Apr 15, 2006
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Record Time?

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Dear Friends,

Here are some interesting excerpts, from an article by Charles Fishman at
The Fast Company. The information systems at any McDonald's are more
advanced, and more useful, says Fishman, than those in your doctor's
office...

<Dr. George A. Saleh is not scared of new technology, and seemed the perfect
candidate for a digital, paperless medical office - a system that allows all
records and charting to be done on computer. He took out a loan and bought
the necessary hardware and software. And last summer, with his staff of
three, he switched everything over to the new system. Patient information
was entered on a screen instead of on a form attached to a clipboard; Saleh
took notes and made orders using a sleek black tablet PC.

Within days, the office was in meltdown. Patients piled up in the waiting
room, and Saleh all but lost control of his day-to-day work. Delays grew so
bad, Saleh installed a TV to distract patients, and Cerner Corp., the
company supplying his software, trundled in refreshments as a goodwill
gesture. "I was running an hour-and-a-half or two-hours late," says Saleh.
"That's the kiss of death for your practice. It was crazy."

A few months later, Saleh shows off his file rooms, filled floor to ceiling
with paper charts. "No paper has been added to these since summer," he says
proudly. Not only is his office back on schedule, but his workday is
shorter--and he's seeing just as many patients. "When I walk out of the
office each day, I'm done," he says. "I don't have to dictate a stack of
charts." His bill for dictation services has dropped from $1,200 a month to
$60. His staff is thrilled. "It's like a new era," says medical assistant
Jamie Clevenger. "It almost feels like a whole new job."

Using digital medical records allows Saleh to file claims electronically,
and quickly; he gets paid by insurance companies in 10 to 14 days instead of
one to two months. In an emergency, Saleh can access patient charts from
home at night; he can view office records from the hospital. The charts
themselves cannot be misfiled, misplaced, or left on the wrong
counter--they're safe on servers in a Cerner data center designed to survive
the most powerful tornado.>

<And yet, in the world of medicine, hurried handwriting remains an essential
form of record-keeping. In thousands of hospitals, vital medical records are
kept on pieces of paper, snapped into a chart that can be read by only one
person at a time, that has to be moved around physically if someone wants to
see it, and that is often transported on the lap of the patient, sitting in
a wheelchair, on the way to X-ray or the lab or surgery.

The workflow at an ordinary McDonald's--orders taken, transmitted to the
kitchen, and displayed there all by computer; sales and operational data
sent automatically each day to headquarters--is far more digitized,
transportable, and useful than in a typical doctor's office or hospital,
although the stakes couldn't be more different.>

<"If you flew in from Mars with the assignment to figure out the health-care
system in this country," says Clifford Illig, "and all you did was examine
the computers we use, you'd conclude that the entire purpose of the system
was to prepare a bill." Illig is cofounder and vice chairman of Cerner, a
company that has specialized for 25 years in helping hospitals and doctors
digitize their day-to-day clinical work.>

<If it is to be truly useful, the software used to manage medical records
must be incredibly sophisticated. It must store and reproduce routine
information about a person, and it must be able to take in information from
medical staff in myriad roles and settings while protecting patient privacy.
The software must be able to import, store, and present information in many
formats, from ordinary blood-test values to the actual images from X-ray or
MRI exams. And it must be able to issue orders for everything from physical
therapy to bags of IV fluid. Critically, the software must be able to look
at all that data, and the rules a hospital or doctor's practice has set up,
and flag problems a patient might experience.

Part of the point of employing hundreds of clinical medical staff at Cerner
is to adapt the software to the traditional ways doctors, nurses,
pharmacists, and technicians do their work, while also offering them new
tools. Many nurses, for instance, carry "cheat sheets" around in a smock
pocket, keeping track, patient by patient, of test results they are waiting
for or tasks that need to be done. Cerner realizes that one reason paper has
persisted in medical settings is that it is fast, and it works. "The reason
it seems medicine is so slow to adapt to this technology," says David
McCallie Jr., a neurologist and Cerner vice president who runs a software
R&D team, "is that with the paper system, a lot of people add value. A
doctor writes an order for a test, a nurse flags the order for blood work,
the lab clerk looks at how to fit that order into the workflow. If you're
going to take people out of the loop, you have to realize all the work that
gets done that you're not quite seeing." >

To read the entire feature, go to:
http://www.fastcompany.com/magazine/104/cerner.html

Cheers!

Maj (Dr) Amit Chatterjee, SM
Strategist / Founder ~ mailto:amit@...
MT India ~ www.mtindia.org
"The Community of MT Professionals"

"It takes years to become an overnight success! Inch by inch, it's
a cinch."

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NEWS AND VIEWS :
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1) Offshoring "risks patient confidentiality"

A medical transcription company has accused NHS trusts of putting patient
confidentiality at risk by sending large numbers of dictated letters and
reports overseas for conversion to text.

According to John Fellowes of the UK firm Dict8, many hospitals and primary
care trusts have outsourced their transcription to non-EU countries,
especially in Asia, that are not bound by Europe's strict data-protection
laws.

http://www.bjhc.co.uk/news/1/2006/n604009.htm

2) TeleDictation at The Med allows radiologists to generate voice-to-text
written reports

Radiologists at The Med have just begun doing something physicians have
longed for since the 1956 release of the movie "Forbidden Planet"-- They're
telling a computer to do their busy work and deliver a report when it's
finished.

