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CPOE and MU with Marc Probst and M*Modal

Posted on June 26, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

As part of my ongoing series of EHR videos, I had the chance to sit down with Marc Probst, CIO of Intermountain and a member of a number of important healthcare IT committees, Mike Raymer, Senior Vice President of Solutions Management at M*Modal and Dr. Jonathan Handler, CMIO of M*Modal to talk about CPOE and Meaningful Use. It’s another great addition to the Healthcare Scene YouTube channel.

In the interview we have a chance to talk about Intermountain’s move from zero CPOE to mobile, voice recognized CPOE. We talk about the future possibilities of voice in healthcare. I also ask Marc Probst about his views on EHR certification, meaningful use, and CommonWell.


*Note: Marc Probst’s sound was less than ideal. Next time we’ll be sure he has a better microphone.

Need Point of Care EMR Documentation to Meet Future EMR Documentation Requirements

Posted on April 12, 2013 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

As part of my ongoing writing about what people are starting to call the EHR Backlash, I started to think about the shifting tides of EMR documentation. One of the strongest parts of the EHR backlash from doctors surrounds the convoluted documentation that an EMR creates. There is no end to the doctors who are tired of getting a stack of EMR documentation where 2 lines in the middle mean anything to them.

Related to this is the physician backlash to “having to do SOOOO many clicks.” (emphasis theirs) I still love the analogy of EHR clicks compared to playing a piano, but unfortunately EHR vendors haven’t done a good job solving the two things described in that article: fast predictable response and training.

With so many doctors dissatisfied with all the clicking, I predict we’re going to see a shift of documentation requirements that are going to need a full keyboard as many doctors do away with the point and click craziness that makes up many doctors lives. Sure, transcription and voice recognition can play a role for many doctors and scribes or similar documentation methods will have their place, but I don’t see them taking over the documentation. The next generation of doctors type quickly and won’t have any problem typing their notes just like I don’t have any issue typing this blog post.

As I think about the need for the keyboard, it makes me think about the various point of care computing options out there. I really don’t see a virtual keyboard on a tablet ever becoming a regular typing instrument. At CES I saw a projected keyboard screen that was pretty cool, but still had a lot of development to go. This makes sense why the COWs that I saw demoed at HIMSS are so popular and likely will be for a long time to come.

Even if you subscribe to the scribe or other data input method, I still think most of that documentation is going to need to be available at the point of care. I’ve seen first hand the difference of having a full keyboard documentation tool in the room with you versus charting in some other location. There’s just so much efficiency lost when you’re not able to document in the EMR at the point of care.

I expect that as EMR documentation options change, the need to have EMR documentation at the point of care is going to become even more important.

Mobile Health Trends and Technology

Posted on December 19, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

While at the mHealth Summit 2012 in DC, I captured a couple videos to try and get an idea of the various mHealth trends that we’ve been seeing in 2012 and what we can expect from mobile health in 2013. Each video is quite short, but full of interesting thoughts on the mHealth industry.

The first two videos are with David Collins from mHIMSS. David has a unique insight since HIMSS has made a big entry into the mHealth space with their acquisition of the mHealth Summit.

In the first video, David Collins talks about the various mobile health trends he’s seen at the mHealth Summit.

In this second video, David Collins discusses some of the key findings from the recently published HIMSS Analytics mHealth survey results.

I also thought it was interesting to hear from Jonathon Dreyer from Nuance Communications to learn what trends he was seeing. Jonathon and Nuance have an interesting perspective since so many mHealth applications could benefit from voice integration. So, they have a unique view at what mHealth applications exist.

Plus, I have to throw in this video that Jonathon made that demonstrates the Nuance voice integration with mobile devices. Nuance actually created this “dummy” EMR system to demonstrate the capabilities of their mobile voice recognition API. I think this was a really smart move since the demo really does illustrate some of the voice capabilities that could be built into EMR software and all sorts of mobile health applications. The video isn’t the perfect demo of the product, but it definitely does give a great window on what could be done with voice recognition when integrated properly.

