Voice Activated Systems and Electronic Medical Records Gary

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Voice Activated Systems andElectronic Medical
Records

• Gary P. Kearney MD FACS

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Medisensehttp//208.146.137.27/

• Appointment Scheduling
• Anesthesia Management
• Medical Records Data Base Software
• Managed Care
• Occupational Health Management
• Interface Engine
• Ad Hoc Reporting

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Medisense

• Employs Btrieve(TM), a relational database with
  ODBC and SQL capabilities, that enables immediate
  access to an manipulation of your data.
• Reports that are preformatted in MediSense or
  designed using the Xtrieve R, Access R, Crysal R,
  R7R R and similar report generators.
• Integrates easily with a wide array of third
  party software applications including various
  medical record systems, coding compliance
  applications, word processing and more.
• Employed in a Novell or Windows NT environment.

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DocSTAR

• Electronic filing cabinet
• documents on optical disks
• Scans paper documents, creating electronic image
  files that exactly match the content of the
  original
• Can be retrieved, viewed, printed, and faxed in a
  matter of seconds.
• Networkable (documents can be retrieved from any
  PC)

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DocSTAR Interface
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DocSTAR Scanning
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DocSTAR Password Protected
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DocSTAR Filing
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DocSTAR Example file
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iMedConsenthttp//www.dialogmedical.com/

• Customizable and print specialty-specific consent
  forms and patient education materials from over
  3,000 template documents.
• Developed and reviewed by an advisory board of
  medical specialists
• Template documents continuously updated via
  website

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iMedConsent

• Enhances patient satisfaction
• Helps manage medico-legal risk
• Allows doctors to work more efficiently and see
  more patients
• Standardizes communication across the practice
  Serves as a practice marketing tool

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iMedConsent Specialties

• Cardiology
• General surgery
• Interventional radiology
• OB/GYN
• Ophthalmology
• Orthopedics
• Otolaryngology
• Plastic surgery
• Podiatry
• Urology

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iMedConsent Interface
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iMedConsent Images
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iMedConsent Template Editor
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iMedConsent Letter Editor
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Healthscribehttp//www.healthscribe.com/

• Internet-enabled transcription technology
  provides electronic document creation and
  management
• Windows based system provides real-time tracking
  of transcription jobs from dictation to delivery
  back to your hospital or clinic. 
• Ability to change job turnaround status to STAT
  as needed, edit/reprinting of reports and
  add/delete physicians in the main database.

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Healthscribe Job screen
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Healthscribe Custom screen
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Healthscribe Job Search
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Healthscribe Reports
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Dragon Systemshttp//www.dragonsystems.com/

• Leading, Award Winning Voice Activated System
  Software
• Medical specific (Medication names, Medical
  procedures, Medical diagnoses, Diseases)
• Works with virtually any Windows application,
  including ChartLogic

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Chart Logichttp//www.chartlogic.com/

• Enables the physician to dictate directly into
  the note in real time
• Reduces time spent tracking charts, waiting for
  transcriptions and report generation.
• Eliminate transcription costs
• Create comprehensive Medicare E/M compliant
  patient
• finished in less time with greater accuracy.
• Anyone on the network can access the patient
  record.

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Chart Logic Interface
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Chart Logic

• Records are stored in a database specific to the
  physicians practice.
• Select the appropriate ICD9 and CPT codes,
  prescribe medications (pre associated by
  diagnosis) and "finish" the report in the exam
  room.
• Create custom report templates

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Chart Logic Generic Database Record
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Chart Logic

• Keep track of a patients current medications,
  vitals, patient problem list, and significant
  history components
• Document scanning of current paper charts
  (paperless office), labs, X-rays, consults, etc.
  Electronic Interface to popular billing systems
  for automatic transfer of ICD9 and CPT billing
  data.
• Automatic drug selection based on diagnosis for
  ease of prescription generation.

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Chart Logic Generic Patient Report
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Chart Logic Referral letters (Urology Specific)
Main Interface -gt Configure templates
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Chart Logic Voice Activation
Speak into Microphone Note Dictation is now on
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Chart Logic Printed Letter
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EndoComwww.contecmedical.com

• A real-time, Web-enabled multimedia clinical
  procedure documentation, and data archiving and
  communication platform
• System operation designed for clinicians
  preferred workflow
• Applicable across all medical specialties using
  any images
• Designed for compatibility with the new
  generation of e-health standards and systems
• ASP approach

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EndoComUnique real-time data capture

• Electronic input of information
• Voice Navigation and Incorporation
• Fully Compatible With Any Imaging Source

