While we have less time to spend with patients through web-based questionnaires, we are now able to be more patient-oriented and provide medical care with a higher level of patient satisfaction than before.
Kanazawa T&D Clinic - Department of Thyroid and Diabetes
Kanazawa T&D Clinic is a clinic for thyroid medicine, diabetes, and internal medicine in Kanazawa, Ishikawa Prefecture, Japan.
We focus on treating patients with "thyroid diseases" such as Graves' disease and Hashimoto's disease, and "lifestyle-related diseases" such as diabetes, hypertension and dyslipidemia.
We interviewed Dr. Oda, the director of the clinic, about the background to the introduction of the Melp web-based medical interview system and how it is uniquely utilized.
- What made you decide to introduce Melp?
Initially, I was introduced to the system by a representative of Medley, the company that provides the CLINICS medical record, the electronic medical record used by our hospital.
However, we received a demonstration, but at that time, we did not implement it. The reason for this was that after using the template of Melp Questionnaire and entering medical questions, I felt that it was a service for general internal medicine and not really suitable for clinics specializing in thyroid and diabetes like our clinic.
Also, at that time, our clinic took a lot of time for face-to-face interviewing by specialized nurses in the interview room, so we decided that our clinic did not need Melp Web Interview and decided to forgo it.
- I see, that's right. What was it that made you consider Melp again after that?
It was the epidemic of the new coronavirus infection, wasn't it?
The new coronavirus infection started to spread, and it became more difficult to ask first-time patients face-to-face for infection control, which was the trigger.
Initially, I tried to incorporate a questionnaire for fever patients using the inquiry form on the clinic's website, but there was a limit to the number of items I could ask, and I couldn't create questions that branched out, so I could only create questions to the level of, "Well, that's something that can be done over the phone in a few minutes.
- How did you feel when you actually started using Melp?
It has been very convenient and helpful. We used to manage medical questionnaires on paper, but since we switched to web-based questionnaires, we have been able to reduce the workload at the reception desk, and our staff is very satisfied.
- When you actually tried using Melp, how was the usability?
It's just so convenient. As we've been working on it, we've found that it can be used in a wider range of ways than we had originally envisioned, and it's really useful.
Initially, we started out with a template for new coronavirus infections for the medical questionnaire, thinking that we would only be using it for patients suspected of having new coronavirus infections.
We added more and more items to it, and started using it for the initial examination of patients with diabetes, thyroid gland, and other specialties, and now we are expanding its use to include patients who come back for follow-up examinations.
- Thank you very much. How is the system currently being operated?
When we receive inquiries from first-time patients about coming to the clinic, we tell them to fill out the web-based questionnaire in advance. We also proactively announce it to return patients and ask them to fill it in after their visit.
- Well, I see. By the way, how do you deal with elderly patients or patients who are not familiar with filling out the web-based medical questionnaire?
To be honest, it's quite difficult for elderly people. To be honest, it is quite difficult for elderly patients. Some of them don't have smartphones, and it is difficult to use tablets in the hospital for infection control.
However, there are some patients who have smartphones but have not been using them much, and they do their best to fill out the web questionnaire.
- It was my impression that Kanazawa T&D Clinic's web-based questionnaire has quite a lot of items compared to other clinics that have introduced the system. What is the response from patients who actually fill out the form?
Is it a lot?
However, even if we didn't have the web-based questionnaire, we would have asked the same questions in face-to-face consultations, and in fact, even with the current web-based questionnaire, we have narrowed it down quite a bit.
So far, no patient has said that there are too many items. Melp WebQuestionnaire is a form similar to LINE, and it may be because it is not so difficult to input.
- Well, I see. It's certainly different in a specialized outpatient clinic. Can you tell us what you liked about Melp?
First of all, I can now take more time to explain to patients. In the past, we used to conduct more interviews in the examination room before the examination based on paper questionnaires, but now we know the patient's symptoms in advance to some extent through web-based questionnaires, so we may guide the patient to the examination before the first visit. I can now spend more time explaining the results of tests and diseases.
We also appreciate the fact that we can ask about allergies and medical history, as well as family structure, menstruation, marriage history, and other information that is difficult to ask in person, but which we need to ask in advance. I like the fact that I can get information without any omissions.
But perhaps the best part was realizing that we can use technology to help people.
I've been a doctor for more than 20 years now, and I used to think that interviewing was just one of the skills of an internist, and that a machine could do the interviewing. Although technologies such as electronic medical records and web-based appointment systems make it more convenient and improve the quality of medical care, I wondered if they would be beneficial in helping me to be closer to my patients. That's what I was thinking.
The epidemic of coronavirus infections triggered the introduction of this system, and through the Melp Web interview, I was able to see that patients were troubled by various things, and I was able to ask them more deeply about them.
Although I have less time to spend with patients, I feel that I am able to be more attentive to them and provide medical care with a higher level of patient satisfaction than before.
- Thank you very much. It is a great honor for a developer to hear that. By the way, can you tell us about the improvements of Melp?
Some patients find it difficult to "go back" to the questionnaire, so we would like to make the movement when modifying the questionnaire easier to understand.
We would also like to be able to color-code the patient's questionnaire by other items as well.
For example, in our clinic, we do in-hospital tests and can explain the test results on the same day, but there are some patients who don't have time and want to hear the results later.