Mobile for EMR Data Input

Posted on October 17, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Note: I know that there are some mistakes and incongruencies in this post. That was partially by design since it was illustrating my first attempt at voice recognition for blog posting. I did try and correct many things along the way, but as you’ll read some of it doesn’t read very well.

I’m stuck on the tarmac in JFK airport thought I’d try see how the voice recognition work today to input on a mobile phone.

Amazing thing is this is the first time I’ve used voice recognition on the Android S3 phone. It seems like a pretty good experience so far with voice even with a soft voice in an airplane it’s turning out quite well.

I was a little concerned about how long it would take to write a blog post on the phone but the voice recognition works out quite well. I have had to make a few corrections to it, but for the most part it’s done really well.

I’m not sure how many doctors will want to use voice and of course I haven’t done any medical terms for example I can talk about my son’s previous diagnosis of mastocytosis as an example to see how it will transcribe. As you can see I didn’t actually have to correct it and I got message cytosis without any problem so it did pretty good.  I wonder if other doctors have used the voice recognition on the Android phones or Android tablets to see how well it does with voice recognition of medical terms.  Although the second time I said mastscytosis it didn’t get it right.

Overall I’m pretty happy with the voice recognition. I have written this whole post in about 5 minutes and it’s the first time I’ve use voice recognition on the phone.  With that said I still probably rather type than use voice recognition for blog posts. However, I would rather use voice recognition than the keyboard on the phone.

Have you used voice recognition? In what ways to use voice recognition? I’m looking forward to using voice recognition more and I’ll let you know how it goes. What is amazing is that this technology is built into every new smartphone out there.

I’m off to the CHIME conference later today so I’ll have more details on that coming soon.

Health IT Q&A with Scott Joslyn, CIO and Senior Vice President, MemorialCare Health System

Posted on September 13, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.


Tell us a little bit about yourself and your organization.
I’ve been the CIO at MemorialCare for about 16 years and with the organization for some 33 years. My training as a pharmacist has allowed me to bring a clinical background into my work as CIO. A subsequent MBA allows me to approach today’s challenges from both a clinical and business perspective.

MemorialCare, based in California, is a private, not-for-profit integrated delivery system that includes 1,500 beds across six hospitals, and a medical foundation with 400 physicians in an IPA model and 150 physicians in a staffing model. MemorialCare is listed among the top 20 percent of health systems nationwide by Thomson Reuters and in 2011 the organization was identified as one of the top 100 integrated healthcare networks nationwide.

What have been the benefits and challenges associated with EHR adoption to date?
Today, we live with Epic across five of six hospitals and 175 physicians. In addition, approximately 300 physicians use the NextGen EHR. Epic replaced an early-generation EHR (TDS, now Allscripts) installed in 1991. The experience with that system – CPOE, alerts, order sets, best practices, etc. – was immensely helpful as we configured, installed and supported the rollout of the Epic system. We know from that experience, for example, the critical role of physicians and nurses as the key leaders and champions of change, patient safety, and system design cannot be overemphasized. Apart from that experience, we also benefited from all that had been learned by other organizations that had gone before us with EHR rollouts, both successes and failures. We went live with Epic at our first hospital six years ago. We completed implementation of Epic’s clinical and revenue cycle systems over the ensuing four years.

We’ve learned that rather than being done with our EHR journey, we are actually just beginning. We are currently live with high levels of physician adoption and have largely eliminated paper-based records in our care for patients. Nevertheless, we find ourselves expanding the Epic system and exploiting its power in an environment where care process and healthcare financing are undergoing a revolution as a result of healthcare reform. Challenges included keeping pace with advances in the features and functions of Epic, increasing cost pressures, the anticipated organizational changes associated with accountable care, a transition from fee-for-service out outcomes focused financing, and the basic operational needs of accountable care.

Other challenges we faced were developing a system that would work well for everyone – from specialist to internist to hospitalist and beyond. Many different but interrelated workflows are involved, some that emphasize content while others are built for procedural speed. Another challenge is ensuring system reliability, speed, and near-constant availability. While we have “downtime” procedures, we are not terribly productive reverting to paper when the system is not available. We simply must take steps to minimize and protect against system failure.

