Testing an Electronic Health Record System for My Practice

For several years, I’ve maintained my massage practice records on a Tablet PC. I like being able to take my notes by hand, and once in a while include a rough sketch to note a specific problem area. My notes have been practical and functional for me, but are not a medical record.

Later this year, my goal is to turn my degree in Chinese medicine into a license to practice acupuncture. As both an acupuncturist and as a massage therapist, I want to be able to work with other health care providers where appropriate. I’d also like to see modalities like massage therapy and acupuncture better represented in mainstream quantitative and qualitative clinical research. In addition to their benefits in streamlining and improving patient care, Electronic Health Records (EHRs), also known as Electronic  Medical Records (EMRs) offer potential for improved communication between practitioners as well as expanded  research opportunities.

Many recent developments have made EHRs available to practitioners even if they don’t belong to a large  hospital or medical group. For me and others like me, the most significant development is that several vendors are offering high-quality, low-cost or even free EHRs. This gives me an opportunity to test EHR solutions for my massage practice even before I add acupuncture to my practice. This in turn presents an opportunity for new clients.

While I can’t offer free massage as incentive to help me test Electronic Health Records, I will offer special discount packages. I am looking for 10 new  clients who will commit to a package of 10 massage sessions of either one hour or 90 minutes each. The packages will be $600 or $750 respectively – savings of  $200 or $250. At this stage, I’m not looking for any special qualities other than a willingness to sample the EHR for 10 sessions.

If you are interested, you don’t have to make a  commitment without being comfortable with me and my message style. We will set up an initial appointment that will include an intake of about twenty minutes. The initial massage will essentially be an assessment like I would do for any new client, after which we will check in for a few minutes to give each of us the opportunity for feedback. Assuming you are comfortable with your massage experience, I will offer some details on what I hope to learn from the trial and what would be different from a regular massage appointment. You may then choose to participate in the trial or not. If you choose not to participate, you will still receive the discount on the single massage, saving $20 or $25 off the regular one hour or 90 minute rate as appropriate.

If you choose to participate, I would prefer that you pay for the package up front. I understand that might make it difficult for some who would otherwise be interested in participating. Among my goals with this trial is to evaluate some of the patient and practice management tools of the EHR. Having the 10 visit commitment makes that possible, and paying up front makes it more likely both parties will follow through on the commitment. If paying for ten visits at once is not possible for you, we might still be able to work together to include you by working out a payment plan.

For more information, feel free to use my Contact page to see how to contact me. If you would like to get started right away, you can use the Book Now link available on any page of my site.

For this trial, I will be testing Practice Fusion‘s Electronic Health Record, and hopefully it’s Personal Health Record (PHR) component as well. Practice Fusion’s EHR system is fully compliant with all relevant privacy laws, including HIPAA. Your personal information will be secure and will not be shared without your permission.

A San Francisco Sunset for Wally Walker

Wally Walker passed away in late May. He had just recently celebrated his 64th birthday. Sunday, ACTCM and the Alumni Association held a memorial service for him at the beautiful and historic Swedenborgian Church in San Francisco. Many friends came to pay their respects and share some of their love for and memories of Wally. While I didn’t take my camera with me because I wanted to be 100% present for the memorial, I did bring it out once I got home. I wanted to share these with you as we say goodbye to Wally’s physical presence, but welcome his spirit into our hearts, and wish him well on his journey onward.

There is just a little more below the photos.

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In the past 15 years, Wally Walker has given a lot to the ACTCM community. But I think there can be little doubt that one of his greatest contributions was the work he did to create a successful Alumni Association. Without his work, alumni services would not exist for ACTCM. I knew Wally as a great advocate for the students and alumni of ACTCM, and never met him without hearing words of encouragement from him, as well as feeling the warmth of his joyful spirit. The college has set up a scholarship fund to preserve and build on his legacy as a passionate advocate for the students of ACTCM.

Rest in Peace, Wally Walker.

On joining Twitter and other thoughts on Social Networking

I signed up for a Twitter account at the persistent prodding of a friend back in March, but I didn’t start using it until a few weeks ago. Going back, it looks like my first post was on June 5th.

I’ve also been busy developing a presence using other social networking resources. You can now follow me on Twitter: forbodyandmind, become a fan on Facebook: For Body and Mind Therapeutic Massage, and San Francisco Integrative Health Networking, and join my networking group on Meetup: San Francisco Integrative Health Networking.

I’ve been pleasantly surprised using Twitter these past few weeks. If you’ve been following the news lately, you’ve probably seen that coverage of the Iran elections has been heavily dependent on Twitter, Facebook, flickr, and YouTube. To me, that in and of itself is reason enough to get on Twitter. Learning #hashtags and @somebody’s id is relatively simple, and allows connection with a lot of information and people in small bits, very quickly. It might seem like a lot of noise to begin with, but becoming familiar with the nomenclature and finding resources to sort through the information and people you’re looking for is not that difficult. Seesmic Desktop is a particularly useful application. Other popular aps are Hootsuite and Tweetdeck. Here are 15 Highly Recommended Twitter Apps for Web Professionals. I found Tweet This! A Twitter Manifesto, 10 Twitter Tips for Professionals and 10 Tips for Twitter Professionals helpful guides for getting started.

