I had Dragon Dictate when it was first released, before there was even a medical version. But even the newer medical version got things wrong, regularly. It was hard to educate the system on what I actually meant when I said things like "widespread dermatophytosis secondary to tinea corporis, and will require azole antifungal treatment."
Dragon wasn't cheap, either. And just like every other product marketed to health care, adding the word "clinical" or "medical" increases the cost 10-fold and typically requires repurchase for upgrades. So in terms of creating an efficient practice, it really was not optimal.
Scribes I find to be expensive and intrusive to the physician-patient relationship, and significant turnover leads to other inefficiencies.
So last year, I tried a different approach by pairing my old software with something new -- Suki, an app-based software platform for dictation. I found that it was great to use, learned my meanings quite quickly, and even though it was not integrated with the EHR system I was using, I could fairly easily cut and paste a note from Suki into my EHR. It was a little pricey, so I sought other ways to reduce my overall office overhead so I could keep this product, which I found reduced my work after clinic by about 40% at the time.
I shared my experience -- including my quest to find an EHR system that could fully leverage Suki's capabilities -- with the AAFP Innovation Lab, which was conducting an initial, proof-of-concept pilot of Suki. I joined the pilot and began the process of moving to a new EHR, which would be my fourth.
After shopping all of my options, including thoroughly vetting the features, costs, transition efforts, customer service, and, most importantly, ease of use and documentation efficiency, I reached out to Suki to find out which software its product had already integrated with. Though the interface was in its infancy, Suki advised me that one of the EHRs was Elation Health, which is what I implemented.
Together, the systems now allow me to see a patient, dictate into my app on my phone, come back to my laptop later, sign off on the note and talk as much as I want, for as many lines as I need, with nearly zero errors, at a fixed price.
But the most important part? I've reduced my WAC by 90%. For example, on a recent Friday, I saw 29 patients, one-third of whom needed COVID-19 evaluations. I was able to dictate between patients. Given that it was a busy day, I could not do my notes as I went. But at home after dinner, I finished 29 notes in one hour. I spent roughly two minutes per note, just to make sure billing was entered, diagnoses chosen and the note completed.
Others participating in the initial phase of the pilot also gleaned substantive time savings. Time really does have a price. I'm willing to pay more money to get time back. In my case though, I was able to find a way to improve efficiency and reduce my expenses. That doesn't happen too often. Technology is supposed to improve our lives, not increase our burden, and it's my belief that with the right research, each of us will find the tools that best do that in our practice. We just need to be willing to do the work, plan the transition, execute the change and realize the benefits.
By moving forward in this way, we can get time back.
The AAFP Innovation Lab's Suki pilot is advancing to stage two, and Academy members (and practice peers) can join. To sign up, learn more about joining the pilot, or to be notified of future pilot opportunities, visit the Innovation Lab.