What role has voice recognition played as it relates to your organization’s EHR adoption?
Today, we’re moving from an era of dictation and transcription to an era of voice recognition. As a result, the role of the transcriptionist is shifting from one focused on transcribing to one focused on editing the text captured by voice recognition.

Our EMR captures data in two forms – structured and narrative data. Increasingly, EMRs are incorporating functions and tools that help streamline the capture of both types of data. Voice recognition, specifically Dragon Medical 360 | Network Edition and Dragon Medical 360 | eScription, play a large and growing role in the capture of the patient narrative. Voice recognition helps make our physicians more productive, as the capture of narrative is integrated with structured data gathering tools such as forms and discrete data fields. This will be especially important and helpful as we shift to more elaborate coding under ICD-10.

How has meaningful use influenced your development roadmap? Have you found meaningful use to be very “meaningful”?
We invested in the Epic EHR well before the HITECH Act and Meaningful Use incentives and embraced MU along the way as part of our adoption and use of Epic. We have already attested for Stage 1 for MediCal (Medicaid in California). We believe in Meaningful Use and think it represents the best interests of patients, providers and payers. Currently, we’re in the process of digesting Stage 2. While we find it daunting as it relates to the breadth of the information provided, we’re confident that we’ll be able to tackle these new requirements over time. So yes, we do find Meaningful Use “meaningful” and generally the right thing to do.

What type of involvement do you see your organization having in Accountable Care Organizations (ACOs) and what role will technology play in it?
EMRs are a foundation of ACOs and increasingly taken for granted – table stakes for participation in an ACO. While we’re still ironing out the details of what an ACO means for our organization, the reality is we’re living in a post-EMR world. ACOs are the next frontier and, clearly, EMRs will play a major role in the making the ACO model a reality. Other technologies, such as analytics, interoperability and data warehousing will play an equally big part in this shift toward the focus on population health and outcomes-based care.

What’s are your thoughts on HIE? What will it take to have a truly successful HIE?
New policies and regulations need to be put in place at the Federal level for HIE to truly work. Today, providers are reluctant to consider or embrace HIE because of the financial and reputational risks associated with the idea of sharing patient information. Issues of patient consent management, opt-in vs. opt-out, and privacy create both real and imagined barriers. We need to create a legal and regulatory environment that is receptive and supportive of HIE rather than potentially risky and punitive. As an organization, we participate in local, public HIE efforts while we endeavor connect our systems to affiliated providers to safely and securely make available patient information as our physicians and patients currently demand and expect in the current environment. We’re encouraged by the progress and ongoing regional and national dialog with regard to HIE though we do think it will evolve slowly and unpredictably.

What’s the most beneficial IT program that your organization has implemented? What benefits were achieved?
Our EMR. It’s had the most dramatic impact on the patient care we provide and how we run our “business” efficiently with substantially higher levels of patient safety. It is a vital go-forward “platform” on which to build new tools and capabilities to survive and thrive in a rapidly-changing healthcare environment.

What are your biggest challenges as CIO?
Figuring out what it really means to be an ACO and what it means to manage the health of a population. I find myself constantly thinking about these questions:

  • What do we really mean by population health?
  • How do we restructure our business to provide population health services, and with which organizations will we need to affiliate to carry out population health initiatives?
  • What tools and technologies will we need beyond the EHR to make population health a reality?

Which IT project doesn’t get enough attention and why?
Establishing social media tools and technologies that can help facilitate internal collaboration – beyond email and our intranet.

Effectively engaging patients in their health care, likely using social media, apps, etc. I’m constantly wondering what patients really need from us in order to manage their health and wondering what role apps or other technology might play in making an effective connection between provider and patient.

EMR Jobs, Olympic EMR, EMR O/S, EHR Dictation, and EMR Purchasing

Posted on May 27, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

You can see we have a jam packed weekend Twitter round up. There were a lot of interesting topics being discussed this week in healthcare social media. As usual, we’ll do our best to provide some of the more interesting tweets. Not to mention we’ll add a bit of our own commentary to provide some background and understanding about the tweets as well.

