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Electronic health records: Key to tracking epidemics — 1 Comment

  1. The healthcare idnsutry has deployed a variety of technological solutions in an effort to bring about cost-effective clinical documentation. I think it’s fair to say that none have worked. Point-and-click approaches detract from the patient-physician interaction if done during the encounter. They take considerable time if performed after the encounter. Front-end speech recognition consumes valuable physician time, both dictating and correcting. Back-end speech recognition just takes the physician’s time to dictate, but it adds delay and expense for a medical editor to correct the draft text. It’s only a marginal improvement over conventional dictation and transcription. Plus, the free-text speech applications will require natural language processing to extract the clinical facts and convert them to codes, in order to qualify for future stages of meaningful use. And a code editor will be needed to correct the engine’s errors. Then the codes will have to be mapped to the EHR’s data fields, and that’s a messy process.Surprisingly, if not shockingly, the ultimate answer seems to lie not in technology…but in people. The new profession of Medical Coordinators (MCs) has proven to be a powerful solution to the conundrum of clinical documentation, while providing other valuable benefits as well. Early adopters are seeing dramatic productivity increases, with the ability to see one additional patient per hour. This pays for the MC while adding six figures to the physician’s income. Equally important is that the physicians are now enjoying the practice of medicine again, exercising their minds more than their fingers. And their patients love the way they listen and analyze, with eye contact, rather than worrying about entering data into the computer.The MCs are not in the exam room. They can be in another office of the building or in their home. They listen to the patient and physician via a secure, two-way microphone/audio connection. Having been trained to be expert in the EHR and in performing the documentation from listening to the audio, which is a formidable challenge, they enter the appropriate codified data and narrative text into the EHR. The information appears (almost magically) on a monitor in the exam room. Or the physician can utilize an iPad.When the encounter is over, the documentation is finished. The MCs also handle the encounter-related workflow. They can get the nurse to the exam room when indicated, do the e-prescribing, assure all the necessary clinical reports are available, remind the physician about something the patient wanted, etc. When encounter is over everything is done. The MC can even do the coding.

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