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Medicare In Peril?
Access to doctors won't improve if more of us have to leave the market. Read More at The Doctors Report

Issue: # 3January 2016

Happy 2016!  This New Years Eve, I was a guest of an intimate party with family and friends. During the party, our host had us do a craft project - we were each given a clean glass and ink to draw on the cup. The host asked us to draw something that would represent 2016. I wrote on my glass - "The Transition Continues."

My son and wife have been teasing me about my cup decoration since the party. Granted, it is a strange thing to express but apparently for me I must be feeling that I am in a period of transition. The most obvious transition is my new medical practice as well as my role in the local health care community. Personally and for my patients, a lot got started in 2015 and I am excited about continuing the transition in 2016. 

In this newsletter I have chosen to discuss and explain some of the new and innovative things that are now possible in patient care and service. The future of healthcare is coming into view, especially for harnessing technical advances in patient management. As usual, I also have a terrific, healthy, and simple recipe featured at the end of the newsletter.
The New Electronic Health Record System Is Improving Service
Close up of a woman hands typing in a laptop in a coffee shop terrace in the street     Note  Shallow depth of field
The Patient Portal is a Value Added Service
A Robust Patient Portal Is Ideal for Primary Care and My Patients

Last year my patients were witness to the painful transition from one health record system to another.  For those of you that felt the difficulties of this transition first hand, I'd like to thank you for being patient with me and my staff as we learned the new workflow. The new system is called AthenaHealth. There were several reasons we chose AthenaHealth, but perhaps the biggest was its unparalleled 
patient portal

A patient portal is a way for patients to access a medical office using a secure webpage on their computer or phone. Many of you are presently using this tool to receive news of your recent test results, to book and confirm appointments, and to view email messages that I or my staff may send. The portal also has an education and search function so patients can read about diseases or health topics. If you presently don't have access to your personal patient portal and want to get started accessing your chart/health record simply follow this link to start a portal account

Medicare and Federal regulations are requiring all physician specialties to provide patients with patient portals. If you see specialists, you may be invited to join several portals which may become confusing and difficult to manage.  If the amount of portals you're invited to join becomes unmanageable, I urge you to focus using your primary care physician's portal.

A primary care physician is the best access point for a patient to monitor and update their health information. The reason for this is primary care physicians provide most of a patients care.  A good primary care physician will be receiving reports directly from all of the specialists that a patient may see. For example, on my portal, you can access records that have been sent to our office from specialists. Think of the IMLWP portal as the go-to place to view your whole healthcare summary.

This year I plan to use AthenaHealth and the portal to find patients with specific health issues who may be past due for services.  Examples that come to mind include: vaccines, annual Wellness visits for Medicare clients, medication recall concerns, and certain disease management issues. These report features and the patient portal will help me and my staff make sure everyone is meeting their health goals.

Other uses of the portal that can make things more efficient and convenient include: 
  • Making a non-urgent appointment
  • Changing an appointment
  • Requesting an appointment
  • Updating your chart to clarify a record error or missing information
  • Reporting a consultants medication change or recommendation
  • Using the education module to learn about your problems or to reinforce recommendations made at the office
  • To inform me or my staff of a nonurgent piece of information 
  • Uploading forms from the office- I plan to have our standard forms placed into digital formats that allow onscreen completion and digital signatures
  • Paying a bill balance
  • Uploading a nice photo of yourself for me and my staff to have on your chart
My next article will discuss another trend of the future that is now available to my patients- sharing health data from internet connected devices (blood pressure cuffs, scales, activity trackers, etc.) with your doctor.  As this project unfolds and matures I will be working towards a way to link this function more seamlessly through the patient portal access point.
My E-retail Source Is Helping With Patient Monitoring
Online shopping order e-commerce internet shop concept with shopping cart
E-Retail in Health Care is the Future
Many people are monitoring their health with devices- I have a solution that allows your data to be seen by your doctor- invite only, HIPAA compliant. 

One distinguishing feature of my practice style is that I am willing to acknowledge that patients want more than the modern traditional doctor model known as allopathic medicine. Today, the term holistic physician implies a willingness to assess the entire person not just their disease.  

Holistic healing also emphasizes maintaining and optimizing health.  It is in the area of maintaining and optimizing health that prevention gains appeal.  For optimizing health we don't have a double blind placebo controlled trial of a "magic medication".  Instead we have observational trials, basic chemistry, biology and population data to help physicians guide people onto the road of health and wellness. 