Brevity inspires creativity. I think that is one of the true gifts of Twitter. URL shorteners like Cli.gs, Su.pr, ow.ly, bit.ly, and tinyurl.com make it possible to link to more in depth discussions of what you bring up on Twitter while reducing the characters you’re using overall. Many of the shorteners will also include tracking data so you can get an idea of who is following your links. Some like Cli.gs, bit.ly, and tinyurl.com also allow you to customize your shortened urls. There is poetry and wit to be had in 140 characters (see #hoekstra, and here, here, and here for background).

Having only been using it for a short time, I don’t have a definitive view of Twitter as a networking platform, but both the coverage of events in Iran and my personal experience suggest a powerful platform if properly employed. Facebook and Meetup have a track record that I’m more familiar with, and in my opinion, Facebook’s recent upgrade of professional pages has improved an already strong social networking presence for professionals. With For Body and Mind Therapeutic Massage, my goal is quite simply to support my massage practice and expand my potential client base. My goals with parallel San Francisco Integrative Health Networking groups on Facebook and Meetup are more ambitious.

My ultimate professional goal is to create a school for integrative medicine, outside of a traditional allopathic model, where practitioners in different disciplines learn to practice together. My intention is for the San Francisco Integrative Health Networking groups to be a foundation for developing such a school. Currently, the closest parallel would be Bastyr University in Washington. In San Francisco, UCSF Osher Center for Integrative Medicine and CIIS offer different integrative health models. The Haight-Ashbury Clinic and St. James Infirmary are probably two of the best implementations of integrative medicine that I’ve experienced, but their ability to provide services is severely restricted in the current economy.

Certainly allopathic medical schools are doing more to teach about complementary and alternative modalities like acupuncture/Chinese medicine, but from what I’ve observed, these programs still place the M.D. in the role of primary care provider over other disciplines. Since they are training M.D.s, this is perfectly natural. In California, acupuncturists, naturopaths, and chiropractors are considered primary care providers as well. While each discipline certainly has strengths and weaknesses, patients will predominantly see one provider for the majority of their care, especially with our economy in a condition like it is now. It is therefore necessary for practitioners to be masters of their own discipline, but also to be familiar enough with others to recognize when a patient should be referred to someone in a different modality for a specific condition. Even better is if that practitioner has a pool of skilled practitioners to whom they can refer. Thus the concept of creating an integrative health networking group. Starting with individual practitioners and small group clinics, a decentralized health network is able to pool a diverse set of resources and knowledge for each other and for patients. We’ll see how the tools provided by Facebook, Meetup, and Twitter can meet this goal.

New Office Location

I’ve joined Heidi Kao’s Integrative Healing Clinic in Glen Park. Monday’s through Wednesday’s, I will be offering services in this wonderful, large, well-lit space. Saturday’s will also be available on and on-call basis. Thursday’s, Friday’s, and Sunday’s I will continue to be available out of my home.  The clinic is easily accessible to Bart, Muni, and the freeway.

Integrative Healing Clinic
30 Monterey Blvd (at Joost Ave)
San Francisco, CA 94131

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A friend in the news

Acupuncture clinic helps night owls mellow out

By Trey Bundy, San Francisco Chronicle, May 18, 2009

It’s called a wince point. When Deb Follingstad runs a little metal rod along someone’s outer ear, she often finds a spot that makes the person grimace, which tells her whether the lungs or liver could use some TLC.

As an acupuncturist and doctor of Chinese medicine, Follingstad has great faith in wince points – tongues and pulses, too.

“They’re kind of our eyeballs on the body,” she says, “our X-rays.”

A longtime denizen of San Francisco’s music scene, Follingstad has started a Monday afternoon acupuncture clinic in her Bernal Heights flat to help bartenders, cocktail waitresses and others who spend their weekends working late hours in nightclubs detox from what can be a booze-fueled grind. Pitting 5,000-year-old techniques against 21st century toxins works well, she says, and the group setting feels more like a day off than a trip to the doctor.

“It’s me giving back to my music people who work really hard and party really hard,” she says. “I don’t want to see them hurt.”

Congrats on the great article, Deb! Best of luck in your practice!

Emotional Fitness

Emotional Fitness: Life presents difficulties, so learn ways to overcome them

By Barton Goldsmith
Ventura County Star, Sunday, April 26, 2009

When emotional pain hits, one of the best ways to deal it is to meet it head on and talk out the  feelings. That’s why good support from another human being helps our hearts. If there’s no one to talk to, writing also is a great way to release some of your inner anguish.

