Going mobile: Physician apps
Going mobile: Physician apps

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Transcription gone high-tech

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Congressional Budget Office forecasts predict that approximately 90 percent of physicians will be using health IT, which includes EMRs, by 2019 as a result of the American Recovery and Reinvestment Act.

But according to a recently published white paper from the AC Group, a healthcare technology consultancy in Montgomery, Texas, it can take a physician an average of 140 minutes per day to fill EMRs using standard data entry. That adds up to hundreds of hours per year of additional tedium for the physician, whose time is clearly better spent seeing patients.

A new technology, Discrete Reportable Transcription (DRT), enables physicians to populate EMRs without the burden of extra typing. DRT technology transforms physician dictations into well-defined notes that it can then insinuate into the EMR automatically, dropping each piece of data neatly in its predetermined space.

Physicians seeking to maintain or increase their availability in the era of EMRs should investigate EMR technologies where DRT technology supplementation has occurred.

Emdat is one example of a popular dictation technology that incorporates DRT to make EMR population seamless.

Emdat, a web-based service that automates medical transcriptions, offers its DRT technology, which they have aptly named Discrete accurate Reportable Transcription (DaRT) to transcription companies as part of its transcription service. Physicians using Emdat can enter patient notes orally as they always have, and forward them via the Internet, all in about 30 minutes per day, or the typical time spent on dictation.

The physician can dictate notes using a digital recorder, which they can dock at their computer to upload the information using Emdat’s InSync technology, or they can dictate it by phone using Emdat’s InTouch technology. From there, Emdat forwards the data files to a MT where DaRT takes over, automatically inserting the data into the EMRs as the MTs type the dictation into the Emdat platform using Emdat’s InScribe technology. The DaRT technology works by identifying distinct in formation such as symptoms and labs contained in the notes and filling the proper fields in the EMR.

The EMRs are then stored in Emdat servers where they are always available from a secure database through web-based software. Finally, administrators, providers, hospitals and clinics use Emdat’s InQuiry technology to manage workflow in a HIPAA compliant fashion. Using InQuiry, providers can search data in the record, create specialized reports, and view, edit, print or sign the transcripts (electronically). The solution works with most major EMR platforms. Physicians aided by Emdat with DaRT have a lot to say about its efficacy.

Emdat saves time, adds to patient satisfaction

Ryan Enke, M.D., an orthopedic specialist, completed his residency at the Mayo Clinic in Rochester, Minn. Today, Enke practices orthopedic medicine at Rockford Orthopedic Associates in Rockford, Ill. Enke’s practice revolves around the non-surgical care of musculoskeletal maladies including pain and injury.

In the course of intervening, responding to and rehabilitating these conditions, the doctor treats variegated issues that can also be neurological in nature. Enke specializes in treatment for runners and endurance athletes and in treating the spine. Enke discusses his experiences with EMRs and Emdat. “I have always used Emdat while in my current practice. In previous medical settings, I often transcribed dictations in a narrative format and placed them in the EMR after editing,” he says.

“The other option was to self-enter all of the data.” Emdat makes a significant difference. “For example, for more complex patients,” Enke explains, “Emdat is helpful with accurately documenting the patient’s history and treatment plan.” That is because Enke can use Emdat to enter information into the EMR that he cannot easily add via a template, which can be restrictive. Enke is happy to quantify the benefits of using Emdat. “I have experienced significant time savings using Emdat.

When used in place of self entry of notes, it can cut five to 10 minutes off of the documentation process per patient,” says Enke. Now, the doctor is able to devote more time to his patients. “This is very valuable for patient satisfaction and patient care,” Enke says. The doctor appreciates Emdat’s automation, too. “I like the fact that dictations automatically populate the EMR in the appropriate section so that the medical record maintains an easy-to-follow format, rather than a narrative style,” says Enke.

Emdat makes EMRs available anywhere

Robert Keighley, D.O., is a general surgeon at St. Marys Surgical Associates in Ohio. Keighley is a board certified surgeon through the American Board of Osteopathic Surgeons and a Fellow of the American College of Surgeons. Keighley is also medical director of Grand Lake Hospice and Home Health.

Keighley works out of the St. Marys Surgical Associates main office, where he uses Emdat for all patient encounters, and the Grand Lake Wound Care Center, where he must enter EMRs manually. At the wound clinic, Keighley menters each patient’s EMR directly after seeing them.

“At the clinic, if I am entering an EMR for a new patient, it can take 10 to 15 minutes per patient,” says Keighley. If Keighley finds an abnormality, he must type the specifics of that into the EMR, then move to the progress notes and enter information there. He must also enter the patient complaint and a plan for treatment, all through traditional data entry methods.

With Emdat, Keighley dictates the history and physical (H&P) and all the other information from his notes into the system. “Emdat saves an hour and a half to two hours per day by enabling me to dictate orally,” Keighley says. And when he recites the history and physical for the EMR in an H&P format, his office can send that to the patient’s family doctor with a cover letter, and he does not have to dictate the H&P anew for that purpose.

“In the old days, I would have to get my patient chart out and dictate a history and physical into the hospital system. Now, I pull it up from Emdat or download it at the hospital,” says Keighley. “It is accessible anywhere I am.” As a result, patient care flows more easily. “I don’t have to stay late at the office, and I can get home sooner. At the wound clinic, I finish up Friday afternoon and I don’t have to come in Saturday to do the dictation,” Keighley says. Ultimately, Emdat improves patient care. “If I dictate into Emdat orally, I can be more detailed. I am basing it more on what the patient tells me. As a result, my treat-ment plan is more detailed,” Keighley says.

Emdat pre-dates EMRs, adapts to changing times

According to Candra Thompson, the chief administrative officer at Albuquerque Spine Consultants in Albuquerque, N.M., doctors Carlos Esparza, M.D., (physiatry) and Claude Gelinas, M.D., (surgical) perform a wide variety of procedures, including spine stimulator implants, which are directed at long-term treatment. Esparza received fellowship training at the Florida Spine Institute in Clearwater, Fla. The doctor also conducted medical research at the University of California and Loma Linda University Medical Center.

Gelinas completed his fellowship in spine surgery in the Department of Orthopaedic Surgery at the University of Maryland. His specialties include spinal tumors, spinal trauma and pediatric spine deformities. The Albuquerque practice offers procedures related to spinal surgery including patient screening for surgical candidacy and pre- and post- operative care, according to Thompson. “The surgeon performs daily hospital rounding and clinic visits two to three days a week in addition to surgeries,” says Thompson.

The doctors at Albuquerque used Emdat before they adopted EMRs. Because Emdat evolved to include a process for dictation to EMRs, the medical providers at Albuquerque Spine Consultants can make the conversion to EMRs without giving up the time-saving ability to dictate their notes, says Thompson. This saves them from engaging in manual data entry, which can be frustrating.

“The physicians are able to dictate the entire note if they like. The process flows the same as it did before,” says Thompson. Though other physicians recover time when using Emdat because they no longer have to sit for manual data entry, circumstances never forced doctors at Albuquerque Spine Consultants to type in their EMRs, though they have that option. Instead, these physicians realize the savings in other ways. “The time savings comes when the information ends up in the appropriate place in the EMR within 24 hours. This has saved 1.5 full-time employees in medical records management,” Thompson notes.

Still, the Albuquerque providers’ favorite Emdat feature is that it enables them to keep the dictation interface that they are familiar with.

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David Geer

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