Brings About Old-Fashioned Care
December 8, 2017 by Cheril Lee
When Dr. Manju Hapke finished medical school more than 40 years ago in India, the latest technology at her school was an X-ray machine.
Since then, the CHI Health Clinic physician completed residencies at New York Hospital Medical Center of Queens and the University of Nebraska College of Medicine.
Hapke has worked in Omaha as a family medicine physician for more than 20 years. During that time, the doctor has seen lots of technological changes, especially in the field of diagnostics.
“We used to solely rely on a physical exam,” Hapke says. “That’s how we made our diagnoses. Now we have such good diagnoses thanks to scans and other diagnostics.”
Dr. Paul Paulman, a professor with the UNMC Department of Family Medicine and a primary care physician, agrees that diagnostics have come a long way, especially in the last five years.
“The radiologists and other imaging professionals have really improved imaging technology,” Paulman says. “Ultrasound is becoming bedside now.”
That is good news, especially in pediatrics. One common use of ultrasound in pediatrics is for appendicitis, which affects 70,000 children in the United States annually.
While ultrasound is leading the way in imaging technology, faster, more compact CT scans and MRIs may not be far behind.
“Pictures are getting sharper, so they can hone in on areas [of the body],” Paulman says. “It’s an area that is constantly improving as computers get faster.”
Ultimately, Hapke is most excited to see what direction diagnostics will take in the future. “I think at some point what will happen is that a patient will walk into a room with equipment and when they walk out we will have all sorts of details about their organs and how they’re functioning. It will be like a diagnostic walkthrough.”
Until that day comes, Hapke has found a technological way to enhance her patients’ care while eliminating some time on data entry.
“I was one of the first physicians who launched the use of Google Glass in Omaha,” Hapke says.
Google Glass is an electronic device that connects to the internet. When it appeared on the scene in 2013, the tech community initially touted it as the next great advancement. The high price point and imbedded camera ultimately resulted in few people using the device, but in July 2017, Google’s parent company, Alphabet, announced that Google Glass 2.0 is coming—this time geared to specific professions, including medicine.
Around the same time as the first Google Glass arrived, regulations on electronic health records became stricter, causing doctors to spend more time on data entry and less time with patients. Hapke realized that by using Google Glass, she could look at her patients, not a computer screen, during a visit.
“There’s so much information the patient gives you with their expressions that you just don’t get through the words,” she says.
A child, especially, might mention having a “tummy ache,” but point at their lower right portion of the abdomen where the appendix resides.
Google Glass works in conjunction with a remote human scribe. The scribe can see and hear the doctor and patient. The doctor must verify and approve the notes that the scribe took during the visit; the notes do not become permanent until the doctor gives the OK.
The scribe can also deliver information to the doctor in real time during the patient visit.
“When you do it in real time, you get a lot more of the information down. When you depend on your memory, you will forget half of it. Google Glass enables me to get both information and cues from the patient,” she says.
According to Hapke, the other advantage is the patient can hear what she is telling the scribe. She asks the patient if he/she understands what’s being said, which helps encourage the patient to ask questions.
Hapke can also have her scribe look up information electronically in the patient’s chart. So if she wants to know the results of a particular test or procedure, the information is available immediately.
“It’s like I have an assistant with me all the time. Because we only have so much time to be with each patient, this helps me maximize my interactions. I can practice old-fashioned medicine with good bedside manner but at the same time have state-of-the-art results at my fingertips,” Hapke says.
She’s been using the technology for about two years and estimates it saves her about 20 hours a week.
Hapke finds keeping up with new procedures and technology easy, especially since she loves to read and admits to being fascinated with medicine.
“It’s not that hard to keep up in this day and age. I am more impressed with my forefathers and how they kept up with everything, and how they advanced medicine to where it is today,” she says.