Doctors using Google part 2: A day in my life

A few weeks ago, I wrote about how I incorporated Google in my daily life, using it to help find ICD-9 codes, patient information handouts, and articles on the fly. It was well-received, so I decided to write further about how Google has become an indispensable tool in my practice. Physicians today can certainly benefit from the power of the internet, with Google as a gateway.

As for my setup, I have internet access both in the office and the hospital. I carry around a laptop with wireless internet access in and around patient rooms, which is required by our EHR. I have full access to UptoDate on the internet.

So, without further ado, let’s talk about a typical day. HIPAA watch: All of these patients and anecdotes are fabricated to illustrate how Google is incorporated into a common primary care practice.

Btw, I do not own stock in Google (although I wish I did).

Blogging time and coffee. Google News is one of my resources, with a glance at the main health page. Keying in “doctor”, “malpractice”, “health”, and “medicine” gives me a pretty wide variety of daily stories to blog about. I also use Yahoo! News, but this entry is about Google.

A 25-year old male is being seen for a tick bite. He is worried about Lyme disease and I explained the typical rash of early Lyme disease, erythema migrans. What does it look like? Using Google Images, it looks like this (Google Images: “erythema migrans”) – and I was able to show him in the office. He asked for some information on Lyme disease, which I was able to find and print out (Google: “lyme disease nih”).

I’m seeing a 40-yo male with hypertension and he’s wondering whether he should be on a low-dose aspirin. The current recommendations are the following: “The USPSTF concluded that the balance of benefits and harms is most favorable in patients at high risk of CHD (5-year risk of greater than or equal to 3 percent) but is also influenced by patient preferences.”

Using the Framingham risk calculator (Google: “framingham risk calculator”), we were able to calculate his risk and decide whether aspirin is indicated.

The hospital calls with a positive result of a doppler ultrasound. I sent a patient over earlier in the day with a swollen left leg – now he has a deep venous thrombosis. I prescribe Lovenox, and remember he weighs 220 pounds. Lovenox needs the weight in kilograms, which can be converted with Google (Google: “220 lb to kg”).

Lunch and paperwork. I receive a form for asking for a diagnosis for the bone density I ordered earlier for a lady who says she is “growing shorter”. Having not memorized the arcane icd-9 codes, I find the appropriate code using Google: 781.91 (Google: “icd9 loss of height”).

A colleague pops his head in my office, asking me to remind him the definitions of sensitivity and specificity. These can certainly be confusing – and I refer him to some definitions from the web (Google: “define: sensitivity”, “define: specificity”).

A diabetic patient I’m seeing wants to know where he can find cheap diabetic supplies – specifically his BD 28-gauge insulin syringe. I gave him some leads from Google’s shopping service, Froogle (Froogle: “BD 28-gauge insulin syringe”). Impressed, he asked me about his One Touch Ultra Test Strips. No problem (Froogle: “one touch ultra strip”).

With the advent of high-deductible insurances, people are asking me about how much procedures cost. Take this patient whom I recommended a colonoscopy for colon cancer screening. She asked me how much one costs. Not sure, I looked it up (Google: “cost of colonoscopy”).

I’m sending a patient to St. Elizabeth’s Hospital in Boston for a referral. She asks me how to get there from the office. I guess I could have referred her to the website, but it was easy to just print it out for her. Just find the address (Google: “st. elizabeth’s hospital boston”) and plug it in to Google Maps (Google Maps: directions, “nashua nh” to “736 Cambridge St, Brighton, 02135”).

I’m seeing a new patient, referred to me from the emergency room at Saints Memorial Medical Center in Lowell, MA. She continues to have abdominal pain and told me she had an abdominal CT scan there. I need the report ASAP, as she is sitting in my office writhing in pain. To cut down on time, I give my office staff the number personally: (978) 454-2369 (Google: “saints memorial medical center lowell ma”).

I just finished some trigger point injections on a patient. Just to be sure I’ve documented the procedure appropriately, I want to look up what Medicare wants in the note (Google: “trigger point injections coding medicare”). Voila.

There you have it – some real-life examples of how I incorporate Google into my medical practice. I’m always interested in new tips, so please share your tricks!