WEST TENNESSEE HEALTHCARE & M*MODAL FLUENCY DIRECT case study
Background West Tennessee Healthcare is a public, not-for-profit healthcare system headquartered in Jackson, Tennessee. The anchor hospital is Jackson-Madison County General Hospital with 635 licensed beds, and centers of excellence through the West Tennessee Women s Center, Kirkland Cancer Center, Emergency Services, West Tennessee Rehabilitation Center, and West Tennessee Heart and Vascular Center. 1 With locations throughout 18 counties in West Tennessee, West Tennessee Healthcare is a family of healthcare services that provides a full compendium of care through: four hospitals, an outpatient surgical facility, an accredited stroke center, mental and behavioral health capacity, medical laboratory services, medical products, primary care and specialty clinics, outpatient infusion services, outpatient rehabilitation facilities, freestanding outpatient imaging facility, early child development intervention services, community support, and education. West Tennessee Healthcare employs over 5,000 people and is one of the region s top employers. A Board of Trustees appointed by the City of Jackson and Madison County is charged with the oversight of West Tennessee Healthcare. The system is completely self-supporting and does not operate on local tax revenues. In preparation for ICD-10, West Tennessee Healthcare is having external consultants carry out a multi-phase readiness assessment, intended to support the implementation timeline in the period up to go-live. West Tennessee Healthcare s started working with M*Modal in December 2012. 1. http://www.linkedin.com/company/west-tennessee-healthcare case study: West Tennessee Healthcare & M*Modal Fluency Direct / M*Modal / pg. 2
The Challenge We had gone live with Cerner Millennium PowerNote, an EMR component that automates the creation of a clinical note relating to care delivery in the patient care setting, explains CPHQ HIM Manager, Susan McConnell. We were encouraging our physicians to enter their patient information, but those who weren t good with a keyboard were facing challenges. As a result, we were seeing increased coding delays. The Solution Following implementation of M*Modal Fluency Direct, Our physicians can now create electronic templates to provide more complete and more timely documentation within the electronically created note, adds McConnell. Tracy G. Hickey, MBA, RHIA, CHTS CP, Director of Health Information Management, Jackson- Madison County General Hospital, notes that M*Modal and M*Modal Fluency Direct were chosen after an evaluation of a couple of vendors, including the previous provider. M*Modal Fluency Direct was part of the package selected, and went live in February 2013, it was rolled out to around 15 users in the first two days, and then quickly reached the maximum number of licenses. M*Modal Fluency for Transcription had been implemented beginning in December 2012. Kudos to the M*Modal team The M*Modal team including M*Modal trainer Kelsey, Richard, Jason, and others have been excellent to work with, says Hickey. Their input and support made it easy for us to learn how to train our doctors. The whole M*Modal team has been great. Fast and easy training Setup and training is really fast and easy users were up and running successfully in around 30 minutes and physician satisfaction is really high, according to Hickey. At one of our clinics, physicians had been using an alternative product (Dragon Medical), and they like M*Modal Fluency Direct much better. One physician initially thought that he was such a great typist that no system could work faster than he could type. I just got a call from him asking if he could use M*Modal Fluency Direct. Susan McConnell case study: West Tennessee Healthcare & M*Modal Fluency Direct / M*Modal / pg. 3
Setup and training is really fast and easy it only takes around 30 minutes and physician satisfaction is really high. Shahla Salemi The Results The M*Modal Fluency Direct roll-out which is voluntary for West Tennessee Healthcare physicians started with hospitalists and radiation oncologists, and as word spread, we had requests from surgeons, pulmonologists, anesthesiologists, pediatricians, ear, nose and throat (ENT) specialists and emergency physicians. Interestingly, the hospital has a physical therapist with macular degeneration who is finding it easy to use M*Modal Fluency Direct rather than having to type, and is now able to complete daily progress notes more quickly. Another staff member, a physician assistant, has some missing fingers, and also appreciates the ability to dictate notes rather than type. Within in a few short months, West Tennessee Healthcare issued all of their user licenses for M*Modal Fluency Direct, and is in the process of acquiring more to keep up with the physician demand for the technology. The average across all dictating physicians nationwide utilize approximately 155.80 minutes of traditional dictation in a given month. