This document describes a proposed solution to reduce physician documentation time called MySmartVisit. It involves patients completing medical history and symptom questionnaires online prior to visits which can then be directly imported into clinic notes. Research showed computer-generated history of present illness from such questionnaires was assessed as higher quality by physicians across domains like thoroughness and comprehensibility compared to physician-documented histories. The solution aims to return the focus of medicine to patients rather than paperwork by saving doctors time on documentation. Initial users, funding for developers, and partnerships with medical practices are needed to further develop the solution.

1. Aaron Gray, MD
@MizzouSportsDoc
@MySmartVisit

2. About Me

3. Finding a Problem…

4. Finding a “Migraine” Problem…
“feels like I’m a data clerk”
"It used to be that as I was I sitting with patients
I was writing the notes, and I would be done
when they left the room. Now, 100 percent of
time I have to stay afterward, and I'm a really
fast typist.“ - Dr. Leora Horwitz
“I spend 1-2 hours at
home completing notes
per half day of clinic.”
Clinicians spend up to 1/3rd of visit looking at
computer

5. JAMA Internal Medicine, 2014.

6. …that someone will pay for.

7. Our Solution
• HIPAA compliant website where healthcare
providers create customized algorithm driven
questionnaires about patient symptoms
• Patients complete information about their medical
history and specific questions about their current
problem online prior to the visit
• Patient information can be directly imported into a
clinic note to increase accuracy and save physician
time

8. Spiegel, et al.
Computer-Generated Vs. Physician-Documented
History of Present Illness (HPI): Results of a Blinded
Comparison.
75 patients completed computer-generated and
physician documented HPIs.
HPI computer algorithm – Automated Evaluation of
Gastrointestinal Symptoms (AEGIS)

9. 48 blinded physicians assessed HPI quality across six
domains using 5-point scales: (Computer vs Physician
avg score, all had P<0.001)
1. Overall impression (3.68 vs 2.80)
2. Thoroughness (3.70 vs 2.73)
3. Usefulness (3.82 vs 3.04)
4. Organization (3.66 vs 2.80)
5. Succinctness (3.55 vs 3.17)
6. Comprehensibility (3.66 vs 2.97)

10. Benefits
• Doctors spend less time on patient notes
• Eliminates paperwork for patients in the office
Return the focus of medicine to
patients, not paperwork

16. Jane Doe - rash

17. Past Medical Hx:
hypertension
Past Surgical Hx:
appendectomy
Allergies: NKDA
Medications:
HCTZ 25 mg daily
Social Hx:
Non-smoker
Family Hx:
melanoma
Chief Complaint: rash
HPI:
Exposure to poison ivy doing
yard work 3 weeks ago.
Duration -2 weeks
Description - itchy red bumps on
arms
Treatment-calamine lotion,
Benadryl
Review of Systems:
Positive: headache, rash
Denies: fever, vision change sore
throat, cough, chest pain,
nausea/vomiting, urinary
problems, joint pain, depression,
hot flashes, bleeding disorders

19. Competitors

20. Future Possibilities
• Patient Centered Big Data
• Quality Outcome Metrics
• Streamline Telemedicine Visits

21. What We Need
• Initial Users
• Physicians, medical practices and clinics
• Funding
• For Developers

22. Twitter - @MySmartVisit
Web - MySmartVisit.com
Email - MySmartVisit@gmail.com