Prestigious Teaching Acute Care Facility had hand-written notes in the Chart!

Today, most facilities, even those with world-renowned specialists, are utilizing an Enterprise EMR system, but 60% of the physicians were either handwriting or scanning their notes. In many cases the Administration decided it would be more efficient and cost effective for the physicians to do their own documentation In essence, they mandated that physicians use their time to do clerical work. Also, at this institution, the system made it necessary for the physician to use a microphone attached to the computer, preventing mobility. Because there are only so many hours in a day, something had to give, and that something resulted in decreased patient volume, and then decreased revenue.

Scanned or handwritten documents did not meet meaningful use in most cases, and was the source of more manpower required to get the documents scanned, and the handwritten notes raised the possibility of potential lawsuits due to inability to read the physician’s handwritten documentation. Studies have shown that physician-generated reports are highly likely to contain errors, some potentially dangerous to the patient.

Phoenix set up the Virtual Scribe model eliminating the need for staffing with onsite Scribes, and all the issues associated with employees..i.e. vacations, no-shows, benefits, management, etc. The physicians could be mobile, using just a Smartphone which downloaded the day’s schedule, and they were able to give the Virtual Scribe the same directions they would a literal Scribe, dictating Tasks for MA’s, colleagues, admins, dictating correct charge codes for the visit. Phoenix’ Virtual Scribes updated Medication and Active Problem lists, added Macros and past histories into the current chart as dictated. Labs were noted as needed, and then charges were prepared for that visit, so the physician simply had to go in and sign the note, and the billing was dropped!

The physicians time went from two to three hours per evening and weekends to minutes per day, with the average of 3 minutes per patient of dictation time.

As a result, the physicians increased their patient load back to the pre-documentation numbers. A comparative review also revealed that the charts were more comprehensive, resulting in increased reimbursement. Risk Management was also satisfied because there was no fear of incorrect data being entered by the physician, since now they had the extra insurance of another person reviewing that data. Physicians were clamoring to jump into this program, and the Facility utilized the EMR as it was intended.


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