Blog: Fixing the Health Care System — Begins with Physicians

A friend’s grandfather was the first person living on his street to own a car. Parking was never a problem, it was easy to get around town, and he thought it was a great convenience over the subways, trollies, and buses running in New York City at the time. But he never chose to drive his car all the way to Boston, instead he took the train. Without interstate highways, traveling long distances in a car was rarely a “meaningful” option. Back then, that trip took more than eight hours, longer than it took by train.

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CMIO interview with Dr. Beazley – Entrada at work

Many vendors claim their products are superior to competition.  We spoke with CEO at Entrada who took a modest approach and suggested we should speak to some of the folks who are using the products and draw conclusions accordingly.  Thus, we spoke with Dr. Cooper Beazley who has fully integrated Entrada’s clinical documentation tools into his practice.  Here is what he had to say:

CMIO Magazine: Tell me a little about you and your practice.

Dr. Beazley: We’re one of the largest and most respected orthopedic surgery groups in the State with 54 providers across 14 sites.  Our team of physicians provides comprehensive orthopedic care with sub-specialties including sports medicine, pediatrics, joint replacement, spine, hand, wrist and elbow, foot and ankle and shoulder surgery.  I have a large patient panel with an average of 5000 visits per year which equates to about an average of 50 patients per full day or about 25 patient visits per half day schedule.   

CMIO Magazine:  How have you integrated the Entrada software into your practice?

Dr. Beazley: I’ve been using Entrada’s clinical documentation solution for about 2 years. At that time, we had been having some major issues with our legacy dictation system, such as trust that we would have accurate and timely turnaround, and providers, including myself, were apprehensive about adopting a new solution.  Part of this apprehension was also due to the fact that we had already attempted, several years prior, to integrate Dragon speech recognition into our practice without much success.  The decision to implement Entrada was met with skepticism by the provider group despite assurances from leadership about its ability to deliver.  With few alternatives and needing to support my department, I decided to use Entrada’s solution and, right away, I was very impressed with the accuracy of my clinical documentation.  I would say it was always 99%, if not 100% accurate.  That said, we’ve fully integrated Entrada at our site and are starting to roll it out to the other sites.  We know that it will integrate well with our current EMR system and the vendor has been very supportive of any issues or enhancements we have suggested.  The Entrada solution is part of our workflow and is essential for us being able to document efficiently and effectively. 

CMIO Magazine:  What are the benefits of the Entrada solution? 

Dr. Beazley: The turnaround time from dictating a note and receiving it for editing is very short, allowing me to close the encounters on 75% of patients the same day.  Entrada’s editing functionality is just similar to editing a MS Word document.  It is easy to learn and fast to use.  It is very user and physician friendly.  The accuracy is high which has given the practice a sense of trust with the software.  For these reasons, our stress level is low resulting in our spending more time with patients and higher volumes.  It is EMR compatible.  Last but not least, it’s very cost effective. All in all, it has a very positive impact in our practice and ultimately it has enhanced patient experience by having access to accurate data at the point of care.   

CMIO Magazine:  How would you describe the adoption of Entrada in your practice? 

Dr. Beazley: Integrating the Entrada clinical documentation solution into our practice was not a major change for us since we have been using a legacy system along with some use of voice recognition solutions.  The rollout of Entrada was more about using a more sophisticated yet surprisingly simple solution to ensure our records are returned to us in a timely fashion and is not lost during the process.  The feature allowing patient appointments to automatically load as dictation jobs to be completed by the physician keeps jobs from getting lost and is an irreplaceable compliance tool.  We can systemically tell who has dictated and who hasn’t and when providers completed their dictation in relation to the date of service which is a great for internal monitoring purposes. 

CMIO Magazine: Any lessons learned from this implementation? Good, bad, and ugly! 

Dr. Beazley: I wouldn’t be afraid to implement the solution “all at once” or at least across large numbers of physicians.  We took a more conservative approach and ended up rolling out the product little by little which, in retrospect, was not necessarily the best method, but which was likely the most aggressive tactic we could employ given our number of doctors and clinic locations.  The system is easy to learn and the adoption shouldn’t be a long process so I highly recommend a big bang approach.  My only constructive feedback has to do with the integration with smart mobile devices such as iPad, iPhone, etc..  These solutions are not always ready for prime time in a medical setting and Entrada needs to play it down until they have solved some of the core issues – many of which are not their own but may be related to things like Wi Fi signal integrity, Apple’s app process.  Any physician adopting Entrada’s solution needs to understand that the most robust connectivity comes via the USB-connected microphone and that iPhone, iTouch, and iPad platforms are luxury items that, while cutting edge in nature, may have some bugs due to things outside of Entrada’s control.  They also need to ensure they can effectively integrate with and understand the nuances of the resident practice management system’s scheduling logic so as not to have any hiccups in the process of pushing patient names into the dictation jobs queue. 

CMIO Magazine: Any closing remarks? 

Dr. Beazley: Working with the Entrada team and their software has been a positive experience for me and my practice.  The team at Entrada is very dedicated and committed to problem solving and addressing our issues.  They respond in a timely fashion and they work in collaboration with us.  We don’t take the implementation of new technology lightly so we’ve been very pleased with their support and solutions.  Finally, we are excited about the possibilities of Entrada’s team helping us with the process of reformatting our dictation to facilitate its being pushed into discrete data fields in meaningful use certified EMR products we are currently evaluating.

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