The point here is that the one thing you don’t want to do is hold your pain in. You need to find constructive ways of releasing your hurt without injuring yourself or anyone else.

For some, taking a drive, exercise, reading or meditation is helpful. Others need to process their pain verbally. Whatever way works for you is the one you want to try, but if it doesn’t do the trick, it’s OK to try something different.

There are numerous methods. Some are new, like visualization, positive psychology or guided imagery, and some are ancient, like acupuncture and massage. All have helped millions of people.

Over twelve years in health and fitness, as a massage therapist and during my experience as an acupuncture intern, many of the clients and patients I have seen have been seeking something to address emotional pressures in their lives. Some have been able to articulate this well, while others have struggled to define what led them to seek treatment other than some form of discomfort. I have come to believe that as a society, we have made a habit of overlooking and ignoring physical or emotional pressures in our lives in order to accomplish some goal, be it personal or professional.

I believe that one of the most helpful things we can do for ourselves is open ourselves to awareness not only that there are significant pressures influencing our daily lives, but acknowledging what those pressures are at a given moment. Through this acknowledgment, it is then possible to flow through the pressure and allow it to strengthen us in body, mind, and spirit; take steps to reduce the pressure; or seek help to face it as appropriate.

From personal experience, I know I do not always have the solutions to every challenge inherently within myself, and sometimes need to cultivate and seek the help from an extended personal network. I find this both from a personal perspective as well as a professional one addressing the needs of clients who come to me for treatment. I feel networking for health is every bit as vital, perhaps even more vital, than networking for business. Thus, I will always welcome new friends, clients, and colleagues into my network, and try to help others shape a network that is best to meet their needs.

Rethinking Massage

From Barbara Brody, Women’s Day Health Editor, in Daily Dose April 24th

When I got a massage for the first time about a decade ago, I was under the impression that it was something you did to pamper yourself when you had a little extra cash to burn (or better yet, a gift certificate). Now I’m beginning to think it’s a medical necessity.

Medical necessity might be a little strong, but as a massage therapist I certainly agree with the sentiment, especially with regard to health maintenance. Her post is short, but perhaps you’ll find some of your own issues reflected in what she writes.

Interesting news for runners

By Amy Norton, Reuters
Weakness in the muscles that support the hips may be a common contributor to many overuse injuries in runners, a new research review suggests.For most runners, overuse injuries occur at or below the knee — including chronic knee pain, shin splints, Achilles tendonitis and pain in the sole of the foot. The new study, a review of previous research findings published since 1980, found that weakness in the hip muscles may translate into a higher risk of these lower-leg injuries.

The findings are published in the journal Sports Health.

This is an article I read and thought, “Oh wow, that exactly describes some of my running experiences.” On the other hand, stretching works wonders for me in extending the time I can comfortably work out and reducing my recovery time.

Arizona State University opens Wellness Wing

From the ASU Web Devil
By: Rheyanne Weaver
Published On: Tuesday, May 5, 2009

A new Wellness Care Wing that includes massage therapy, acupuncture and chiropractic services will open today at the Campus Health Services building.

[…]

Dr. Allan Markus, director of Campus Health Services, said that Campus Health Services, Undergraduate Student Government and the Health and Counseling Student Action Committee decided to create the new wing because it would be best to put all the alternative services that students want in one place.

[…]

He said ASU is the first campus in the nation he knows that offers comprehensive wellness care in the nation, and that Campus Health Services is also working to create a wellness care package for the fall.

“Students will be able to pay one price and get a free first nutrition visit, a wellness profile and significantly discounted rates for massage therapy, acupuncture and chiropractic services,” Markus said.

He said that acupuncture has been available on the Tempe campus for three years, massage therapy since the spring 2009 semester and chiropractic services since last fall.

Here’s hoping that more wellness centers of this type develop across the country, that costs are reasonable for the clinics, and that they can help bring down overall health care costs through more preventative health maintenance.

Acupuncture Proven to Prevent Postoperative Nausea and Vomiting

Acupuncture Proven to Prevent Postoperative Nausea and Vomiting

Natural News.com Thursday, May 07, 2009 by: Dave Gabriele, citizen journalist

According to a 2009 review from The Cochrane Collaboration, an international not-for-profit and independent medical organization, stimulation of the acupuncture point P-6 (Pericardium-6) significantly reduces the symptoms of nausea and vomiting after surgery. The review was published in the second 2009 issue of The Cochrane Library, a publication of The Cochrane Collaboration. The review, led by Dr. Anna Lee of the Department of Anesthesia and Intensive Care at The Chinese University of Hong Kong, is an update of a previous 2004 Cochrane review, which fostered similar results.

This is a nice and brief article by a student of Chinese medicine. It includes source links as well as links to other research on the P-6 acupoint.