Now without further ado, a few EMR and healthcare IT tweets for your reading pleasure:


I saw this job tweeted. I didn’t necessarily find this job all that unique, but it’s an interesting contrast to see all the EMR jobs tweeted out, posted on the EMR and EHR Job board, and posted to the Healthcare Scene LinkedIn group. Compare that with experiences like this one posted on EMR Thoughts. It’s such a conundrum that so many don’t have jobs while many can’t find qualified EMR talent.


GE Centricity has been the choice of the USOC for a few years now. I’d love to go to London to see it in action first hand. Anyone want to sponsor that? I do LOVE watching the Olympics!


Does operating system really matter anymore? I’m finding that the operating system is mattering less and less. Ok, with most client server products you need a certain operating system, but with most well done SaaS EHR it doesn’t matter. I’ve reinstalled a few computers recently myself and all I do is reinstall my browser, hook up dropbox and I have probably 90% of what I need.


The sub head on the article describes the link of EHR and dictation better: “Doctors who dictate their clinical notes before they’re entered into an EHR have lower quality of care scores than those who type or enter structured data directly into the EHR, according to Partners Healthcare researchers.” I’m always suspect of these studies. Particularly because they usually have a much narrower focus, but provide for a great headline.

Plus, I think it’s still early on NLP (natural language processing) and CLU (clinical language understanding) technology that will extract more data from unstructured text in real time to support quality care measures. Let’s look at this in 3 years and we’ll see if voice and narrative text is common place or gone the way of the dinosaurs.


I’m sure that this number is lower than many ambulatory EMR companies expect. It’s certainly much less than ONC would predict. I personally predict the number is a bit low. I expect we’ll see a few more EHR purchases than 7-8%, but probably not more than 15%.

EMR Voice Recognition, EMR As Medical Devices, ACOs and HIEs, Top 100 Hospitals, and MU Stage 1 Money

Posted on April 29, 2012 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’m traveling in what I consider the heart of healthcare IT: Boston. Everywhere you turn and look there’s healthcare all around. I’ve seen multiple vans with Partners on them. I even had a mobile health story in the Delta magazine I checked out on my flight out. Although, I’m not actually in Boston for work. I’m just here on vacation with my wife. So far I’ve done a pretty good job enjoying the vacation and not working. We’ll see how the last couple days go.

Don’t worry Boston, I’ll be back in two weeks for Health 2.0 Boston and we’ll get all the #HITsm crew together for some healthcare IT fun. Yes, bad planning on my part, but I do have an affinity for visiting Boston.

Ok, enough of the sidebar. Now to the usual round up of Healthcare IT tweets:


Is there an EMR where you can’t use voice recognition? I wrote a post on that a long time ago where the answer was no. They can all use voice recognition. Although, as I’ve written about the deep embedding of voice in some EMRs, it’s also true that not all EMR voice recognition is created equal. So, check it out if you like voice.


My answer is that they’re not medical devices. I think we have more than enough regulation in EMRs and I haven’t seen that regulation actually improve EMR software. So, I’m against more EMR regulation.


It’s true that many EHR vendors hold the blame for not exchanging data even if they put on nice demos at the Interoperability exchange at HIMSS. How about next year the interoperability showcase at HIMSS can only show actual implementations of real exchanges? I wonder how different it would be.


This top lists are always fun to click and rarely have much value. Although, to me it probably mostly shows a correlation by the money made and the IT implemented. The more money they have the more likely they are to implement healthcare IT.


Stage 4? You have to have completed every EMR stage (ie. Full implementation).

Common EHR Implementation Issue – Inadequate EHR Templates

Posted on September 6, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

Time for the latest entry in my series of Common EHR Implementation Issues. See also my previous posts on Unexpected EHR Expenses, EHR Performance Issues and a little follow up to avoiding the EHR performance issues altogether.

This weeks common EHR implementation issue is: Inadequate EHR Templates.

