Electronic Records Saving Money, Time
BWH is seeing millions of dollars in savings with computer aided medical transcription services and significant time savings with scanned medical records as the hospital continues to cross the bridge towards electronic medical records for patients.
BWH physicians and other care providers record approximately 20 million lines of dictation a year using eScription, voice recognition software that turns out an initial draft of dictated notes. Medical transcription service organizations then review the initial draft, edit it and send it to hospital for review. The notes are turned around within four hours and uploaded to BICS or LMR, and stat notes are done within two hours.
Nuance Communications Inc., the Burlington-based company who recently purchased eScription voice recognition software, recently announced that BWH has saved an aggregate of about $10 million using its service compared to rates BWH had been paying for transcription services prior to eScription.
At BWH, use of this voice recognition platform started with a pilot in Ambulatory Services in 2001 followed by an inpatient pilot in 2002, and the Emergency Department began using it in 2003. This service went hospital-wide for inpatient records in 2004 and ambulatory in 2007. The Pathology Department began using eScription in 2006.
“We’ve seen a drastic improvement in transcription turn-around time and a significant cost savings,” said Georgette Wilson, manager in Health Information Services. “Our clinicians save a lot of time, too. Notes dictated in the morning are typically available in their queues for review and signing by the afternoon.”
Time savings and efficiencies have come with BWH’s transition to scanned medical records, a massive project that began in January 2007. To date, nearly 10 million record pages have been scanned, and that includes inpatient records and records from the Emergency Department, Day Surgery and the newly opened Brigham and Women’s/Mass General Health Care Center at Patriot Place in Foxborough.
HIS staff scan progress notes, notes on patient histories, physicals and consults, anesthesia records, including consent and advanced care directives. Once scanned, those documents are available online within 24 hours through BICS, LMR and CDR. The paper copies are destroyed six months later and the rest of that patient’s records—including the big flow sheets—are sent to storage.
“This switch has meant less hassle when staff review records, resulting in an enormous timesaver,” said Joshua Kosowsky, MD, clinical director in the Department of Emergency Medicine.
HIS expects to roll out its scanning project to additional service areas, including Family Planning, Cardiac Catheterization and In-vitro Fertilization by November.
Changes to LMR e-prescribing coming in Fall 2009
The LMR Team is working on the integration of the LMR prescribing module with Surescripts, a nationwide network of pharmacies and pharmacy benefit programs. With the completion of this work, the LMR will be certified by Surescripts and meet the most important criteria for federal e-prescribing incentives. The new features available through this project are:
Eligibility request: Does the patient have pharmacy benefits?
Formulary request: Is the drug I want to prescribe covered for this patient?
Medication history request: What medications has the patient received under his/her pharmacy benefits?
Currently, the LMR prescribing module offers two versions of the Prescription pad: Traditional and Advanced. Only the Advanced Rx pad will support the new features that meet the criteria for the federal e-prescribing incentives. During the month of September, the Traditional Rx Pad will be retired, and only the Advanced Rx Pad will be available. Beginning in August, the LMR team is providing training to educate users who currently are not using the Advanced Rx pad. More details will follow.