The Regional Medical Center at Memphis invested $300,000 in TalkStation
TeleDictation, a system that allows radiologists to read X-rays and speak
their interpretations into a microphone. The software has been programmed to
recognize the voice patterns of each doctor and can generate a
letter-perfect radiology report, delivered within 20 seconds.

Most radiology procedures are standardized, so 90% of each report was the
same. These fill-in-the-blank templates are already loaded into TalkStation
so the doctor can just give the variables. Since there are no hanging
questions, there's no need to proof and correct a report. It's
electronically transmitted to everyone who needs the information.

The system has a traditional dictation mode, but Gold insisted that it be
disabled to compel the 12 radiologists plus residents to invest the time
necessary to train the system to their voice and train themselves. By
logging in, the system automatically goes to files that recognize a doctor's
particular voice patterns and personal shorthand.

A radiologist, for example, can train the system to enter 'cerebral
arteriography' every time he says 'c-a.' The doctor can say 'normal chest'
and the system will insert several paragraphs that explain a normal chest.

Insurance firms look for specific terms before they'll make a payment, so
TalkStation is programmed to include the verbiage needed to satisfy the
carrier.

http://www.bizjournals.com/memphis/stories/2006/04/17/story7.html

3) Beware of the pitfalls of working at home

"It is the holy grail for mothers to be home with their child and also
making money," says Jessica Hartshorn, an editor at American Baby Magazine.
And that has attracted scammers eager to make a quick buck.

At a time when demand for at-home employment has soared, so too have the
schemes, their sophistication and their ability to reach an audience. "It's
our No. 1 complaint," says Al Polizzi of the Better Business Bureau,
Southeast Florida and the Caribbean. "The Internet and e-mail are giving
these people new lead-in ways to address people."

At the same time, a growing number of consumer-product and service
businesses are outsourcing work to people in their homes, too. Companies are
recruiting everything from call-center agents to home-based auditors,
insurance salespeople and underwriters. That makes sorting the legitimate
from the fraudulent increasingly tricky.

Polizzi recognizes a common thread for the schemes. "They claim no
experience necessary, and they usually ask for a fee upfront for an
instruction pack, guide, kit or computer software," Polizzi says. You send
money, but all you get is a kit with some craft materials and printed
instructions, or, even worse, you get nothing.
Among the most prevalent scams: envelope stuffing, medical claims
processing, medical transcription, product assembling and multilevel
marketing.

http://www.grandforks.com/mld/grandforks/business/14321465.htm?source=rss&channe\
l=grandforks_business

4) TTSI makes available prepaid cards for medical transcription tutor online

If you want to succeed in a medical transcription career, you can now
enhance your skills with the Medical Transcription Tutor Online (MTTO), an
affordable prepaid tool for current and would-be Medical Transcription (MT)
students and practitioners.

The first and only prepaid medical transcription learning tool, MTTO is
offered to all MTs and medical transcription professionals from any training
center seeking additional practice time. This prepaid program offers
valuable exposure to various dictations with different specialty and
difficulty levels. You may also explore different level selections such as
beginner, entry-level, intermediate and advanced, and see the description of
materials used for the tutorial. MTTO provides access to lectures, voice
files, and answer keys that are useful for assessing your transcribing
accuracy. View your proficiency level by clicking on the "Report Cards"
icon.

MTTO's other features include re-loadable wallet, web-based access, four (4)
levels of difficulty, automatic calculation of student's productivity
(number of lines per day), self-pace and self-assessment of quality. It is
powered by Total Transcription Solutions, Incorporated (TTSI), a Philippine
offshore facility, affiliated with the American Association of Medical
Transcription (AAMT), Medical Transcription Industry Association (MTIA),
Medical Transcription Association of the Philippines, Inc. (MTIAPI) and
TESDA.

http://www.mb.com.ph/INFO2006041661452.html

5) Holy Week closes the Philippines down

President Arroyo has virtually "closed down the government" from Wednesday
afternoon until Easter Sunday. She has officially declared "Black
Saturday," April 15, a nonworking holiday.

Some critics of both the Arroyo administration and the Philippine tradition
of long holidays associated with religious commemorations told The Times,
"Long holidays that virtually close down the government do not help develop
a mentality conducive to industrial and economic productivity."

As if to lend credence to the critics' observation, an American businessman,
Dean Bartlett, was disappointed to find out that instead of marathon
meetings with lawyers and filing of papers with the Securities and Exchange
Commission, his Filipino partners would be giving him a holiday treat in
Boracay. He flew in to the Philippines on Monday to hold meetings with
people he had been having telephone and e-mail negotiations with about
setting up a medical-transcription company with a Makati business
establishment.

Sen. Aquilino Pimentel feels "It's a time to take a rest, considering that
it's very hot nowadays. It's time to meditate on the higher things-and try
to feel that, like Jesus, we must learn to sacrifice ourselves for the
common good."

http://www.manilatimes.net/national/2006/apr/11/yehey/top_stories/20060411top3.h\
tml

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The MTIndia Team
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