Before I begin with the major issues of inadequate EHR templates, it’s worth noting that there are a few EHR software out there that use a different EHR documentation paradigm than templates. For example, some use voice recognition to power their documentation. Others have a system that learns your documentation over time and based on that learning remembers how you want to document certain procedures. Others, use lots of independent documentation methods (one EHR vendor calls them controls – check box, radio button, freetext field, etc.) which can be grouped and used in interesting ways.

However, even with all of the above alternative documentation methods, there’s often an element of templating that’s occurring. They’re PR and marketing people will shudder at the term template, but concepts related to templates seem to pretty much always apply. For example, in voice recognition there’s something called a Macro. That’s basically a template. The EHR system that learns your documentation method is just using your initial documentation in the EHR to create personalized templates of how you like to document. The independent documentation methods often group those various “controls” into groups of common visits. That sounds like a template to me.

I’d be interested to hear of an EHR system that doesn’t use the principles of templates. It is worth noting that all EHR templates aren’t created equal. Some are much more flexible than others. Now to some details.

The inadequate EHR templates shows itself in a number of different ways.

No Specialty Specific EHR Templates – This has to be the complaint I hear the most. It usually goes something like this, “The EHR salesperson said they had templates, but they don’t have any templates I can use.” Did someone say EMR salesperson mis-communication? Yep, happens all the time. Let’s be honest for a second. How could the EHR salesperson know how good their cardiology or neurology templates really are? They just go by what they hear and what they’re told by the EHR company.

Incomplete or Unusable EHR Templates – You may have noticed a subtlety in the quote I put above. At the end the doctor says “templates I can use.” Maybe the EHR salesperson isn’t lying to you about them having those cardiology or neurology templates. Maybe they do have a bunch of templates for those specialties (or whatever specialty that interests you). However, just because they have templates for those specialties doesn’t mean that you’re going to want to use any of the templates that they’ve created.

My favorite complaint is when they say that the specialty templates seem to have been created be a general medicine doctor and not an actual specialist from that field. I’ve heard it far too much not to mention it.

The other major problem with this point is the unique documentation preferences of each doctor. Has there ever been any two doctors that document the same way? We could debate the good and bad merits of such documentation, but the point is that each doctor is very different. Some feel the need to over document the encounter. Other doctors want to just document the bare minimum. Plus, some (purposefully or not) do a terrible job documenting the visit. The templates in an EHR could reflect any of these various documentation patterns and depending on your perspective could mean that EHR has inadequate templates for your needs.

Hard to Modify, Add to, or Adjust – While not specifically an inadequate template, this is an important part of templates. Turns out that if a user can easily modify, add to or adjust a template that is inadequate, you’re going to be a lot better off. Some template systems are like pulling teeth to modify. Others are amazing at how you can on the fly modify the template.

One promise I can make you, You WILL want to modify their templates. I can’t say I’ve ever heard of someone using the templates perfectly out of the box. Well, maybe I’ve heard of one or two using them, but that was when they were complaining that they had no way to modify the things they wanted to change.

Avoiding EHR Template Inadequacies

The best way to avoid this issue is to test drive the EHR software and the specialty specific templates you hope to use. Run through the templates like you’re charting on some common patients. You’ll learn a lot about what templates are available doing this than anything else. You’ll see if the templates are overkill or below standard for your needs.

Another great test is to try using multiple templates for a complex patient. How easily is that done and how well does the documentation display?

Then, during your EHR demo with the EHR salesperson, ask them to modify part of the EHR template they’re using to document. Tell them you don’t like to ask one of those questions, so you’d like to see them remove it from the template. Many are likely to respond, “It can be done, but I’d have to switch systems to do it or I’d have to call in to tech support to make the change.” I think we all know the real message they’re sending.

For those not interested in EHR templates, you might take a second to read Dr. West’s Experience implementing EHR templates in his office.

Dragon Medical Enabled EHR – Chart Talk

Posted on July 12, 2011 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I recently was asked by Deanna from Mighty Oak to check out a demo of their Chart Talk EHR software (previously called DC talk). It’s always a challenge for me since there are only so many hours in a day to be demoing the more than 300 EHR companies out there. So, instead of doing a full demo, I asked Deanna to highlight a feature of Chart Talk that set them apart from other EHR software companies.

