Our patient has access to a card, photographs of interventions, γ-images of teeth and all treatment protocols
Patients usually lack the following data:
- What exactly happens to them: the exact diagnosis, that is, the records of the card.
- The treatment plan is primarily a list of interventions, their timing and prices.
- All materials on the card: the results of all analyzes, all X-ray and other hardware images, photographs of an intraoral scanner, and so on.
- Treatment protocols: what exactly the doctor will do at the next appointment and in what sequence.
We opened all this for the patient, and described it not in medical, but in user language.
A simple case of caries, here is one photo showing exactly how the affected tissues are excised by the therapist, the second is already – restoration of the anatomy of the tooth, the end of the intervention
Plus, they added photo protocols of treatment: the state before, the state during the intervention and the state after. That is, everything that happened to the patient is not only logged in detail, but also available to him.
This is such an obvious decision that it turned out that we were the first to do it in Russia.
Let me tell you what happened, it is very interesting economically and in terms of improving the quality of treatment.
“Let’s open the cards to the patients.”
The doctor usually hides the cards with all his might, because even in the medical institute they teach him that they are written not for the patient or the head physician, but for the prosecutor. That is, we have here and quite inaccurate formulations, and clumsy handwriting, and storage only in the hospital (or its database) and complicated attempts to get at least some kind of extract.
On the other hand, patients very often consult other doctors according to their cases. The practice is that this “advice” is trying with all its might to complicate, not giving access to the same diagnostic X-ray images or intermediate photo protocols (in normal dentistry they are conducted).
At some point, we realized that this was a dead end. You cannot be customer-oriented and at the same time hide important data from the patient.
The first objections were at the level “He will not understand anything and will be frightened.” Diagnoses in general often frighten people – starting with the phrase “HIV is NEGATIVE” (well, what prevents from writing “not found”, eh?) And ending with a histological description of an ordinary mole with words from which relatives died.
Accordingly, we needed a medical translator into Russian. This is easily accomplished with a script, because the medical language is actually a collection of diagnoses and comments. These diagnoses are, in fact, codes in our software that are assigned to each tooth. Nobody bothers to make one presentation for the doctor and another presentation (with an explanation of what it is in general) for the patient.
And we also made a normal render. Now it looks like this:
For each tooth, you can see the statuses:
When showing it to another doctor, it is more important to have documents – pictures, test results, protocols of interventions, and so on. This is also on the card and is also available to the patient. Patients often get second opinions and are not comfortable asking for such data. Many are simply embarrassed to request such data. We already have it unloaded in the application.
This is how the protocol looks like:
“Let’s show a photo before, during and after”
One of my colleagues once gave the car to a car service, which kept a detailed video recording of everything that was happening. They sent me key photos of the damage, photos of their elimination and a link to the video. After watching the video, I was able to conclude that the details from the invoice really changed, but there were real defects. More importantly, the very fact of committing set me up for much more trust in the service. If they show what they are doing, then they are unlikely to deceive me, because this is immediately the evidence base.
Well, what prevents you from doing this with patients?
As it turned out, nothing bothers us. Let me remind you that in ordinary clinics, access is usually done manually. With us, all interventions, without exception, are carried out under operating microscopes, which dramatically increases their accuracy and removes a sea of possible complications. Microscopes still cause fierce seething in the dental environment, I wrote about this in more detail here. But for our history it is important that the microscope contains many features, ranging from ultraviolet illumination for the isolation of affected tissues or a rough analogue of flowmetry and ending with a video fixation module. That is, you can write a video for it.
Moreover, our protocols imply normal diagnostics before interventions, that is, the patient will receive a check-up of the “as arrived” condition in a more or less complete form, and not only according to the declared symptom (this is the advantage of paid medicine in the medium-expensive segment).
All this together made it possible for us to issue photographs to the patient directly from the scene. Video is also possible, but we haven’t fixed it yet: there are problems with integration, uploading and storage, because a very heavy file is written there. Perhaps in six months there will be an intermediate solution with the ability to download a video, but it will not be stored after two weeks.
But the photo alone has already produced 80% of the effect we expected.
“Let’s do it in the application”
Since the advent of touchscreen phones, all the fun has been happening in apps. Therefore, we almost immediately took up the development of the application and, which is logical, we screwed up payments and recording in the same place. It turned out to be incredibly convenient for the patients. At first, I assumed that we would cover only introverts and make our life a little easier at the reception, but it turned out that making an appointment without a person, canceling or postponing a visit is a huge plus in the service for many. The only thing is that only card payments are working fine for us so far: Apple Pay, for example, requires the bank to switch to their intermediate mobile site in the current implementation.
- Patients feel that we are taking care of them. It is normal that we want to do what is best, but we do not speak. Practical matters in this matter are decided.
- Patients feel in control. This is a sore point in Russian medicine in general: doctors are often arrogant, do not explain the intervention, do not talk about a medical case and the basis for choosing a solution, do not speak out the causes and effects. Let me remind you that our approach is non-Russian – we are for evidence-based medicine, and in the case of two identical diagnoses, two identical protocols will be applied. That is, they can be predicted and the patient can be prepared according to them.
- Patients know everything about money. In dentistry, the final bill is often hidden from the patient, because it is too late to return with a half-healed tooth. Or it often happens that the doctor does not want to name the full amount at once, so as not to frighten the patient. In general, in any case, the amount is not always accurate for various reasons. We show the complete treatment plan and price prognosis for all interventions.
- Patients can monitor compliance with the protocol. If you open an upcoming visit, go to the treatment protocol and see the procedure (well, or do it retrospectively), then you can compare what the doctors actually did with what should be the standard. This is an additional protocol control system that is very important for correct treatment.
- Doctors feel responsible. It’s one thing when you bury a joint in a card, another thing is when no one bothers the patient not only to show his data to one of the doctors with whom he consults, but also to publish a photo of the tooth on the same Instagram. And I’m not kidding, a lot of people do that. At first, this worried the doctors very much, but now it seems to have stopped. We have the best equipment in Russia, very good treatment protocols, we still take photographs, at least for a cross-review, so why not let the patient open it? From my point of view, complete openness improves the quality of a doctor’s work – well, it also works so that other doctors gasp, seeing this, and, with a certain ambition, come to us to find out about vacancies (the second turned out to be unexpected).
You can download the application in Appstore or in Market… True, without a visit to us, the card will not appear there for obvious reasons. We definitely have how to finish it, it is now far from as clean and sleek as we would like, but I am sure that we have already made a very steep first step.
So hello, traditional medicine. See what we’ve done. Weak the same way?