San Diego Heart & Vascular Associates Case Study


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San Diego Heart & Vascular Associates Case Study

  1. 1. Dra go n Medic a l P ra c tice Ed itionSan Diego Heart & Vascular Associates CouplesDragon Medical Practice Edition with AllscriptsEnterprise EHR to Improve Level of Service, EnhanceDocumentation Quality, and Reduce Costs “ e took the opportunity to implement W Dragon Medical Practice Edition at this time because we’d heard that its quality was at the necessary level. I wasn’t disappointed.” — aul Phillips, MD, Cardiologist P San Diego Heart Vascular Associates San Diego, CACHALLENGE Summary• ake advantage of CMS incentives for T Caring for patients since 1987, San Diego Heart EHR adoption, eliminate $20,000 annually Vascular Associates is one of the largest in transcription costs, all while creating cardiology practices in San Diego with locations comprehensive patient documentation in Hillcrest and Coronado and privileges at five hospitals. Physicians are ABIM board-certified in invasive and non-invasive cardiovascular medicine and have been recognized forSolution excellence in medical teaching and patient• peech-enable the EHR by coupling S satisfaction. The practice has been repeatedly Dragon Medical Practice Edition with Allscripts cited as members of “San Diego Magazine Enterprise EHR to create complete, real-time Top Doctors,” and “America’s Top Physicians.” patient notes Physicians in the practice have published more than 30 research articles, two books, and have created a statin website. results • ragon Medical Practice Edition within D The practice has recently deployed “front- Allscripts Enterprise is now used by seven end,” real-time speech recognition with the physicians to create high quality documentation Allscripts® Enterprise Electronic Health Record unique to each patient encounter. Significant (EHR) to improve clinical workflow. The practice annual cost savings include $20,000 of has significantly reduced costs, improved transcription expenses. Turnaround time documentation quality for its EHR system, for documentation has been reduced from and cut turnaround time for notes, referral letters one week to one hour, which helps improve and patient handouts. Currently, seven out of accuracy and allows the practice to better the practice’s eight physicians are using communicate with patients and to more easily Dragon® Medical Practice Edition to complete their share information with other physicians who documentation within Allscripts Enterprise EHR. may be treating the patient. h e a lt h c a r e
  2. 2. Dra go n Medic a l P ra c tice Ed itionEnhancing Point-and-Click EHR Expert Consulting from MedicalDocumentation Speech SolutionsThe physicians at San Diego Heart Vascular The practice decided to implementhad long employed transcriptionists to create Dragon Medical Practice Edition three monthsdocumentation, patient handouts and referral before installing Allscripts Enterprise EHRletters. Recently, the practice adopted the to give its clinicians time to get comfortableAllscripts Enterprise EHR in an effort to with speech recognition before turning theirparticipate in the EHR reimbursement program attention to the EHR. The implementationavailable through the Center for Medicare and of Dragon Medical Practice Edition wasMedicaid Services (CMS) as specified by the overseen by Todd Ruddle, President ofHealth Information Technology for Economic and Medical Speech Solutions, a reseller ofClinical Health Act (HITECH). Dragon Medical Practice Edition. Ruddle trained the physicians on how to install and use the systemAs the practice prepared its move to the EHR, as well as how to set up templates and was aware that the EHR’s “point and click” CHMB of Escondido, California implemented thetemplates would limit the physicians’ ability Allscripts Enterprise enter relevant information into the patient’srecord. Since few physicians wish to type “At first, Todd came in for 30-40 minutes to showlengthy notes into an EHR, the practice would me the basics,” said Dr. Phillips. “After that, he toldhave needed to continue its use of the costly me to play with the system for five or six patientstranscription service. to determine what I needed help with, and then he came back to answer my questions. The trainingAdditionally, the process of transcribing notes and was superb. Todd was always available, and Iintegrating them into the EHR was cumbersome had a really good experience.” Once Allscriptsand complex. As Paul Phillips, MD, Cardiologist, Enterprise EHR was up and running, Ruddlerecalled, “We would have to dictate notes, returned to make sure the combined Dragon/EHRsend them out for transcription, and have the infrastructure worked well together.transcribed notes emailed back. The physicianwould then have to proofread the notes and send Expecting Great Things; Living Up Tothem to a technician to locate the right place to Expectationsenter them into the EHR.” The practice went into the Dragon Medical Practice Edition implementationThe Solution: Speech Recognition