Orthopedic practices around the country are looking for ways to increase efficiency and decrease costs, and implementing a speech-enabled electronic health record system could help in this crusade. Michael Rauh, MD, an orthopedic surgeon at UB Orthopaedics & Sports Medicine in Orchard Park, N.Y., discusses the benefits he's seen from implementing an EHR and voice recognition technology in his practice.
Q: What prompted you to begin using electronic health records?
Dr. Michael Rauh: We've been using EHR since the mid 1990s, using a system based in the northeastern United States. At that time, our EHR was more along the lines of a paper chart that was digital. Then, we began utilizing a template-driven EHR with voice recognition capabilities. We could dictate directly into the EHR, but it still required transcription review and editing. In costs, traditional transcription was so expensive and sometimes cost more than our reimbursement, so I decided to look for other options. That's when I became very interested in Dragon Medical, a speech recognition software that would let me dictate directly into my EHR. As I dictated the system would transcribe on the screen simultaneously, allowing me to capture my patients' stories in my own words. As part of the workflow, I always have the opportunity to view the text and when necessary to edit it; this provides me with complete control over what ultimately goes into my patients' records. Since I've been dictating and editing my own notes, I have eliminated high costs associated with transcriptionist.
Q: What are the biggest benefits to using these automated systems?
MR: I think the biggest benefit of this is that my notes are generated the same day that I see the patient and the primary care physician can get information on their patients the same day. The technology also promotes communication between myself and physical therapists as well as other specialists. With traditional transcription, it may be two or three days before you get the report written, and then it takes longer to receive approval. With the automated program, the report can be generated and approved in the same day. In a lot of cases, primary care physicians who refer their patient to me get the notes even before the patient leaves the office. This convenience has really increased my referrals because the primary care physicians feel comfortable that something is going to happen and they know what the plan is for their patient.
Q: What financial savings has your practice seen since using this technology?
MR: From a cost standpoint, we have more than 30 physicians in our group and we measure the cost of transcription per patient across the board. We found that those who are non voice recognition users cost about $6.52 per patient. Those who continue to use the technology are reporting an average of $2.34 per patient. One of the partners found it costs him $1.06 per patient, and another reports an average of $0.63 per patient. It's a huge cost savings on the front end transcription. Those who are using this technology are also billing at a higher level because the claims are documented appropriately. When there is a lower cost per patient and a higher rate of reimbursement, it ends up doubly benefiting us.
Q: Was the technology challenging to train on and implement at your practice?
MR: The systems are usually user friendly, which makes it easy to learn and train on. It takes about a month or two to realize where it would fit best into your practice. The learning curve lasted about a month or two before I really felt comfortable about where using the technology made the most sense for me. Different people have different ideas about how the EHR can best serve them: with new patients, old patients, postoperative patients, etc. For me, 98 percent of the time I dictate directly into the EHR and the other two percent of the time is when I'm dictating off-site, such as when I'm covering a game. I take care of the Buffalo Bills, Sabres (professional hockey team) and Bandits (professional lacrosse team). At those games, I generally rely on the digital Dictaphone to record my notes, which I can then have transcribed with Dragon Medical when I'm back at my computer.
Q: How has technology implementation affected the way you are able to run your practice?
MR: From a voice recognition standpoint, we certainly have greater possibilities in the office, but there are also greater possibilities for increased efficiencies in the research world. I can dictate papers and e-mails, and there is a template for my dictations in the operating room. In the surgery center world, this is a way to certainly save money for physicians who are working there and are incentivized to increased revenues and decrease costs. The increased efficiency also allows me to spend more time with my family.
Learn more about UB Orthopaedics & Sports Medicine.
Read other coverage on EHR and EMR in orthopedic practices and surgery centers:
- 4 Key Concepts for IT Upgrades in Orthopedics
- 6 Statistics About EMR Use for Office-Based Physicians
- Adopting EMR in an Orthopedic Practice
Q: What prompted you to begin using electronic health records?
Dr. Michael Rauh: We've been using EHR since the mid 1990s, using a system based in the northeastern United States. At that time, our EHR was more along the lines of a paper chart that was digital. Then, we began utilizing a template-driven EHR with voice recognition capabilities. We could dictate directly into the EHR, but it still required transcription review and editing. In costs, traditional transcription was so expensive and sometimes cost more than our reimbursement, so I decided to look for other options. That's when I became very interested in Dragon Medical, a speech recognition software that would let me dictate directly into my EHR. As I dictated the system would transcribe on the screen simultaneously, allowing me to capture my patients' stories in my own words. As part of the workflow, I always have the opportunity to view the text and when necessary to edit it; this provides me with complete control over what ultimately goes into my patients' records. Since I've been dictating and editing my own notes, I have eliminated high costs associated with transcriptionist.
Q: What are the biggest benefits to using these automated systems?
MR: I think the biggest benefit of this is that my notes are generated the same day that I see the patient and the primary care physician can get information on their patients the same day. The technology also promotes communication between myself and physical therapists as well as other specialists. With traditional transcription, it may be two or three days before you get the report written, and then it takes longer to receive approval. With the automated program, the report can be generated and approved in the same day. In a lot of cases, primary care physicians who refer their patient to me get the notes even before the patient leaves the office. This convenience has really increased my referrals because the primary care physicians feel comfortable that something is going to happen and they know what the plan is for their patient.
Q: What financial savings has your practice seen since using this technology?
MR: From a cost standpoint, we have more than 30 physicians in our group and we measure the cost of transcription per patient across the board. We found that those who are non voice recognition users cost about $6.52 per patient. Those who continue to use the technology are reporting an average of $2.34 per patient. One of the partners found it costs him $1.06 per patient, and another reports an average of $0.63 per patient. It's a huge cost savings on the front end transcription. Those who are using this technology are also billing at a higher level because the claims are documented appropriately. When there is a lower cost per patient and a higher rate of reimbursement, it ends up doubly benefiting us.
Q: Was the technology challenging to train on and implement at your practice?
MR: The systems are usually user friendly, which makes it easy to learn and train on. It takes about a month or two to realize where it would fit best into your practice. The learning curve lasted about a month or two before I really felt comfortable about where using the technology made the most sense for me. Different people have different ideas about how the EHR can best serve them: with new patients, old patients, postoperative patients, etc. For me, 98 percent of the time I dictate directly into the EHR and the other two percent of the time is when I'm dictating off-site, such as when I'm covering a game. I take care of the Buffalo Bills, Sabres (professional hockey team) and Bandits (professional lacrosse team). At those games, I generally rely on the digital Dictaphone to record my notes, which I can then have transcribed with Dragon Medical when I'm back at my computer.
Q: How has technology implementation affected the way you are able to run your practice?
MR: From a voice recognition standpoint, we certainly have greater possibilities in the office, but there are also greater possibilities for increased efficiencies in the research world. I can dictate papers and e-mails, and there is a template for my dictations in the operating room. In the surgery center world, this is a way to certainly save money for physicians who are working there and are incentivized to increased revenues and decrease costs. The increased efficiency also allows me to spend more time with my family.
Learn more about UB Orthopaedics & Sports Medicine.
Read other coverage on EHR and EMR in orthopedic practices and surgery centers:
- 4 Key Concepts for IT Upgrades in Orthopedics
- 6 Statistics About EMR Use for Office-Based Physicians
- Adopting EMR in an Orthopedic Practice