Digital Tools for Podiatric Practice Enhancement

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Jennifer Spector, DPM: Welcome back, everyone, to Podiatry Today podcasts, where we bring you the latest in foot and ankle, medicine and surgery from leaders in the field. On this episode we are thrilled to have with us as our guest, Dr. Jim McDannald. He's the founder and director of Podiatry Growth, which provides online strategy and services for podiatry clinics. He also has his own podcast on practice marketing and was in podiatry practice for 10 years prior to starting his company. Today, we're going to speak about digital tools for practice enhancement. Dr. McDannald, thank you so much for joining us, and we're so glad to have you with us today.
 
Jim McDannald, DPM: Thanks so much, Jennifer. I'm really excited to join you guys today.
 
Jennifer Spector, DPM: So there's been an explosion in various options in the tech space that leverage artificial intelligence for a multitude of functions. We've talked a little bit about this before. But for doctors who aren't really plugged into this part of the space, could you provide us with sort of the current status of these AI applications that podiatrists might want to know about? Specifically, I'm thinking we can start with the ones we might be more familiar with like ChatGPT or Bard. How do these play into practice administration?
 
Jim McDannald, DPM: Yeah, that's a great question. You know, I think on the last podcast we talked a lot about kind of some general use cases for these things, right? Like, it was kind of in its inception. You know, we kind of have the ChatGPT website or the Bard website. And basically, you can go on there, you can ask questions. And it kind of pulls information, either from the Internet or from kind of a data set, and it kind of puts it together in more kind of human spoken language, as opposed to just getting a link to a result or gathering information that way. It all kind of shows up in that kind of results box, if you if you will, and you know if I say, what is a bunion, for example, it's going to kind of go through different types of libraries of content and kind of mash together something that seems like it's not. It's not a perfect article, but maybe it's 80% of the way there. So it's kind of a way to, whether it be an administrative task or maybe we've talked about some content creation last time. It's kind of a way to just not be staring at a blank page anymore. It's a way to structure some content, or maybe some administrative tasks in a in a way that's helpful.
 
And I think what we'll get into a little bit, you know, as we go on today, it's not just this one or 2 websites, and just kind of put some information, get text back. But there's been a lot of integrations these days. I think pretty much any tool that we use these days you're going to see, now with AI or all these kinds of tools, or whether it be different types of advertising, or just be kind of any of the daily tools we use on the Internet. So that's pretty interesting. And then also these different would be Bard or ChatGPT, or starting to develop their own app stores. So you can go here and you can have, for example, maybe there's like a Bard podiatry question, you know, like the board podiatry GPT, that basically takes all the answers or takes all the potential questions for board certification and kind of makes a quiz game out of for you or something. So there's all these new kind of ways that that AI is going to incorporate it into a lot of the apps. You know. It's improving the ChatGPT. In the Bard app, but it's improving a lot of the other apps we use on a daily basis.
 
Jennifer Spector, DPM: So I've heard a little bit about ambient listening platforms as well. How can clinicians apply this in their practices? And what is it?
 
Jim McDannald, DPM: Yeah, that's a good question. It's one of those things where you want to kind of have an AI solution that makes sense to use in the real world, right? And I think when we first got computers into our practice, it was great to have that way to document as you went. But there's also kind of a loss of personalization, or that patient physician relationship in a way. And you know, if you're sitting behind your under keyboard typing away while the patient’s talking, you may be looking through a computer screen to nod at them, and it can be really beneficial to have that one on room relationship. So there's some new tools out there. One's called Nabla. There's some other ones out there as well. But basically what it is, it’s an ambient kind of just basically a recording of your patient kind of onboarding conversation, that kind of patient visit. And basically it's going to transcribe it as you're going. So you can talk to the patient. You obviously have to have a microphone and maybe a Chrome extension. Or you can use your iPhone as well for some of these different products. But it just helps.
 
Basically you get out of the documentation mentality for a period of time and really connect with that patient. Listen to their story, ask them questions, knowing that in the background that that's being taken care of. These don't have any context. So right now, they're kind of best, for you know, they don't dig into an EMR, so they're basically just kind of recording that initial conversation that you have. It can be copy pasted into, you know the record and into the clinic note.
 
But it is important to note that it’s kind of the beginning stage of these ambient listening things. It's kind of having that, you know. I've heard some people are using Scribes, right? You know, they just get the scribe on the phone. But this is almost like a similar way. But just using your your iPhone or your browse.
 
I'll also mention with that is that you know the goal in the future. For them, I think, is to get something that you know obviously is HIPAA compliant that you, the patient, has consent, but then also can draw context out of EMR. So there's going to be some work that has to be done on the, on the privacy side of things, but also on the technology side of things that you can kind of pull up that context. Because right now, from what I understand, it's not great with follow up notes. It's more that kind of initial patient encounter, and that Nabla, I think it runs somewhere the ballpark of $120 per provider to have that implemented per month. And they might have some discounts and stuff for other folks. But yeah, this kind of at an inception. I think we're going to see a lot of these different kind of ambient Scribes, digital Scribes working for practices.
 
Jennifer Spector, DPM: I've heard in different medical spaces that they're hoping that eventually it could lead to being able to extract pieces of that conversation and enter it into the EMR. Being able to list things like allergies and history of present illness and previous treatments tried, and all of that. But there's definitely a lot of work still to do like you said on the privacy and technology end. So in your observation, are there any AI powered systems that might help with automation in various parts of medical practice.
 
