During an Oct. 8 session at Becker’s Health IT + Revenue Cycle Virtual Event, two industry experts discussed digital health and its effect on clinical care and the patient experience.
The panelists were:
- Bret Shillingstad, MD, chief medical information officer at Nuance Healthcare
- Jose Talavera, director of health information management at Casa Colina Hospital and Centers for HealthCare in Pomona, Calif.
Here are two excerpts from the conversation, lightly edited for clarity and length. To view the full session on demand, click here.
Dr. Shillingstad on how Nuance is working to optimize documentation amid a drastic rise in telehealth utilization: Nuance and Epic, and I’m sure other EMRs, have released free-of-charge templates that comply with CDC recommendations as to what should be captured for a COVID-19 visit. … Nuance also has sets of templates for different specialties to help you meet the needs of those top 15 to 20 conditions that you may commonly see [treated using telehealth].
There’s also EMR personalization and optimization labs. One thing that has become very popular is video coaching. We see a lot of organizations setting up a one-hour block of time with a physician where they will actually go into the EMR help physicians build and generate workflows that are more efficient, fast and easier to use, and then mapping a lot of their templates and patient education to voice commands, to support faster, more efficient visits.
Probably the coolest thing that’s been added is something called Dragon Ambient Experience, or DAX. DAX actually captures the patient and physician conversation that’s going on within a telemedicine visit on video and converts that conversation to a SOAP note. [If] the patient says, “I have right knee pain,” it will [document] “chief complaint: right knee pain.” It’ll add the responses [to questions] the physician asks the patient, put that all into the [history of present illness] and then add information regarding orders, lab tests and other stuff done as part of that video visit. It’s really using [artificial intelligence] to create a note from a simple conversation. This, of course, is going to eliminate the need of even creating a note — using a virtual scribe that’s running in the background as you do your telemedicine visit.
Mr. Talavera on how Casa Colina Hospital and Centers for HealthCare leveraged this technology during the pandemic: Because I’m the administrator to our voice-recognition software, Dragon Medical One, I immediately met with our customer success specialist at Nuance. She helped me create a telehealth and a COVID-19 template for our medical staff. This was a very big help to our physicians because it reduced their documentation time, which freed them to focus on their patients’ care. My main goal was to alleviate physician burnout. Since we implemented of our telehealth template, we have seen a 95 percent increase in telehealth visits in our outpatient physician clinics.
We had a pretty unique implementation. We created what’s called a COVID-19 dashboard within our internal intranet for our employees. The dashboard includes statistics like current counts of COVID-19 patients, given to us by units on how many patients were positive, how many patients are pending rule-out, and how many patients tested negative. The dashboard also includes the supplies on hand for our N95 masks, isolation, masks, gowns, gloves and disinfecting wipes. It also includes different references and updated links to CDC and the California Department of Public Health.
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