Sapna Mukherjee, MD is the founder of Chicago-based concierge practice Premium Care Pediatrics. As PCP’s sole staff member, Mukherjee sees up to two patients a day via house call. Though her practice is too small to qualify for the Meaningful Use program, she has implemented an EHR. She is also on staff at several area hospitals.
How are the technology needs of a concierge practice different from a more traditional, solo physician practice?
The needs of an office-based practice and concierge practice are the same. The difference is that I make house calls, so I need to be able to take my supplies with me. I look for the most compact pieces of equipment and also choose supplies that don’t have to be refrigerated, if possible. I have capability to test for Influenza, RSV bronchiolitis, and strep infection with a Veritor unit from BD. I use the CardioCheck machine for cholesterol and glucose monitoring. I can also measure blood oxygen levels and heart rate with a unit from Quest.
Also, my Dr. Chrono EHR can be used on an iPad or a laptop. Since I am making house calls, I need to have all of my records available to me at all times since I don’t know who I may be seeing later in the day. These reasons justify the expense of an EHR for me.
What type of technology makes your life the easiest? What kind do your patients gravitate most towards?
The availability of immediate test results (flu, strep, mono, bronchiolitis) for infection helps with diagnosis, management, and medical decision making. Similarly, being able to test for and immediately know the results for anemia, lead exposure, high cholesterol, and glucose during the visit makes preventative health maintenance easier. Families really appreciate that comprehensive care and guidance is provided at the time of the visit and that a plan of action until the next visit can be created, discussed, and finalized.
Additionally, families really appreciate the ability to text, send photos or communicate via Skype or Facetime. These forms of advanced communication may help me provide an immediate assessment or help them avoid a visit to the emergency department. Overall, they help me provide better care for my patients.
How do you envision technology helping you to grow your practice – either via the addition of staff, or your ability to take on new patients?
As discussed above, advances in the various forms of communication are changing the way we care for patients. Many times, a video chat can help to assess the severity of an illness or help make a decision to immediately begin intervention. This saves the family time and worry, and allows me to schedule my day more efficiently and, as a result, provide care for more families.
How have your colleagues reacted to your decision to move to the concierge model? Is this a growing trend?
My colleagues have all been very supportive. Many of them are parents and definitely see the advantages that concierge medicine, especially a house call-only practice model has to offer! Concierge medicine is certainly a growing trend as more and more families are seeking both the amenities and level of service that concierge medicine is able to provide.
What are your thoughts on the current state of interoperability?
I e-prescribe, order, and view lab and imaging results via the EHR. There are other aspects of interoperability that are advancing, such as being able to order labs at outside labs right from my computer and having results accessible online. E-prescribing is another area that is really simplifying patient management. The pharmacy’s information helps to create an additional layer of checks and balances in terms of allergic reactions or medication history.