Jim McDannald, DPM: Yeah, there can be. And I think one of the things that we had kind of big hopes for early on. And you've seen it kind of proliferate on different types of websites to somewhat, I would say, an annoyance. But it's just they weren't very good as these AI, these kind of chat bots that have shown up on a lot of different websites we have, and the hope there is that by kind of having more of a custom AI or a custom GPT. Let's say you have documentation about your practice and the type of things that you do in your practice. And it's all you have kind of like standard operating procedures or certain treatment plans usually have patients with.
 
And it's not that you're going to share this, treat yourself. But if you have an idea about how you approach different types of problems, whether it be a bunion surgery, or plantar fascia. For example, this information can be uploaded into an AI or to a GPT, so that something like a chat bot can be much, much smarter in the future. And basically, when people have questions about specific things, not giving medical advice, but just kind of giving a little bit more direction, as far as you know, at XYZ foot and ankle, you know these are the things that we usually recommend that people do. This is a good reason for you to come in and see us kind of those criteria about, you know. When should you maybe consider doing something at home versus coming and see the practice, and could be much smarter and based off of individual preferences of practice, because not everybody's going to practice the same, right? Someone might be a wound care clinic. Someone might be doing sports medicine. So it's a way to kind of individualize that aspect of things. And we'll get into a little bit later.
 
One of the tools we talk about, it seems kind of counterintuitive but these AI systems also give people an opportunity to kind of, give more individualized or custom responses to things you might think, well, it's a robot, it's talking to it. But if it has all this documentation about you, your practice, how you treat, what you want to treat, it's going to be almost like, a way to extend the knowledge of your practice and kind of help build a bridge from that online world into your real practice. So you know whether that's in your marketing material that things are on your website, you're able to kind of create better marketing or better practice materials by having all of this knowledge kind of in a GPT or one of these AI systems.
 
Jennifer Spector, DPM: So what about for those docs that are really focused on marketing right now as opposed to workflow efficiencies or admin capabilities? Is there anything out there in the AI world for specifically digital marketing?
 
Jim McDannald, DPM: Yeah, there definitely is. And it's, you know, like I said, it's kind of getting added to all the different marketing tools. But one thing that I found a tool that I use to help the practices I work with is something called a Descript. Yeah. So Descript is basically a kind of a video editor or an audio editor. That's very beneficial. Because basically what it does is, maybe you record a video about this is the way you treat plantar fasciitis. And instead of you having to kind of be an expert when it comes to color correction and audio and all these kind of difficult things, what happens is it basically transcribes that video that you have or that audio that you have.
 
And you can do things like overlay images very simply or you know, like today, we're doing a podcast we could, I could take each of these videos and kind of put it side by side and make it very simple, and as far as set of editing a timeline or you're trying to figure out: “Where's that word? I know. He said a word on in minute 2 or 3.” You just can search through the script. And you know, it's actually a very powerful way that included like AI technology where you can basically create a blog post from that and create social media posts. You can make clips. So if you have, 20 seconds of a very important thing you think would be beneficial for your patients. It could go on to your social media. So it's a way to take one piece of content and repurpose in a way that can be really beneficial for a practice.
 
Jennifer Spector, DPM: Is there anything else that you'd like podiatrists to know about this topic?
 
Jim McDannald, DPM: I think one thing to be helpful should know about is that it's a rapidly changing ecosystem and environment. One thing we didn't touch on. We touched on the kind of the scribe side of it. But you know these are starting to really play into EMRs as well, and there's some EMRs in the market that are really kind of going down this this AI path, one that would be populate that I'm aware of. And what they're trying to do is not only on that front end gather that patient information to HIPAA compliant manner. So you walk into the room with the patient, and maybe, you know you don't. It's like 70% of the notice filled out with the HPI. You can read through it very quickly. And then you have that. Maybe it's then it's kind of a handover. Maybe it's to that that voice kind of ambient listening device. So your those 2 things are working in concert, and kind of in and concert with each other. And then at basically at the tail end.
 
Once the patient leaves, you have the charting done. It's getting smarter with smarter with billing as well. I know that that populates and some other folks are really trying to find ways to help provide suggestions to practices to be compliant, but also to make sure that they're billing in the right way to kind of maximize, reimbursement and revenue with practice, because, as Medicare and other insurance companies kind of slash some of the kind of revenue that's generated by practices, the better you can code, and the more compliant you are. With your coding can be really helpful. So I see that's kind of one of those areas of growth for AI is that it's going to make the kind of coding decisions, or that, is it one or the other. Which level is it at? It's going to give you more information to make better decisions there. And you don't have to be, you know, opening up books or googling things. It's going to be there within your EMR. and the more things you kind of keep in the EMR and not have to go out and spend 30 seconds here 3 min there doing things. It's just going to save people time. And I know that people had a lot of pain points with EMRs and hopefully that these will. This will be a tool that can be incorporated in there to help relieve some of that.
 
Jennifer Spector, DPM: Well, this definitely seems like it's an area of growth and evolution that we should be keeping our eyes on. Thank you so much to the audience and definitely to Dr. McDannald for sharing his expertise today. Be sure to check out this episode and other episodes of podiatry today podcasts on any of your favorite podcast platforms and on podiatrytoday.com.