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The Copy & Paste Problem in EHR Patient Documentation

Skyrocketing rates of physician burnout and provider frustration with the time required to enter records into the EHR have driven the widespread use of copy and paste when entering patient information into electronic health records.

Back in 2017, a study published by the Journal of the American Medical Association reviewed thousands of EHR records and found that only a small minority of them were manually entered – but more than 80 percent of the notes were imported or copied from elsewhere.

The team analyzed 23,630 inpatient progress notes written by 460 caregivers who were direct care hospitalists, residents and medical students.

Researchers found that 46 percent of notes were copied, 36 percent were imported, and just 18 percent of the text was entered manually.

Accuracy, security and patient safety are all put in peril when copying and pasting from one patient note into another. Additionally, inaccurate and incomplete records can result in delayed or denied reimbursements for the practice.

The ECRI Institute published its “Health IT Safe Practices: Toolkit for the Safe Use of Copy and Paste” guidelines in 2016 in an effort to educate the medical community about best practices for utilizing copy and paste in EHR documentation.

According to the 58-pages of the ECRI Institute’s guidelines, adopting safer copy-and-paste practices would require each practice to implement a series of cumbersome steps, including establishing new levels of staff training and oversight, flagging pasted material for easy identification, distinguishing between appropriate and inappropriate times to copy/paste, and more.

It’s clear that putting the new processes into action could undermine any speed improvements derived from copying and pasting.

Fortunately, there is a better way to enter patient notes.

NoteSwift (founded by a practicing physician) has developed an A.I.-driven EHR Transcriptionist – Samantha – that simplifies patient note entry and eliminates the need to copy data.

Samantha takes the physician’s narrative input (either typed manually, or from any medical speech recognition tool) and intelligently parses the information to identify structured data elements, assign required codes, and present the complete patient note to the user for verification. Samantha then enters the entire patient note into the correct menus, fields, and check-boxes of the EHR automatically, saving time, virtually eliminating clicks, and ultimately helping to reduce physician burnout.

With Samantha, the increased speed encompasses all aspects of the patient note, including entering narrative text and structured data, navigating from screen to screen, looking up complaints, and completing and sending prescriptions and lab orders.

Want to see Samantha in action? Contact us to schedule a live demonstration for your practice.

 

Three Ways A.I. is Improving EHR Performance

NoteSwift CEO Wayne Crandall discusses “Three Ways A.I. is Improving EHR Performance” on Healthcare IT Today this week.

From the article:

“Let’s be honest — we can all see the immense promise of a healthcare world fully connected through EHR systems, but first (and even second) generations of EHR software have not yet achieved that promise. Many practices have had the opposite experience; instead of benefits and promises, their EHR systems have been frustrating, cumbersome, and difficult to manage.

But don’t give up! Advancements in artificial intelligence are rapidly improving the ability of EHRs to become more accurate, more user-friendly, and more connected.

Here are three major ways artificial intelligence is improving the world of EHR:

  1. Advances in Voice Dictation for Note Entry

Voice dictation is already a valuable tool for many doctors to make EHR entry take less time — in fact, 62% of doctors already use voice dictation software to assist with their EHR entry, and nearly another 20% have plans to add voice dictation to their workflow in the coming year. Natural Language Processing (NLP) continues to make voice dictation more accurate and more useful for physicians and staff.

  1. Structured Data Elements

Long the Achilles heel for EHR entry, structured data elements are the vital data formatting structure that allows practices to use their EHRs to achieve Meaningful Use and participate in HIE requirements. According to many researchers, unstructured data is the cause of much of the adoption and transition pain practices feel around EHR use. Many practices simply dump old data into their new EHRs, which both fails to meet MU requirements and reduces the physician’s ability to actually use the data to improve patient care. A.I.-powered solutions such as Samantha, the real-time EHR transcriptionist from NoteSwift, are using artificial intelligence to turn dictated patient narratives into structured data at the time of entry.

