Detroit Free Press 11/10/2007
Voice-recognition cuts time doctors spend on paperwork
By Patricia Anstett Detroit Free Press Monday, November 19, 2007
DETROIT — Like many busy orthopedic surgeons, Dr. Shivajee Nallamothu's day started early and ended late, some 60 patients later.
The paperwork alone took more than two hours to complete — forms for hospitals; prescriptions for drugstores; memos for referring doctors, and notes on every patient. He remembered some easily; others, he'd have to look up. Then he'd dictate the notes into a recorder and send the tape to companies that returned the typed notes a few days later.
But since August, a new electronic medical records system Nallamothu purchased from gloStream, a Bloomfield Hills, Mich., company, has drastically shortened the time he needs for paperwork and improved the way he helps his patients, he said.
Mike Sappington, chief executive officer of gloStream, is launching his new gloEMR v4.0 records system for doctors' offices nationwide this month through a network of sales partners.
Unlike many computer firms that focus on large hospital installations, gloStream is aimed at doctors' offices, which are under a federal mandate to develop electronic medical records by 2013.
It's a big, potentially lucrative market because only 10 percent of an estimated 1 million physicians in doctors' offices in the United States have adapted electronic medical records systems. GloStream's earlier software, gloEMR v3.5, is one of 100 products from 80 companies to receive certification from the Commission for Healthcare Information and Technology.
The figure represents about 40 percent of about 200 office electronic medical record products, according to Sue Reber, communications director for the commission. It rates products for functionality, interoperability and security features.
Sappington charges about $1,000 a month for the hardware, software, training and maintenance of the new system. That compares with $600 to $1,000 a month doctors typically spend on medical transcription services that type up dictated notes.
Nallamothu spends another $40 a month for storage costs to back up his office records. He plans to convert the office space that now holds paper records into space for another assistant.
"I hope all those records will be gone in a couple months," he said, pointing to a bookcase packed with manila medical record folders.
Sappington tested the system first in Michigan. Doctors like Nallamothu gave it high marks, citing in particular its voice-recognition tool.
That feature immediately turns a doctor's dictated notes into a Microsoft word document. The system is also hooked up to computer fax software that sends notes to hospital and doctors' fax numbers entered into the system. Nallamothu likes having immediate access to records and fax notes he sent the day before from his Clarkston office, the Michigan Center for Orthopedic Surgery, waiting for him the next morning at several Oakland County hospitals where he operates.
Last week, seconds after Bob Brumback, 70, saw Nallamothu for a presurgical consultation for an upcoming knee replacement, the doctor held a recorder to his mouth and began to dictate:
"Patient here today complaining of bilateral knee pain. Period." The words immediately appeared in Brumback's electronic medical record.
Nallamothu clicked on an icon on the computer to print out a 10-page knee surgery handout for Brumback. Then he clicked another icon to fax his notes to Brumback's primary care doctor.
The system uses a Microsoft Vista platform that works by clicking on features doctors can customize at the top of the computer screen.
Some typical features that can be customized to these dashboards are patient histories, lab results, X-rays and patient education resources. A companion feature follows the patient through a visit, indicating their location and time for each office encounter, from when they entered the lobby to discharge.
"This gets doctors back to practicing medicine, which is what they like to do, and it eliminates the chart chase," Sappington said. Paperwork and other administrative issues often drive doctors out of medicine, he said.
"We can have a huge impact on the medical field," said Sappington, 40, a finance and accounting major from Central Michigan University. "Doctors spend too much time laboring over administrative tasks. This helps reduce that."