As my long-term patients know, over the years I have sought and adopted some selected product lines and tools to help all of us in this journey of health and wellness optimization.  A few years ago I partnered with Paquin Healthcare to launch an e-retail store to help my patients purchase healthcare products that I recommend. 

Since then, Paquin Healthcare has continued their commitment to connecting patients with physicians and they have developed a software for remote patient monitoring of health data called iRemedy Remote. I am currently beta testing the software because I believe it will help my patients further optimize their health and wellness.

Here's how it works; currently, iRemedy Remote works with Withings blood pressure cuffs and digital weight scales. Users of these devices connect them to the iRemedy Remote dashboard. Once the dashboard is set up, data from the device(s) are sent directly to me through a secure HIPAA compliant server.  In real time, I am able to access your data to observe trends and communicate with you if I see something that might require urgent attention. iRemedy is working on expanding compatibility to other devices such as Fitbit and Garmin products.  

Close-up Of Doctor Holding Mobile Phone With App For Health
Metrics is the New Medicine

Presently my patients with high blood pressure are asked to keep home blood pressure measurements on a paper diary and "remember" to bring them to the office.  Now, using the Withings blood pressure cuff interfaced with a free phone app, measurements can conveniently go to the free iRemedy Remote dashboard.

Advances in the "Internet Of Things" makes digital home glucose monitors, temperature monitoring, and unforeseen other monitoring systems a real probability. Even now there is a glucose monitoring device that we are working on adding to our e-retail store.  Imagine having your glucose results reported in real time to your doctors monitoring dashboard -- how convenient! 

Heart failure patients need to monitor their weight as fluid retention and weight shifts are very important in knowing whether a person's heart failure medications are working and dosed properly.  Having a Withings weight scale with remote monitoring creates and opportunity for improved care and management.  

The future is here and available at my office right now. If you are interested in participating in the online remote patient monitoring beta program for blood pressure or weight, contact my office to schedule an appointment and we will set you up with the devices and dashboard.
Healthy Cabbage Salad Recipe
Red cabbage salad served on plate closeup
Red Cabbage Lunch Salad
Cabbage is healthy and its crunch is fun!

Here is the latest salad creation that was a both a personal and family hit. 

I like cabbage because it adds bulk, flavor and crunch to my lunch.  I use shredded cabbage in wraps and it is terrific sauteed. A head of cabbage keeps in the fridge for weeks, unlike lettuce which spoils sooner.

This salad will keep in the fridge for days and the flavors change a bit as it ages, sort of like a fine wine. 

  1. Cut or shred 3-4 cups of red cabbage-place in large bowel.
  2. Add 2-3 tablespoons of pine nuts. Chopped walnuts or sliced almonds would work as well.
  3. Add 1/3-1/2 cup of dried cranberries or raisins.
  4. Slice 3-4 fresh Medjool Dates
  5. Drizzle liberally fresh olive oil over the ingredients (1/4 to 1/3 cup if you must measure).
  6. Drizzle liberally and to taste balsamic vinegar (1/8 to 1/4 cup if you must measure).
  7. Grind fresh ground pepper over as seasoning.
  8. 1-2 teaspoons WicklesTM spicy(red) hoagie relish (this is the magic ingredient).
  9. Cover bowel with fitted lid or use plastic wrap to top of bowel. Shake/toss to mix all ingredients.
Enjoy!  Let your imagination run with different ingredients to add to your "cabbage base" in future dishes. Consider radishes, cherry tomatoes sectioned,diced or sliced bell pepper, shredded or sliced carrot, cut/diced apple and poppy seed dressing for instance. 

2016 has potential. Besides technology changing health care, I believe our last 7 year experiment in health insurance mandates and ongoing price-fixing of Medicare has been an unmitigated disaster as predicted.  

New practice models and more "free market" changes will be the saving grace. Let's hope our citizen's support this over more government run health care. 

Raymond W. Kordonowy MD
I appreciate the opportunity to be of service.

Raymond Kordonowy MD
Internal Medicine, Lipid & Wellness of Fort Myers
Digital Monitor Systems and iRemedy Remote
Soon Dr. Kordonowy will be reviewing and adding more useful products to make life more convenient and in many cases more affordable for health related products.  There is a search box on the site if you can't find a product using the various links.  In the coming months we plan to have available more home monitoring devices that will digitally download measured data to Dr. Kordonowy's office dashboard, allowing him to see you information between visits.  The future is now!