CMIO Magazine: Tell me a little bit about your background and about Entrada.
Bill: I am a formally trained CPA with over 20 years experience in business, primarily HealthCare,. Working with growth companies is second nature to me as I’ve been involved with a number of businesses in helping them grow their infrastructure, products, and service offerings. I joined as CEO last year to lead an acceleration of Entrada’s growth efforts. Entrada has grown significantly in the provider space serving software to physicians that allows them to capture their clinical notes efficiently and accurately. We are web-based with low up-front costs. Our software bolts onto any clinical system with bi-directional capabilities. Our goal has been two-fold; to protect and increase physician productivity while simultaneously working to reduce overall service costs. To that end, we pay close attention to workflows when we design our software. It’s an obsession for us to analyze and focus on clinical documentation workflows as we solve problems and develop products.
CMIO Magazine: What key clinical projects are you working on?
Bill: There are two key initiatives at Entrada: One is sharing clinical data at the point of care for multiple separate organizations which each must bill from the same clinical notes. For example, a surgeon can dictate an OP note at a surgical site. It is sent to our processing center, reviewed, completed and sent back to the surgeon for review at his home clinic, often in less than 30 minutes. At that point, the doctor can review, edit, and eSign the note within our application. Once completed, we route the signed note to the appropriate clinical system at both the facility and the physician’s office. This is all done with no work needed by medical records staff.
The second initiative is to develop multiple solutions for returning data into clinical systems. In its simplest format, documentation can be inserted as a single document (e.g. PDF, rtf, tiff). However, we have also developed two other ways to split data apart and insert it into an EHR. First, we can set up structured templates in our application to allow physicians to dictate their notes in sections. This information can be returned into the EHR system in these tagged sections. This option allows physicians to complete discrete fields within our applications and in a mobile environment. The second option is similar, but is consummated within the EHR system itself. We can embed a web recording device in the clinical system that can be accessed by the physician with the click of a mouse. Dictated text can be streamed to our data center in real time and returned in completed format to the same field from which it originated.
CMIO Magazine: What Entrada products or service offerings should hospitals and other providers know about, but probably don’t?
Bill: Our automated solution has decreased the turnaround time for chart completion. We have taken a bottoms up approach to information exchange and turned electronic health records on its head by feeding critical patient information into the EHR at the point of care with a heavy emphasis on a workflow based approach. We are focused on both ambulatory and acute care settings, thus the information (clinical documentation) flows across a multi-disciplinary platform. This approach has helped tremendously with physician adoption of our system as it is very easy for a specialist, such as a surgeon, to document a surgery or patient visit in a short amount of time. Also, we routinely reduce cost for our clients significantly in excess of our fee. In one case, a 25 physician surgical group gained 90 minutes per physician a week by using our automated solution and, at the same time, eliminated a total of $250,000 per year in services costs (i.e. medical records and transcription) after our fees. This is a significant cost savings for an organization or a small practice and the time and money savings allows our clients to care for patients more effectively.
CMIO Magazine: How have your solutions made a difference in the patient experience?
Bill: We are getting tremendous positive feedback from the physicians using our system. If we can make the difference between a physician using an EHR or not, this is a huge plus for the patient, in that using an EHR systems is the ultimate in terms of quality of care and for the ability to share data among caregivers.
We believe that improving physician and staff productivity ultimately leads to more time with patients. A positive experience impacts the staff and, ultimately, the patients. The patients gain confidence that their caregiver has appropriate information at the point of care which improves the quality of care.
CMIO Magazine: When IT costs come under the microscope, how can technology, including that provided by Entrada, prove that it’s paying its way?
Bill: First and foremost, the question we simply ask our clients is this: “Are you eliminating more costs than you are paying us?” We routinely achieve a 30%+ service cost reduction for our clients. We have minimal up-front costs and the payback is almost immediate.
The second question we ask is this: “Is our solution freeing up time for your physicians to see more patients?” We routinely help our physician clients save over 1.5 hours each per week, while simultaneously helping them make their clinical data more accessible.
CMIO Magazine: Any closing remarks?
Bill: We need a smoother adoption of EMR systems. Part of the solution is for vendors to consider the natural physician work flows and incorporate them into their solutions. I am afraid this is not always the case and many vendors fail to fully develop their systems as a result. We keep the physician workflow at the center of everything we develop which has given us a great track record and has made our solutions easy to adopt. It takes less than an hour for physicians to learn and start using our system. The training necessary to use our system essentially does not impact physician productivity, yet there is a tremendous cost savings with Entrada.