This action might not be possible to undo. Are you sure you want to continue?
12 March 2010
Problem: Diabetes has recently evolved into an epidemic that is sweeping our nation. Consequently, the number of individuals requiring medical attention as a result of diabetes is overwhelming. In addition, there has been a unanimous surge to reform healthcare in our country. While senators and congressmen continue to dispute over who knows best, the medical community persistently develops outstanding ideas that often go unnoticed. Nevertheless, the challenge remains. How can we improve patient compliance and quality of life, decrease the load for physicians while maintaining reimbursement, and still manage to keep insurance companies happy? Here is one idea that takes a huge stride in the right direction. Lab-book, DM Overview: Lab-book, DM has the potential to create a revolutionary change in the way chronic disease processes are managed in the medical field. Diabetic patients are among those that will benefit most from this technology. The name Lab-book comes from the idea of having a home laboratory device combined with a medical spin-off of the popular website, Facebook. The device will have the capability to measure routine lab values such as blood pressure, hemoglobin A1c (Hgb A1c), cholesterol (HDL, LDL, and Triglycerides), and urine ketones/microalbumin/creatinine/BUN that DM patients and physicians use to gauge the progression of the disease process. Once the patient obtains lab results, he then connects his device to the internet, either by USB cable or through a wireless hot spot using the device¶s wireless capability. After logging in to the Lab-book, DM website via username and password, the lab values will be uploaded to the patient¶s profile page and compared to previous values using charts and graphs. The patient then has the opportunity to answer a questionnaire and submit it, along with the lab results, to his physician. The physician will have 72 hours to review the submission and reply via the website. This will count as a regular ³check-up´ for the patient, and has the to potential replace routine visits that serve the same purpose. The Lab-book, DM machine will be no larger than a typical glucometer (0.5 x 2 x 4 inches) and will serve to function as such. This will allow patients to report all glucose readings along with the labs in order for the physician to observe possible trends. The device will have the ability to store 6 months worth of lab and glucose data. It will house a valve for attaching the blood pressure cuff, a door for inserting test strip cartridges (25 strips), a slot from which the strips will exit, an outlet for plugging in the charger and another for the USB cable, and a slot for keeping the ³stylus-like´ pricking device. The
pricking device will be reusable and come standard with each cartridge of 25 strips. One strip will perform all tests. This efficient design eliminates the ³blood sugar kit´ by housing tests strips within the machine, and replacing the traditional lancet and lancet device with a reusable stylus device. Patient Advantage: Patients will love Lab-book, DM for several reasons. First, it eliminates the inconvenience of frequent doctor¶s appointments. The patient can go to their appointments at home, on their own time. There is no taking off of work, getting a babysitter to watch the kids, waiting for hours in a busy clinic, or spending precious gas money to drive across town. Since the doctor has 72 hours to respond, patients can conceivably submit any day of the week, any time of day. Secondly, Lab-book, DM allows patients to monitor their diabetes with a newfound vigilance. Even if the patient is not due for a submission, he can still check his numbers without submitting. This gives the patient a greater sense of ownership and control over the disease. Thirdly, there is an opportunity save money on doctor¶s visits. Although there would be the initial co-pay associated with purchasing Lab-book, DM, each submission will be 50-75% of a regular visit co-pay. The patient will be given the option to take care of this fee online. Nonetheless, overall cost would decrease when using Lab-book, DM. Next, the patient will be required to have a prescription from their doctor in order to purchase Lab-book, DM. Therefore, those ³on Lab-book´ will be an elite group of patients who are well-controlled. The patient must prove to the doctor that he can handle this degree of independence. The hidden benefits here are potential improvements in patient compliance as well as patient self-motivation. Possibly the most attractive patient benefit of Lab-book, DM is the social network. Of course, only the patient¶s physician will have access to medical information, but patients will be able to create their own social profile that their Lab-book, DM contacts will be able to view. There will be options concerning what information the patient allows viewed, and by whom. The possibilities are endless in terms of support groups, sharing advice, coping with struggles, celebrating successes, or simply making friends who understand what it¶s like to live with diabetes. Physician Advantage: Convenience and efficiency will attract physicians to Lab-book, DM. The physician will have full reign in terms of what submissions he will accept and when he will accept them. This will prevent the physician from having to reply to the overzealous patient who submits once a week. On the other hand, the physician will also have the ability to send the patients a reminder if they are late with a submission. Also, once a patient starts Lab-book, DM, there is no rule that they cannot come into the office if needed. A generic patient questionnaire will be provided for the physician to gather information along with the lab values. The physician will have the option to edit the questionnaire to fit his personal needs for a ³patient visit.´ Once a submission is received, the physician will have several options via the website, including messaging the patient, and sending a prescription to the patient¶s pharmacy. At the end of a full visit (patient submission followed by physician reply), the physician will also have the opportunity to print the entire dialogue for the patient¶s chart.
Although the visit will be stored on Lab-book, DM, a paper backup will also ensure that the physician will not have to dictate or write a note in order to be compensated. The estimated time required to complete a Lab-book, DM visit is 3-7 minutes total. According to recent headlines, the average time physicians spend with each patient is around 20 minutes. Using this data, physicians working with Lab-book, DM will be able to treat as many as 7 patients in the time it takes to visit with 1 in the office. And this does not include dictation or note-writing time, which is eliminated with Lab-book, DM. Suddenly, it becomes possible to treat more patients in the same amount of time while still maintaining sanity. Insurance Advantage: This is exactly the kind of idea that insurance companies will be adopting in lieu of the imminent changes to the medical industry. Health insurers have huge targets on their backs these days, and finding new ways of doing business is essential to their survival. Lab-book, DM will allow insurance companies to decrease overhead costs on their diabetic patients since the online submissions carry a slightly lower fee than regular doctor visits. Furthermore, the physicians¶ discretion will ensure that the type of patients using Lab-book, DM are likely to be the cream of the crop when it comes to diabetics. As a result, there is less risk involved for insuring a Lab-book, DM patient than a traditional diabetic patient. Finally, Lab-book, DM is a tool that will give insurance companies leverage with which to work. It is an opportunity for promotional marketing, preventative medicine, patient motivation and compliance, and ease of billing. It¶s a packaged deal insurance providers won¶t want to pass up. Conclusion: The incredible state of technology begs us to find new ways to improve life. One of those ways can be realized with Lab-book, DM. The outstanding feature of this product is the enormous number of people that would benefit from it. Not only does this system enhance patient quality of life, but it also makes the experience easy and desirable for both physicians and insurance companies. Moreover, the ease of use is incomparable. The urinalysis and blood tests are synonymous with checking for ketones and testing blood glucose, respectively. Most DM patients are already familiar with those procedures. Maximum training necessary for patients would be demonstrating how to apply the automatic blood pressure cuff, for which a package insert would most likely suffice. With the increasing number of DM patients, the convenience of Lab-book, DM is almost a necessity. There are not enough physicians trained in the treatment of diabetes to accommodate the multitudes of diabetics. Lab-book, DM takes a huge chunk out of that dilemma by ³transporting´ the physicians to the patients¶ homes. Online medical records, visits, and prescriptions are the wave of the future. The possibilities that could be implemented with this kind of technology are endless, including group chat with a physician, or question and answer sessions with numerous healthcare professionals. Due to lack of space, only a few examples were listed here. Nevertheless, with the Lab-book, DM system, the sky is the limit and the impossible will become a way of life.