Speaking of Solutions
Qualify for a free subscription to HealthLeaders magazine.
In the late 1990s, the Joint Commission cited St. Mary’s Medical Center in San Francisco for poor handwriting. And the organization is still working to fully solve the problem, says John Umekubo, MD, medical director of clinical informatics. “The question was, ‘What are you doing about it?’ And we didn’t have any answer,” he says. “At that time we really didn’t have anything except dictating progress notes, but that’s very expensive.”
The organization started by identifying the worst offenders and asking them to print their notes in block letters. But that was so much slower than scrawling that ultimately the tactic was abandoned.
The next step was rudimentary word processing templates with prefilled fields. But the documents weren’t easily secured—and it was impractical to ask users to password-protect every document. “That was very short-lived,” Umekubo says.
In 2007 the organization started using Cerner’s electronic medical record and CPOE product and added some more prefilled data, such as vital signs, into the documentation. And now that the notes were legible, the organization realized it had content problems. Docs were cutting and pasting the same chunks of text over and over. The notes were becoming less concise and more generic. “Everything sounds the same,” Umekubo says. “The problem is I’m not getting the real story.”
Throughout these years, voice recognition software continued to evolve and improve.
St. Mary’s chose a Webmedx voice recognition product that has natural language processing—it learns and adapts to the individual’s voice. Special medical dictionaries and patient information, using patient account numbers, are preloaded into the program so the technology doesn’t get hung up on words that the average person would find difficult to pronounce. “In terms of medications, it’s right on,” Umekubo says. “Even really complex medications.”
And the information is imported into the EMR so it is available to other clinicians immediately. “It’s instantaneous; as soon as you dictate it—literally within a few minutes—it’s in the electronic record,” Umekubo says.
- CEO Exchange: Preparing for Population Health
- Advocate, NorthShore Deal Would Create 16-Hospital System
- Better HCAHPS Scores Protect Revenue
- EHR Systems 'Immature, Costly,' AMA Says
- Narrow Networks Cut Costs, Not Quality, Economists Say
- 3 Strategies for Retaining Millennial Employees
- 'Early Offer' Malpractice Programs May Spur Reform
- Power of price: In South FL and the nation, healthcare costs often are shrouded in secrecy
- Two NY hospitals to offer free hip and knee replacement surgeries for qualifying patients in December
- Hospital mergers may lead to higher prices