Ancient Medicine, Modern Gadgets: A Guide for Your Practice
By Denise Cicuto, LAc
There are lots of applications and devices out there for the acupuncturist-on-the-go. From general phone apps to help you get organized, to more specific apps made for acupuncturists and students of TCM, we'll take a look at some that can help make your job a little easier.
Please note: a lot of this information is about iPhone and iPad apps. I do not work for Apple; I just like their products. You can also find PC versions and Android apps.
Get organized and make money
When I got my iPhone a few years ago, I could answer patient phone calls and e-mails really quickly. It sometimes makes the difference between getting a new patient before they contact someone else for an appointment. I could even order herbs online while riding the bus to work. One of the best things about it is that I can now accept payment from patients on my phone. The iPhone has increased my efficiency while allowing me to have fun with a shiny new gadget.
I got an iPad this year and I was determined to get a lot of use out of it. The bigger screen and a wireless keyboard have enabled the iPad to become my portable computer when I don't want to carry around my heavier laptop. I can e-mail patients about appointments and send them attachments as PDFs, write notes, look up information on apps or the Internet, and makes posts to all of my Cicuto Acupuncture Facebook, Twitter and Google + accounts. The only thing I can't do with my iPad is use Quickbooks on it, yet.
Teresa Green, of Green AcuClinic in the Richmond, Virginia area, uses another kind of tablet, the Galaxy Tab, the Evernote app for organization and Dropbox to store files.
"I can save anything either with a few taps on the keyboard, choosing "share page" for web sites, or even take a picture of it! Then, I tag everything as many different ways as possible," Green said. "Since its saved online as well as on the app, it's backed up. I can then e-mail it, send it to Facebook, etc. It has become a major part of my "brain." I also love Dropbox as a way to have access to my important or often used files. Both are available as very functional free versions."
Green and I both use Square to process credit cards. Square was the first mobile credit card processing app I tried and, simply put, it works really well. You pay a percentage per transaction and that's it. There are no monthly fees and you don't have to buy a terminal. The Square card "swiper" itself is free and plugs into the headphone jack on your phone or tablet. Patients sign their name on your device using a stylus. You can e-mail a receipt or send it to a cell phone with a map square showing where the purchase was made. Money gets transferred directly to your bank account within a few days. You can download reports of transactions via the Square web site to use for accounting purposes. HSA cards can be processed by Square if the acupuncturist sets up their account with Square as a licensed health care provider. Flexible Spending Accounts (FSA) and other benefit cards are not supported by Square, but some acupuncturists have been able to process FSA cards.
ROAMpay is another credit card processing device. Like Square, it plugs into the headphone jack on your phone but you can't use it on a tablet. ROAMpay allows for Flexible Spending and Health Savings Account cards. When you apply for an account, you can list yourself as a health care provider and it enables you to take those cards.
ROAMpay is cheaper per transaction than Square. However, after using both devices for a while, I've found that the ROAMpay software just doesn't work as well as Square. I often have problems with it crashing or not recognizing cards when I swipe them. Most recently, I found out when I called customer service that this is because the swiper doesn't work with the latest iPhone operating system. They will be sending me the latest app as soon as it's available. I've only had the Square app crash a few times.
My advice is to use both Square and ROAMpay and figure out which works best for you. The convenience of being able to process credit card transactions on your phone or tablet is really worthwhile, plus there are fewer fees, which make them accessible for small businesses.
Patient Privacy and Technology
Another extremely important consideration when using handheld electronic devices is patient privacy. Both Square and ROAMpay apps use secure technology for making the patients' credit card information safe. The credit card information is not stored on your phone or tablet. If you choose to use your phone, tablet or computer to write patient records and information via cloud computing, you'll need to consider HIPAA compliance.
You can access practice management software on your computer such as Client Tracker, AcuBase and MacPractice via an iPad. Those programs are already set up to be HIPAA compliant. Steve Favarger is an IT consultant in the San Francisco Bay Area who specializes in setting up medical practices with iPads and practice management software programs like MacPractice. How does he ensure patient privacy with his work?
"The HIPAA compliance is already taken care of inside of the software," said Favarger. "What we then deal with is everything that is ancillary to the software. By that I mean: Is your backup solution HIPAA compliant? Is the way that you're communicating with your clients HIPAA compliant? Is the way that you're transferring patient data between yourself and your vendors HIPAA compliant? And that's what we focus on because the practice management software that they're going to purchase are, ipso facto, going to be HIPAA compliant and meet all federal regulations or they wouldn't be in business."
How apps can save you from back pain
There are versions of the huge textbooks I carried around in school on my phone. "A Manual of Acupuncture" by Deadman, Al-Khafaji and Baker is now available as an iPhone and iPad app - 675 pages now fit in the palm of your hand. The app is beautiful, elegant and extremely useful. It even has something that the book doesn't - videos with point location instructions.
I was just as excited to find BenCao a few years ago. It's an app for Chinese herbs and formulas. If the folks at exebeche hadn't come out with it, I was ready to find a friend who writes iPhone apps to collaborate with and make one myself. One of my favorite features of this app is a field where you can write and save your own notes. Also, the Chinese characters are listed for each herb and formula. I've found this handy in case I need to show a herb shopkeeper the name of a formula but I can't pronounce it. There are also photos of each of the herbs on BenCao, which can help students while studying.
Miridia Acupuncture Technology makes Auriculo, an ear acupuncture app, which has detailed picture of points and protocols for different conditions. It's a lot easier to use than an ear acupuncture chart. You can flip the picture by tapping on the screen to see a left or right ear and zoom in on the point. (Miridia also has a useful Points app, which I have mostly ignored since getting A Manual of Acupuncture.)
TCM Clinic Aid combines diagnosis, herbs and points and quizzes all in one app. This is one that acupuncture students told me about, and at just under $10, it's a great price for students and practitioners alike.
Tungz! is an app that's all about tongues. It's a great, affordable app for patients to learn what their tongues can tell them about their health. There are photos of tongues and health tips with diet and acupressure points. It can be a helpful tool for us to use when our patients ask "So what does my tongue tell you?" Tungz! is a great combination of a consumer level app that helps practitioners to explain our medicine.
There are many general medical applications that can be useful to acupuncturists as well. One of the most useful for insurance billing is Stat ICD-9 Coder. It contains over 14,000 diagnosis codes and is simple to navigate. The app will also be updated soon to reflect ICD-10. Epocrates has information, interactions and pill pictures for thousands of prescription drugs.
There are a lot of apps, programs and gadgets out there that can be overwhelming to choose from. It is extremely important to remember to ensure your technology means your patients' information is safe and secure. Spend some time exploring these options to help save you time and money now, and in the long run.
Denise Cicuto is a licensed acupuncturist and Chinese herbalist, specializing in women's health and immunity. Denise has a private practice with offices in San Francisco and in Alameda, Calif. She can be reached at www.cicutoacupuncture.com.