  1. Heuristic Learning and Clinician Review

A recent study noted that there is currently a 7.4% error rate in voice dictation data entry when not supported by software optimization and clinical review tools. Thankfully, artificial intelligence solutions are rapidly improving the accuracy of dictation while also offering clinicians more robust tools for quickly and effectively reviewing and approving EHR entries. Samantha from NoteSwift features A.I.-powered heuristic learning technology that improves clarity and accuracy of the EHR entry every time a physician uses the solution. So, the more you use it, the better it performs.”

Read the full post on Healthcare IT Today.

Ready to see how Samantha’s A.I.-powered technology saves physicians 6-8 hours a week over traditional documentation methods? Contact us to schedule a live demonstration of Samantha, the real-time EHR transcriptionist.

 

NoteSwift Nominated for Speech Technology People’s Choice Awards 2019

NoteSwift is proud to be nominated by Speech Technology Magazine for their 2019 People’s Choice Awards.

NoteSwift is nominated in two categories for our revolutionary, real-time EHR Transcriptionist, SamanthaTM:

  • “Artificial Intelligence / Machine Learning / Natural Language,” and
  • Virtual Assistants”

Read more

Physician Burnout Affects More Than Just Physicians

NoteSwift CEO Wayne Crandall is featured on Healthcare IT Today this week discussing the far-reaching effects of physician burnout.

From the article:

“Physician burnout is a real challenge facing the healthcare industry — in fact, the magnitude of the challenge is so great that 10 major healthcare CEOs recently labeled “physician burnout” a public health crisis.

But physician burnout doesn’t affect just doctors or practices. Patients are also at risk.

Consider the effects on patients:

  • Physicians suffering from burnout are working less hours, leading to longer patient waits for appointments.
  • A 2014 research survey connected physician burnout and “emotional exhaustion” to higher mortality rates in intensive care patients.
  • A 2017 Mayo Clinic report notes that physician burnout negatively affects patient care, patient safety, physician turnover, and patient satisfaction.
  • An Advisory Report published in 2016 notes that physician burnout is linked to a 16% decrease in patient satisfaction and an 11% increase in reported medical errors, increased turnover, and early retirement.

This is yet another reason we as an industry owe it to our doctors and patients to have an honest discussion about the causes and effects of physician burnout and to collaborate on meaningful solutions to overcome the challenge together.

While there are many factors that influence and add to the increase in physician burnout, experts agree that the regulation, use and management of EHRs is one of the primary culprits. EHRs can add tremendous value to our work, but most EHR workflows are cumbersome and inefficient, requiring hours of manual work to meet the requirements of the EHR platform and government regulations.

Our recently published white paper goes into greater detail on the subject of physician burnout. It’s a fantastic resource for doctors looking for research to reinforce their feelings of burnout, and for practices and health systems looking to better understand the challenge.

But we need more than just conversation on this topic — we need action, we need solutions, and we need a strategy to confront the causes of physician burnout.

Read the full post, “Physician Burnout Affects More Than Just Physicians,” on Healthcare IT Today.

Want to see how NoteSwift is helping physicians reduce burnout? Contact us to schedule a live demonstration of Samantha, the real-time EHR transcriptionist, for your practice.

 

NoteSwift CEO discusses “The Financial Cost of Physician Burnout” on Healthcare IT Today

NoteSwift CEO Wayne Crandall is featured on Healthcare IT Today—the newest site from the team behind EMRandEHR.com and HealthcareScene.com—discussing The Financial Cost of Physician Burnout.

From the article:

Over 54% of doctors are now expressing mild to severe levels of burnout, which affects both their personal health and the quality of care they can provide. Burnout leads to poor job satisfaction, negative workplace culture, increased medical errors, and a poor patient experience.

But the negative impact of physician burnout doesn’t end there—recent studies have begun measuring the financial impact of physician burnout on small practices, hospitals, and health systems.