She told me that Chart Talk’s killer feature was its integration with Dragon Naturally Speaking’s voice recognition software. I was very familiar with DNS and other voice recognition software, so I was interested to see if they really could create a deep integration of Dragon Medical over the other EHR software I’d seen that integrated it as well.

I have to admit that I was pretty impressed by the demo. It was really quite amazing the number of things that you could do with your voice in the Chart Talk EHR software. Certainly standard transcription like documentation worked out well in Chart Talk. However, the impressive part was how you could navigate the EHR with your voice. Here’s a demo video that does a decent job illustrating it:

What made the documentation even more interesting (and is partially shown in the above video) is the use of various DNS macros and the even more powerful built in macros for pulling in vital signs, past history, etc. Plus, I like the idea that when you have any issues with Dragon Medical, you don’t get someone at your EHR company who doesn’t really know much about Dragon. Since Chart Talk’s completely focused on Dragon integration, you know they know how to support it properly.

I of course only saw a partial demo of the Chart Talk software. So, I’m only commenting on the Dragon Medical integration in this post. It would take a much longer and more in depth evaluation to know about the other features and challenges to the software.

Plus, there’s no doubt that voice recognition isn’t for everyone. They tell me that some people do the charting with their voice right in front of the patient. That feels awkward to me, but I guess it works for some people. Then, there’s the people who don’t want to go through the learning curve of voice recognition. However, I’d guess that Chart Talk could make a case for being some of the best at teaching people to overcome that learning curve since every one of their users uses it.

I also know that Chart Talk originally started as DC talk. So, anyone considering Chart Talk should likely take a good look at how well the software fits with their specialty. I know the people at Mighty Oak have been making a big effort to work for any specialty. However, like every EHR software out there, they just work better for some specialties better than others.

It’s also worth noting that Chart Talk is a client server EHR. I guess the web browser isn’t quite ready for the processing power that’s required to have a nice voice enabled user experience.

Needless to say I was impressed by the voice recognition integration and how pretty much every command can be performed using your voice. I’d be interested to know of other EHR companies that are striving for that type of deep integration. I’m not just talking about being able to basically dictate into a text field. I’m talking about actual navigating the EMR with your voice.

“I use EMR and so I am MY OWN transcriptionist.” – Doc at AAFP

Posted on September 30, 2010 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 15 blogs containing almost 6000 articles with John having written over 3000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 13 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’m currently in Denver attending the AAFP conference. So far I’m really glad that I’ve come to the conference. It’s really fantastic to be surrounded by providers. It’s a stark contrast to HIMSS where you’re mostly surrounded by industry insiders and not that many providers. The practical questions the doctors ask are fascinating.

Of course, the comments they make are also fascinating. The title of this post is a comment one lady made in the David Kibbe session on Meaningful Use:
“I use EMR and so I am MY OWN transcriptionist.”

The problem with this comment is that it just doesn’t have to be true. It could be true depending on which EMR software you selected and how you implemented the EMR. However, that’s a choice you make when you choose and implement an EMR without any transcription.

I’ve actually seen a number of EMR vendors that have some really nice and deep integration between their software and transcription companies. There are even transcription companies that are building their own EMR software which obviously leverages the power of transcription.

Plus, many doctors happily use voice recognition like Dragon Naturally Speaking to still do what essentially amounts to transcription with their EMR.

Add in developments around natural language processing and the idea of preserving the narrative that is so valuable and interesting while capturing the granular data elements is a really interesting area of EMR development.

Of course, one of the problems with this idea is that many people like to use the savings on transcription costs as a way to justify the cost of purchasing and implementing an EMR. Obviously, you’ll need to look for other EMR benefits if you choose to continue transcription.

Just to round out the conversation, there are a wide variety of EMR vendors which each have their own unique style of documentation. Part of the problem is that many people don’t look much past the big “Jabba the Hutt” EMR vendors which are these ugly click interfaces that spit out a huge chunk of text that nobody wants to see. There’s plenty of EMR vendor options out there. Keep looking if you don’t like an EMR vendor’s documentation method.