Confidential 1450 Physician Powerpoint EMR Ver 12-23-08

7/30/2019 Confidential 1450 Physician Powerpoint EMR Ver 12-23-08

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The Dragon Medical Solut ion


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Presentation Summary

The Challenge: Documenting Care in an EMR

The Solution: Speech Enable Your EMR

Dragon Medical: Overview / Demonstration

Dragon Medical: Case Studies


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The Challenge: Documenting Care in an EMRBecoming a Near - Requirement

1. Clinical documentation Rapid Adoption of EMRs Market demanding electronic documentation instantly available

US Government 10 year plan for an EMR for every American

100% EMR adoption by 2014

2. Remuneration evolving from fee for service to pay forperformance Reimbursement levels flat / declining from 2008 on

You dont get paid for what you dobut what you document.

More documentation is neededbut created in a more cumbersome way

just to maintain reimbursement levels.

= HIGHER DOCUMENTATION COSTS= LOWER PRODUCTIVITY


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Template-based notes in an EMR are lowerquality dont support ability to personalize for each specific

patient encounter

Point and click interface lacks patient narrative andmedical decision-making

Generate cookie-cutter reports and EMRs impact productivity and

profitability Point and click slows physicians down

Studies have shown that EMRs do not in themselves

lead to higher reimbursement Physicians didnt go to medical school to become

typists

Transcription prohibitively costly oftentimeseliminated to pay for EMR

The Challenge: Documenting Care in an EMRRequires Using Point and Click Templates


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The Solution: Use Dragon Medical 10 toSpeech Enable Your EMR

Hands-free Use of EMRs

Dictation

Navigation

The Market Leader

80,000+ clinicians All Windows-based EMRs

Increase Physician Productivity

Improve Patient Care

Eliminate Transcription

Maximize Reimbursement

Faster Adoption of EMR

Provider PC with

Dragon Medical &

PowerMic II

EMR System
http://www.cerner.com/public/default.asphttp://www.epicsystems.com/index.php


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Dragon Medical Lets Physicians Dictate in their OwnWords, Complementing the Rigid Structure of an EMR

Dragon Medicals Impact on EMR Use

Survey Results1

It significantly improves or improvesEMR use and facilitates the practice of

medicine (80%)

it speeds my EMR use up so much I see

the same or more patients prior to going

live with the EMR (80%)

Thanks to Dragon, theres been no

increase in patient backlog (75%) Im coding at higher RVU / billing levels

using Dragon... (75%)

Structured point

and click dataentry

Dragon-dictated narrative: History of Present

Illness, Assessment and Treatment PlanDragon-drivennavigation

command/control

1 Source: Survey of AHLTA EMR and Dragon Medical Physician Users, Telemedicine and

Advanced Technology Research Center (TATRC), U.S. Army Medical Research and Materiel Command,
http://mydominanthemisphere.files.wordpress.com/2007/07/caduceus_large.jpg


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Typing inEMR

Speech Recognition Helps Clinicians RegainProductivity Lost When Adopting an EMR

Productivity Loss

Productivity

Documentationmethod

Phone

dictationSpeech driven

EMR

New point of reference for self-edit speech

Compare self-edit speech with the speed and

accuracy of typing.


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Dragon Medical 10 Demonstration


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Proven Value Proposition

Increase Physician Productivity25% faster Using an EMR

Improve Patient Care Higher-Quality, More Complete Notes

Eliminate Transcription Save $10,000+ / Year Per Physician

Higher Reimbursement Increase $10,000+/ Year Per Physician Faster Adoption of EMR

Return on Investment in 1-2 Months


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Dragon Medical: Case Studies

Community Medical Center

University of Rochester Med Center

Group Health Cooperative

Fallon Clinic


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Dragon Medical Case Study Community Medical Center

Challenge:

Automate the creation of medical records in the organizations Emergencydepartment EDIM application to improve patient care and increase theuse of the EMR system

Solution: Deploy a 20-user Dragon Medical software license to eliminate the need

to hand type information into the EMR application

Results:

A reduction of over $500,000 in transcription costs in the first year, withthe software paying for itself in the first few months of use; reducedmalpractice liability and a measurable improvement in patient care


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Case Study: Group Health Cooperative

Overview: 900 Physician, Multi-Specialty Clinic (Seattle, WA)

100% Commitment to EpicCare EMR

Challenge:

Enhance Epic Adoption: Offering a Way to Dictate Narrative

into EMR

Solution: Roll Out Dragon Medical on System-Wide Basis

Results:

Accelerated Physician adoption of Epic

Reduced Time Spent Documenting Care

Achieved Higher Quality of Patient Care

Enhanced Provider Satisfaction Improved Quality of Documentation

Raised Confidence of Higher Coding Levels

Eliminated 80+% Transcription Costs

Dragon has really shortened the processof creating notes. It shortens my day by11.5 hours because I no longer have to

log in from home to complete charts.