Consider the following numbers:

Download the free white paper: Physician Burnout by the Numbers

Dr. Christine Sinsky, vice president of professional satisfaction at the American Medical Association, sees the clear connection between physician burnout and EHR requirements.

“We have to recognize the exacting toll that the first generation of electronic health records have had on physicians,” Sinsky said.

“I would identify it as one of the most important drivers of physician burnout.”

Atrius Health, Massachusetts’ largest independent physician group, has announced a very interesting strategy to reduce burnout—they are attempting to reduce the total number of mouse clicks required by their physicians by 1.5 million a year.

How can this strategy be effective? Because EHR workflows have become bloated, increasingly regulated, and directly connected to reimbursement, which forces physicians to handle most of the tasks. Making the EHR workflow simpler, more intuitive, with less clicks and more accuracy is a primary way we can all help physicians reduce levels of burnout and improve patient care at the same time.

Read the full post, “The Financial Cost of Physician Burnout,” on Healthcare IT Today.

Want to see how NoteSwift is helping physicians reduce burnout by reducing clicks and saving time on EHR documentation? Contact us to schedule a demonstration of Samantha, the real-time transcriptionist.

 

Samantha™ Named One of “Top 9 Apps in the Allscripts App Store” for 2018

We’re proud to announce that Samantha, the real-time transcriptionist for Allscripts Professional EHR, was selected as one of the Top 9 Apps in the Allscripts App Store for 2018 by Tina Joros, JD, Vice President & General Manager, Open & Allscripts Practice Management Business Units.

In the latest Allscripts eMagazine, she compiled a list of the 9 best third-party apps featured in the Allscripts Developer Program Store, examining not only how each can be used, but also how it brings value to the user, and, ultimately, the patient.

“Samantha leverages the Allscripts Open platform to seamlessly integrate with Professional EHR, and to support any existing templates, order sets or workflows a practice may already have in place,” Joros explains.

“Samantha’s A.I. technology makes entering all the contents of the note as easy as writing it down on paper or using a dictation recorder, automatically capturing all the structure, codes and special formatting elements required in today’s complex healthcare environment.”

Click here to view the full list of the Top 9 Apps in the Allscripts App Store – 2018.

Want to see for yourself how Samantha saves Allscripts Professional EHR users an average of 6-8 hours each week on patient charting? Click here to schedule a live demo of Samantha, the real-time transcriptionist for Allscripts Professional EHR.

JAMIA study asks: What is the most accurate & efficient way to input data into an EHR?

A recent study conducted by the Journal of American Medical Informatics Association, referenced in the 2018 ONC report, “Strategy on Reducing Regulatory and Administrative Burden Relating to the Use of Health IT and EHRs,” asked a simple but important question: which is a more accurate and efficient way to input data into an EHR—speech recognition software, or manual typed entry?

Most people would assume that speech recognition would be both more efficient and more accurate, but the results of the study point in a surprisingly different direction.

The study focused on emergency department physicians—each physician was assigned 8 standardized clinical documentation tasks using a commercial EHR and Dragon Medical. These tasks were split between simple and complex tasks, and levels of efficiency and accuracy were measured for each task completion.

The results of these tests show that medical speech recognition on its own does not improve the efficiency of entering patient documentation. The numbers are quite surprising and are not inflated due to experience with the EHR or speech recognition.

For the tasks undertaken in the study, creating EHR clinical documentation with the assistance of speech recognition was nearly 20% slower for both simple and complex tasks.

In addition, there were far more system/integration errors, including network transmission delays of the speech recognition or data going to the incorrect location in the chart. The report further emphasizes that these errors could be avoided with more seamless integration of the speech recognition products or more speech-friendly EHR design.

And this is the important caveat to the study’s findings: Speech Recognition itself can be much more efficient and accurate for inputting data into the EHR, but this requires better integration between EHRs and speech recognition solutions.

