see how that works. And also there's a chat bot in there that works pretty well. It's called Clara. It's part of Mod Med. It's it's kind of a neat patient communication tool. And we, it sounds like we have the deluxe meaning we're paying for online reviews after patients come in.
We're, we're paying for online booking, we're paying for all these other things because I think it'll reduce some of the staff load because right now the staff are answering tons of calls and tons of communications via that, that chat bot.
¶ Leveraging automation to reduce call volumes and improve patient flow
But it seems like the communication portions working, working well. They have a pretty good system there. Certainly everything has a cost to it, but I think in the end it's going to make it a little bit easier for making appointments. We never had anything online. We kind of struggled because a lot of times patients don't know how to make their own appointments and sometimes you don't take their insurances. So we've had a couple of questions in there prior to kind
of filter them out. We kind of said what insurances we don't take on there and we just are like, yes and no questions. That'll help a little bit with the flow. OK. So that's what's going on, getting a little bit better. Everything else is good and we'll talk to you guys later.