Dr. Dean CarrPrimary Care Physician

I often use my voice to trigger acommand in Epic which pulls in labsinfowith a single command Its fun! It

makes a tedious task more enjoyable.

Dr. John KaschkoPrimary Care Physician

The complete documentation facilitatedby Dragon allows me to now code more

at a level 4 as opposed to level 3

Dr. John KaschkoPrimary Care Physician


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Case Study: University of Rochester Medical Center

An asynchronous process becomessynchronous with DragonWhen I closethe note, Im done, period.

Dr. David KruschChief Medical Information Officer

URMC

The software works outstandingly. Itinterfaces smoothly with the EHR. It isaffordable, replacing highly expensive

transcription services use Dragonssuccess is inevitable.

Dr. Betty RabinowitzPrimary Care Internist

URMC

Overview:

Leading Academic Medical Center

2 Acute Care Hospitals, Primary care network of 100

providers

Challenge:

Lower Physician Productivity Post EMR Go-Live (Allscripts)

Solution:

Deploy Dragon Medical 10 Across Primary Care Network

Easily Allows Individuals to Create and Modify Templates

Lets Physicians Document Unique Narrative per Encounter

Seamlessly Integrated with Allscripts EMR On-Site Training

Results:

100% of All Primary Care Physicians Using Dragon Medical

An Additional 100 Physicians Have Gone Live

Physicians Report Higher Patient and Clinician Satisfaction

Saving Over $1 Million Annually in Transcription Costs.

Return On Investment in < 3 Months


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Case Study: Fallon Workflow Impact Study

Spring 2008 Fallon Clinic proposed a funded study to evaluate the impactof Dragon Medical V9.5 on:

Note quality

Provider satisfaction

Productivity/cost

Real-World Setting Implemented with 10 diverse providers:

Specialty

Computer and typing skills

Age and gender

Baseline use of dictation 1-2 hours of formal 1-on-1 training

Limited customization with macros

Limited support as needed

1Preliminary results.


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Fallon reported that Dragon Medical generated:

17 % reduction in the average # of minutes after patient left that the visit was closed so bill couldbe sent (55 minutes 46 minutes, P


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Installation Cost for first 3 years: $3,435/MD

License

Annual Maintenance

Professional Tech Support Professional Training

Handheld Philips Speech Mike Pro USB 5280

2 GB RAM Upgrade

3-Yr Cost of ~8 minutes/day/MD: $25,476 0.11 RVUs/minute at CMS rate of $38.09/RVU

Total Cost for first 3 years: $28,911/MD


Financial Analysis


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Reduced Transcription Costs for first 3 years: $15,492/MD

Increased billing from correct coding for first 3 years:

$34,762/MD

Total Hard Savings for first 3 years: $50,254/MD

Net savings of $7,114/year/MD

Savings from faster and better communication, as well as

happier Physicians.

Priceless!


Financial Analysis - Savings


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20% Accuracy Improvement over Dragon Medical 9

38% More Accurate than Dragon NaturallySpeaking

Professional in Clinical Settings

50% Faster Response Time than Dragon Medical 9 Regional Accent Support for Non-Native Speakers

Contains Medical Vocabularies Covering More Than 75

Disciplines.

MyCommands Window Personal Commands in Browser

Configurable PowerMic Buttons

Announcing Dragon Medical 10The Fastest, Most Accurate Dragon Medical Ever


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Dragon Medical 10 Includes Vocabularies for All Specialties Dragon Medical 10 supports a range of regional accents

Powerful Templates and Marcos can be used to optimize

workflow See Demo

Quick Voice Formatting Demo

Announcing Dragon Medical 10Did You Know that


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Dragon Medical 10: Increased Number ofMedical Specialty Vocabularies

Includes Vocabularies for Essentially All Specialties


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Dragon Medical 10:Improved Regional Accent Performance

Nuance has collected data from many speakers and enriched its models. More

people will get better accuracy quickly.

