Practice Improvement

Many years ago, when my now-grown children were babies, we had the bare necessities for raising our young ones. Cloth diapers and diaper pins, plastic bottles and NUK nipples, and the all-important windup baby swing. Now decades later, parents have an assortment of high-tech gadgets to help raise their newborns.

I began the January 2016 Peds v2.0 article “Expediting medical documentation” by stating that my “theme” for this year’s articles is the “retaking” of pediatric practice for ourselves and our patients. I continue this discussion by borrowing a slogan from one of our presidential candidates, in the hopes that pediatricians can be motivated to implement needed reforms that will make practices more efficient, improve the care we provide to patients, and enhance the lives of pediatric providers.

When I opened my first practice in 1986, I was intrigued by an advertisement in Contemporary Pediatrics that caught my attention, and days later I was the proud owner of a FirstTemp tympanic thermometer.

To continue our ongoing theme of “taking back” the practice of pediatrics for ourselves and our patients, I’d like to discuss utilizing behavior portals to facilitate the diagnosis of patients with autism spectrum disorder (ASD), developmental delay, attention-deficit/hyperactivity disorder (ADHD), as well as depression and anxiety.

Let’s begin our recovery of medical practice by discussing alternative ways of documenting office visits.

In this article, I describe my experience visiting vendors in the NCE’s exhibit hall and detail some of the best tech presented at this year’s workshops.

Physicians and parents are using a variety of health-related gadgets and gizmos that communicate with our smartphones and tablets. These range from fitness devices that monitor daily exercise, to glucometers used by diabetics to monitor sugar levels, to sphygmomanometers used to measure blood pressure.

Barring a last minute reprieve, International Classification of Diseases version 10 (ICD-10) diagnostic coding went into effect the first of this month. If you read my March 2015, Peds v2.0 article on ICD-10 adoption-and heeded the advice contained therein-you have successfully implemented ICD-10, and everything is going smoothly now.

Contemporary Pediatrics brings you 10 tips to make the switch to the ICD-10 coding system.

When I started my pediatric practice in 1986, we tested patients for strep throat by performing a throat culture, which was placed in a small office incubator for 48 hours. Typically, we put patients on an antibiotic pending culture results and would stop antibiotics if the culture proved negative. In my first year of practice, an interesting new technology arrived-rapid antigen detection tests (RADTs). These tests were reasonably accurate and enabled us to make a diagnosis at the time of the visit.

Despite the growth of retail-based clinics, the availability of direct-to-consumer video visits, and the implementation of the Affordable Care Act, you are having a busy day in the office.

In this follow-up to his article "Telehealth: A primer for pediatricians" that appeared in the June 2015 issue of Contemporary Pediatrics, Dr. Andrew Schuman describes the logistics of implementing your own office telehealth program.

Andrew J Schuman, MD, FAAP, presents his take on the US Supreme Court decision to uphold the healthcare subsidies provision of the Affordable Care Act and how the monumental decision will affect the future of pediatrics.

Whether you realize it or not, you have been practicing telehealth for years. By communicating with patients by telephone, you are managing their care at a distance.

Although I’ve been writing articles for Contemporary Pediatrics since 1988, I have never received as much supportive e-mail as I have in response to my 2 maintenance of certification (MOC) articles published in the January 2015 issue.

Despite our best efforts, pediatricians have little success in encouraging our patients to eat a healthy diet and get the recommended amount of daily physical exercise.

Pediatricians must learn the nuances of new ICD-10 coding and prepare for the transition now! Dr Schuman presents the reasons behind ICD-10 implementation as well as key elements of ICD-10 adoption to assure a smooth transition for your practice.

The stethoscope is perhaps the most iconic device associated with medical practice, and the most important part of the stethoscope will always be the part “between the ear tips.”

There has been much discussion both for and against Maintenance of Certification (MOC) requirements. This article explains how a permanent board certification program for physicians transitioned into MOC recertification and discusses the controversies surrounding the current program.

I recently had the good fortune to present a forum on medical office technologies (“Must-Have Gadgets, Gizmos, and Technology for the Pediatric Office”) at the American Academy of Pediatrics (AAP) National Conference and Exhibition in beautiful San Diego.

It is easy to take for granted some of the technologies we use every day. The pulse oximeter was invented 40 years ago and has become such a routine part of medical practice that oximetry measurements have often been referred to as the “fifth vital sign.”

Insurance companies are now beginning to compensate pediatricians for performing photoscreening, billed under Current Procedural Terminology (CPT) code 99174. We applaud the efforts of the many pediatricians, pediatric ophthalmologists, and state chapters of the AAP who have aggressively petitioned insurance companies to cover this important service for our patients. -Andrew J Schuman, MD, Section Editor