with high expectations. “We took the opportunityThe physicians determined that speech- to implement Dragon Medical Practice Edition atenabling the Allscripts Enterprise EHR with this time because we’d heard that its quality wasDragon Medical Practice Edition provided at the necessary level,” said Dr. Phillips. “I wasn’tan optimal solution. (Today, over disappointed.”25,000 physicians across the U.S. useDragon Medical Practice Edition to document Dr. Phillips got up to speed oncare into Allscripts EHR solutions, including Dragon Medical Practice Edition by first dictatingEnterprise.) Dragon Medical Practice Edition only new patients, then all patients. By the timecoupled with Allscripts Enterprise EHR promised the EHR was in place, he was ready to useto provide the physicians a way to create Dragon Medical Practice Edition to enter anycomplete, comprehensive, real-time patient notes. notes he wanted to into the EHR. He’s been 2
  3. 3. Dra go n Medic a l P ra c tice Ed itionpleased with the results. Said Dr. Phillips, “I can The system also minimizes errors. Previously, iftalk at a regular pace. It’s amazingly accurate for the transcriptionist didn’t understand somethingphysical exams, which require shorter notes. I tend in a physician’s dictation, they’d leave it be pretty expansive with free text. In that area, Then when the note came back several days later,I’m still training Dragon and it’s still training me.” the doctor would have to remember what they said. If Dragon Medical Practice Edition makes aStrong Integration with the EHR mistake, the physician knows what they just saidSpeeds Data Entry and can correct the notes on-the-spot – ensuringUsing Dragon Medical Practice Edition with the note is complete and done the first time.Allscripts Enterprise has eliminated limitationsimposed by the EHR’s point and click interface Faster Turnaround Enhancesand “canned” notes. “I’m not much of a point Patient Careand click person, I’d rather say things,” explained Using Dragon Medical Practice Edition hasDr. Phillips. “I want to describe what the patient compressed the transcription process from onetells me the way they say it. I also like to week to near real-time. Real-time turnaroundemphasize findings that my experience tells me means that physicians can enter informationare important, not what the EHR tells me I should into the EHR as well as send notes or letters tofocus on. As a result, whenever Allscripts gives referring physicians and to patients the option to do free form notes, I take it. Said Dr. Phillips. “For patients, timely transcriptionWithout Dragon Medical Practice Edition, that improves understanding and communication.would slow me down.” Because patients can take assessment reports home with them, they get the message moreDragon Medical Practice Edition templates further clearly about what they need to do. Rapidspeed data entry. For example, the doctor does transcription also helps improve service to otherseveral stress tests, including standard exercise physicians. For example, if the patient needstests and exercise nuclear tests. Previously, semi-urgent surgery, it’s much easier for me tohe’d have to dictate all the text to describe his make sure the documentation is ready for theresults. Templates enable him to simply state the anesthesiologist and the surgeon.”numerical test results. “That makes it really fast,”said Dr. Phillips. Lower Transcription Costs Costs are lower as well.Overall, the integration between Dragon Medical Practice Edition has eliminatedDragon Medical Practice Edition and Enterprise $20,000 a year in transcription excellent. “The integration is better thanpromised,” said Dr. Phillips. “Wherever I go in Conclusionthe program, I can dictate.” Overall, Dragon Medical Practice Edition has exceeded the practice’s expectations. “I wouldImproving Quality of Notes Within absolutely recommend it to other physicians,”the EHR said Dr. Phillips.As a result of using Dragon Medical Practice Edition,documentation quality within the EHR remainshigh. “It’s easier to say things. WithoutDragon Medical Practice Edition, my documentationwould be much less personalized and recommen-dations would be minimal,” said Dr. Phillips. 3
  4. 4. Dra go n Medic a l P ra c tice Ed ition 7/12 DTMHighlights• physicians currently use 7 Dragon Medical Practice Edition with Allscripts Enterprise EHR• 20,000 in annual transcription expenses have $ been eliminated• ather than producing canned notes, R Dragon Medical Practice Edition lets physicians create thorough documentation unique to each patient encounter• urnaround time for documentation has been T reduced from one week to one hour• hysicians improve communication with P patients and with other doctorsCopyright © 2012 Nuance Communications, Inc. All rights reserved. Nuance, the Nuance logo, and Dragon are trademarks and/orregistered trademarks, of Nuance Communications, Inc. or its affiliates in the United States and/or other countries. All other brandand product names are trademarks or registered trademarks of their respective companies. h e a lt h c a r e