For the US product:

US regions

British, Indian, Australian, SE Asian

Spanish

New User Wizard offers Accent list

If in doubt, pick General.

During Optimization, Dragon may

automatically select what accent itidentifies as matching your data


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Dragon Medical 10:More Powerful Macros and Templates

Powerful Customized Templates and Macros streamline workflows


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Dragon Medical 10:Macros and Templates

Macros and Template Demo


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Summary and Review

Documenting Care in an EMR is a Challenge

Speech-Enabling Your EMR with Dragon Medical is a Proven Solution

Dragon Medicals Value: A Return on Your Investment in 1-2 Months

Dragon Medical 10 is the Fastest, More Accurate Speech RecognitionSolution Ever:

20% more accurate than version 9

50% faster

Contains Full Range of Specialty Vocabularies

Now Has Regional Accent Wizards to Assist Non-Native US Speakers

Can Be Customized for Greater Efficiency Using Macros and Templates


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Contact Information

Company:

Telephone Number:

Website:


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Backup Slides


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Trends Impacting you

Trend 1: Clinical documentation moving to EMR

Driving the demand for better patient health documentation via EMRs

US Government 10 year plan for an EMR for every American

100% EMR adoption by 2014

Clinical documentation will move from paper files and MS Word documents to

centralized EMRs

25,000 to 30,000 physicians move to EMR per year

EMR use requires clinicians to enter structured data in fields and discourages narrative

dictation

Physicians need to do their own data entry and typing

Lower transcription costs, but reduced productivity as the physician starts typing

Physicians are less productive


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Trends Impacting you

Trend 2: Remuneration moved from fee for service to pay for performance

The way physicians are paid has changeddramatically.

In the past you were paid by patient contact; now youare paid based on the level of complexity of the

patient contact (level 1 to 5).

More complex -> higher paid

Doctors need to prove service level withdocumentation.

Physicians are paid based on what they document.


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What Do Physicians Say?

What is a clinical narrative?

A first person "story" written by a clinician that describes a specific clinical event orsituation. Writing the narrative allows a clinician to describe and illustrate her/his currentclinical practice in a way that can be easily shared and discussed with professional colleagues.In addition, the narrative can help clinicians examine and reflect on their clinical practice oranalyze a particular clinical situation.

Describing Practice through Clinical Narratives: Guide for Clinicians, MGH

Narrative allows us to share complex ideas in an efficient and often seemingly effortlessmanner. Its use in the medical record is extremely important for clinicians because it allowsthem to synthesize disparate facts and data elements and to paint a picture rich with meaningthat is easily interpreted by other clinicians.

Jason S. Shapiro, MD, Department of Bioinformatics, Columbia University

Studies have shown that EMRs do not in themselves lead to higher care

Template-based systems lack a narrative

Patient notes generated by EMRs all look the same


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Manual Driven EMR - Typing

Traditional Dictation + MT

Speech driven EMR

HIGH COST LOW COST

EMR

Increased cost

Cost and Time Documentation

The Speech Enabled EMR


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Speech Enable EMR: Increases $/Visit

Full freedom to document observations and plans in physicians ownwords not constrained by structure

More complete documentation in History, Physical Exam and MedicalDecision-Making Aspects of Record

At point of charge capture, additional detail gives physician ammunition

to code at a higher rate than structured note


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RBRVS (Resource-Based Relative Value Scale)

January 1992

Fee Schedule Maintained by CMS

Input from AMA/Specialty Society RVS Update Committee

23 Medical Specialties Represented

80+% of Private Insurers Use!

Reimbursement Calculation 5 Levels of Service Codes for New / Repeat Patients

Fee = relative value of service + amount of resources consumed

= amount of Doc Time + Practice Expense + Liability Expense

Adjusted by Geographic Practice Cost Index

2008: reimbursement 10% lower than 2007

Reimbursement requires adequate documentation

to support level of service billed.

Speech Enable EMR: Increases $/Visit


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The Solution:Speech-Enable Your EMR Using Dragon Medical 10

Dragon Medical is perfectly positioned to solve the problem of:

1. Lower productivity due to EMR data entry

2. Higher documentation costs

3. Loss of reimbursement due to less-complete notes

The combination of Dragon Medical + an EMR gives the highest productivity and financial

benefits for the hospital and provider.

DNS EMR

StructuredData input

The Speech driven EMR

Speech

Confidential 1450 Physician Powerpoint EMR Ver 12-23-08

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