The benefits of better integration is clarified in the study’s conclusion discussion—the authors write that the combination of speech recognition and natural language processing found time and usability benefits within EHR use. The report further defines that if EHR companies would help design their EHRs with speech recognition in mind (versus just keyboard and mouse), additional efficiencies will be realized, particularly in the area of system integration.

The take away here is important: EHRs have grown into more complex applications due to various regulatory requirements, payer needs and the desire to improve patient outcomes. As a result, stand-alone speech recognition requires additional functionality and integration to be of value to the input process of patient records.

The need for a fully integrated solution to help reduce the burden of entering patient documentation is the only way to add this kind of valuable functionality, save physicians time, and reduce input errors. There are 3 primary needs to ensure these user efficiencies are achieved:

  • Medical speech recognition must be used with the proper input device for the task of capturing the clinicians’ words and converting those into text.
  • Artificial Intelligence and Natural Language Processing technologies must be employed to intelligently take the text from the speech recognition software and parse out the structured data elements the EHR is expecting.
  • Seamless integration must occur with the EHR via their own supplied interfaces (APIs) so the resulting data, both narrative and structured, is placed in the proper areas of the EHR without having to navigate from screen to screen and with the required coding in place.

At NoteSwift, we’re passionate about meeting this need for physicians. Our fully integrated solution, Samantha, is available now with seamless interfaces using the EHRs APIs into many EHRs. Samantha works with any speech recognition software and provides the artificial intelligence, natural language processing, and complete “out-of-box” seamless integration necessary to not only save physicians hours of time, but also improve the accuracy of their EHR notes and better patient outcomes.

This study is another example of the fact that technology alone does not make our health care better. However, when we can bring together powerful technologies like speech recognition, artificial intelligence, and natural language processing into integrated solutions, we can create better EHR workflows for physicians and help them focus on what’s most important—caring for patients.

Click here to access the complete ONC report: Strategy on Reducing Regulatory and Administrative Burden Relating to the Use of Health IT and EHRs.

Click here to access the complete JAMIA study: Efficiency and safety of speech recognition for documentation in the electronic health record.

 


About Wayne Crandall

Wayne Crandall’s career in technology spans sales, marketing, product management, strategic development and operations. Wayne was a co-founder, executive officer, and senior vice president of sales, marketing and business development at Nuance Communications and was responsible for growing the company to over $120M following the acquisition of Dragon and SpeechWorks.

Wayne joined NoteSwift, Inc. at its inception, working with founder Dr. Chris Russell to build the team from the ground up. As President & CEO, Wayne has continued to guide the company’s growth and evolution, resulting in the development of the industry’s first AI-powered, real-time EHR transcriptionist, Samantha(TM).

New White Paper: Physician Burnout by the Numbers

It’s no secret physician burnout is a serious problem:
  • 88% of physicians surveyed said they felt “moderately to severely” stressed and burned out on a given workday (1)
  • More than 80% of physicians surveyed said their organization is doing “nothing” to help them deal with stress and burnout (1)
  • Physician burnout is linked to a 16% decrease in patient satisfaction and an 11% increase in reported medical errors (2)

In a new white paper, Physician Burnout by the Numbers: Examining the Power of A.I. to Reduce Physician Burnout, NoteSwift partnered with Dr. Robert Van Demark, Jr., to explore how artificial intelligence technology has to potential to significantly reduce physician burnout.

In this paper, you’ll find the following:
  • Compilation of recent data and studies on the symptoms and causes or physician burnout
  • Research connecting physician burnout to employee retention
  • Examination of how EHR use contributes to the burnout crisis
  • A look ahead to emerging solutions to this crisis

Dr. Van Demark, Jr., a board-certified orthopedic surgeon and Clinical Professor, Section Head of Orthopedic Surgery at the University of South Dakota – Sanford School of Medicine, has been practicing medicine for more than four decades, and is an advocate of A.I. in healthcare.

