JENNIFER BOULDEN

Urologists and other physicians seeking expertise from or a referral to the Genitourinary Oncology Clinic at the University of Arkansas for Medical Sciences (UAMS) in Little Rock now have an expedient new shortcut.

The clinic, headed by Dr. Graham Greene, the Robert Woods Bass Chair in Urologic Oncology, made available in April a new HIPAA-compliant physician Web portal to expedite referrals, enhance communication and share information about Greene’s and Dr. Rabii Madi’s research and clinical work.

Greene said that he had read about physician Web portals in use at major hospitals and started thinking several years ago about how to employ one to promote and facilitate the growing urologic oncology program.

“I had an idea of how to reach out to physicians and give them a different way to get a hold of us,” Greene said. “It started with myself. I was so busy, I wasn’t able to return calls and was always trying to play catch up, and physicians still weren’t able to get the access they deserved and needed for their patients.”

He said that when Madi joined the program a year and a half ago, the need to get the message out that UAMS had a second fellowship-trained urologic oncologist created additional motivations for developing the portal.

Using the portal, which is accessible through the Referring Physician part of the UAMS Web site or at http://www.uams.edu/uro-onc, physicians can bypass the UAMS Access Center and send requests, questions and referrals directly to Greene’s and Madi’s computers and PDA devices. The clinic guarantees a response within 24 hours.

“Both Dr. Madi and I basically live off our Blackberrys,” Greene explained. “We’ve got it set up so every new query goes to our Blackberrys. In between cases or patients, we can check that and have a fairly prompt response to various queries and notifications of new patients.”

“I think it’s very unique and a very new idea,” Madi said. “I don’t think there’s any comparable Web-based portal for the GU oncology or urology fields anywhere in the nation. Instead of calling the center here and staying on hold, and then getting transferred from one phone to another before having to leave a message for us, in this case the physician can do it online in just a few minutes, any time of day, and be guaranteed a reply within 24 hours.”

Greene said another problem he hopes the portal will help solve is getting too many referrals for patients with minor problems that don’t require their specific expertise.

“It helps us manage our patients so we are seeing the right kinds of patients. We’re urologic oncologists who do quaternary care,” Greene explained, saying his goal is for at least 50 percent of the patients they see to be operative.
“Instead of seeing microscopic hematuria or other small things, we can see the high-level cases for things nobody else wants to treat anyway. So our clinics won’t be bogged down with 10 new patients, only one of which is a quaternary patient.”

Greene, who did a three-year fellowship in basic science as well as clinical research at M.D. Anderson in Houston, said his professional interest is in advanced urologic malignancies of all the organ system sites, including the kidneys, adrenals, ureters, bladder, testes and penis.

Dr. Madi is a urologic oncologist who trained in minimally invasive surgery, including laparoscopy and robotic surgery, at the University of Michigan.

“Having Dr. Madi here is an enormous help,” Greene said. “He’s an excellent surgeon, a great resource. The state really needs to know how lucky we are to have him here.”

Greene said they see a lot of patients who travel from the far reaches of the state. “So much of the stuff we get unnecessary referrals for is because we physicians don’t get together and talk,” he explained. “This way, they can ask the question quickly and save the patient an eight-hour trip. And we still can coach and help them manage their patients that way.”

He said he and Madi don’t want to compete with local urologists who are “very capable at taking care of oncologic cases of a particular level.”

“We’re here to offer our expertise in advanced cases, as well as to fulfill the missions of education, outreach and research.”

Besides routing queries and referrals directly to the two doctors, the site is also a repository for information about the program, the physicians and research clinically under way. Madi said they have plans to add videos of the robotic prostectomies and other minimally invasive procedures he does, additional educational content and PowerPoint presentations. Long-term plans include the possibility of live chat sessions, enabling Greene and Madi to conduct formal consultations online.

“On the Web site we have a research section, so if physicians say, ‘I wonder what Greene and Madi are doing at UAMS,’ they can log on and it lists all our clinical trials, and has inclusion criteria on them, so if there’s a patient they want to send, they can see whether or not to send them instead of wasting a trip,” Greene said.

“Definitely it has the potential to be expanded and include lots of other things,” Madi said.

“What physicians need to know now is that it’s available, it’s free, it saves time and money and makes their lives easier,” Madi said. “It definitely makes the communication faster and simpler. Eventually, it will benefit the patient care because the patients will be getting better access to the urology clinic here and to our expertise.”



June 2008