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Clinical procedures a wealth of information
Patient information
Procedure referral
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Procedural reporting with EndoCom
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EndoComActual Report
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EndoComActual Report with Text
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eScriptionhttp//www.escription.com/

• Continuously Reduce Costs of Medical
  Transcription
• Employ Best of Breed Technologies
• Advanced Speech Recognition, XML, Java
• Provide Integrated Solution
• Integrate with Existing Hospital/Healthcare
  systems
• Integrate with Internet Infrastructure
• WITHOUT Interfering with Physicians Workflow

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Demographics

• 7-85 Physicians now using the Internet (2000)
• 300,000 new internet users/week (world wide)
• Spending Medical Information Systems(MIS)
• 1997-2002 3.69 B- 6.09 B (10.6)
• 1999 5 Market Penetration
• EMR Software Companies gt150
• Urology Specific EMR lt3
• EMR PPMS 2 functions but integrated.
• ASPS Web-based, Application Service Provides

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THE BEST PRACTICE MODEL 1977 Monographs in
UROLOGY. 18, No 1.

• Distributive Software for data collection
• the lowest cost center- the patient.
• Effective Physician Extenders
• to obtain data at point of contact(all
  employees).
• Automated HCFA Compliance.
• Automated ICD-9 CPT Coding.
• Robust Consultant Reports(M.D. Specific)
• Immediate Record Creation.
• Significant Value Achieved Typing, Dictation
  Time, Proper Coding/Billings.

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Distributive Software Data Entry Process

• FORMS sent to all new follow-up Patients.
• Formscompleted by patients med. Assist.
• Forms scanned into database.
• 85 of EMR Completed!!!
• Urologist focus on Initial Health Assess.-C/O,
  HPI, PE, DDx. Treat.Plans.)
• Coding/Billing is automated(no points counting)
  driven by
• Complexity of Diagnoses,
• Data Collected/Reviewed,
• Planned Diagnostic Procedures and
• Management Plans

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Problems of EMR Resistance due to Culture

• Culture rather than Process
• Driving the SoftwareOptions
• Voice Template v Free Text.
• Typing Template v Free Text.
• Handwriting Template v Free Text.
• All of these processes will decrease Free Text.
• Commitment from Top/Down!
• Delegation of Processes to staff members

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Example Cost per annum EMR
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Example Financial Benefits EMR
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Non-financial Benefits of EMR

• Improved work product with audit trail
• Automate HCFA compliance peace of mind from HCFA
  audits
• Medical Records available 24 hr/day, 7 days a
  week
• Others Forms-encounter, billings, laboratory,
  hospital, radiology, preoperative patient
  instructions prescription.
• Linkage ASP, web-based services for practice
  management, outcomes disease management

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EMR Benefits from HCFA Compliance

• Robust Coding
• HCFA Comp.
• Learning curve
• Volume Types of Billings
• Data Analysis

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Additional EMR Companies and Products

• Millbrook Corporation
• www.millbrook.com
• ComChart Medical Software
• www.comchart.com
• GBA Health Network Systems
• www.gbahn.com/
• Professional Support Inc.
• psimed.com
• Provox Technologies
• www.provox.com

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Millbrook Corporation www.millbrook.com

• Millbrook Practice Management Solutions features
  include
• Scheduling
• Patient Information
• Billing
• Managed Care
• Reporting
• Accounts Receivables and Collections
• Electronic Claims Submission and Administration

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ComChart Medical Software www.comchart.com

• ComChart is one of few open source EMR program
  available
• Allows the user to customize every feature of the
  program

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GBA Health Network Systemshttp//www.gbahn.com/

• PMS Gold is a comprehensive, modular practice
  management software application
• Appointment Scheduling
• Electronic Claims
• Managed Care
• Open DataBase Interface (ODBI)
• Patient Recall
• Custom Letter Writer

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Professional Support Inc. www.psimed.com

• Healthcare Information Software Comprehensive
  Information Systems Management
• Appointment Scheduling
• Medical Billing
• Claim Expediting
• Practice Report Query Expert
• Home Healthcare

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Provox Technologies www.provox.com

• TalkNotes, Voice Recognition Software
• Transcribes with integrated voice recognition
• Specialty specific vocabularies and a medical
  grammar.
• Utilizes OVR (Original Voice Recall) digital
  recording of the speakers voice to reference if
  needed during editing.
• Uses dictation devices such as a noise-reduction
  headset.
• Allows for multiple users per workstation.
• Allows quick electronic retrieval of notes based
  on a variety of search criteria.