“As a practicing physician, I’ve felt the weight of added regulations, new technologies, and the pressures that come with our daily work,” explains Dr. Van Demark, Jr. “Like you, my goal is to focus on improving patient care, and I believe our way forward looks brighter with emerging A.I. solutions.”

Click here to download the free white paper: Physician Burnout by the Numbers: Examining the Power of A.I. to Reduce Physician Burnout.

 

Sources:

(1) VITAL WorkLife & Cejka Search (2015). 2015 Physician Stress and Burnout Survey.
(2) Advisory Board (2016). Combating Physician Burnout; Five Insights to Help Restore the Balance.

Samantha for athenaClinicals EHR Product Update – October 2018

We’ve released several exciting new features recently, making Samantha for athenaClinicals EHR an even more robust and effective solution to the pervasive problem of physician burnout.

Please don’t hesitate to reach out at any time with questions. You can also click here to schedule a live demo of Samantha for athenaClinicals EHR for your practice.

New Features & Product Enhancements

  • Previous Encounter Templates: Users can now dictate, “apply template previous encounter” in both Review of Systems and Exam sections of the note to automatically apply the values applied during the patient’s previous visit.
  • Applying “All Normal” to Templates: Users can now dictate “apply [template name] all normal” and Samantha will automatically update the template, instead of the user having to manually navigate through each section and select “Normal.” 
  • Note Section Templates: Users who commonly dictate the same note sections for each patient encounter can now use Note Section Templates to automatically pre-fill the section headers, making it easier to dictate the note.
  • Support Added for Additional Note Sections: Samantha now supports Order Sets, Patient Instructions, Discussion Notes, Patient Education, and Surgical History. 
  • Improved Speech Recognition Performance: We’ve improved Samantha’s speech recognition performance to make it easier to document.
  • Improved Matching Ability: We’ve made improvements to Samantha’s matching capabilities, resulting in better terminology matches and fewer displays of the Corrections Window. 
  • Improved Overall Speed: We’ve made improvements to Samantha’s speed, including at log-in, launch, and microphone handling, to make the documentation process even faster.
  • Dragon Medical One (DMO) is now supported: Users can dictate directly into the Samantha Soap Note window using DMO.

 

Want more information about Samantha for athenaClinicals EHR? Email samantha@noteswift.com, or click here to schedule a live demo for your practice.

 

Samantha for Allscripts Professional EHR Product Update – August 2018

At NoteSwift, we’re committed to continuously improving our revolutionary EHR Virtual Assistant, Samantha for Allscripts Professional EHR. Regular updates and feature enhancements are included as part of our low monthly or annual subscription pricing — users never pay for updates.

We’ve released several exciting new features and functions recently, making Samantha an even more effective solution to the pervasive problem of physician burnout and EHR documentation fatigue.

Take a look at some of our latest features and product enhancements below, and please don’t hesitate to contact us at any time with questions. You can also click here to schedule a live demo of Samantha for Allscripts Professional EHR your practice.

New Features & Product Enhancements

  • Easily update past encounters from previous days: Provides users the ability to return to a previously-started note and make additions, edits, and corrections (if necessary) prior to sign off.
  • Full support of the E&M calculator to help make sure patient encounters are coded correctly and include the necessary documentation to ensure claims are approved for payment.
  • Dictate ICD-10 codes directly into Samantha: As a user preference, instead of dictating the full diagnosis (e.g., a user can dictate “Diagnosis: M61.261” instead of dictating “Diagnosis: Paralytic calcification and ossification of muscle right lower leg.”)
  • Visual display for the status of each patient encounter: Users can easily identify which stage the patient encounter is currently in: scheduled, in process, or completed and signed-off.
  • Patient Words are displayed from the Reason for Visit in the Samantha summary window: Users can see all relevant patient information in one place.
  • Dragon Medical One (DMO) is fully supported: Allowing users to dictate directly into Samantha Soap Note window with DMO.
  • Reduce clicks by using the enter key in the Date Range box to accept changes and dismiss the box. No more having to click “OK” to accept the input.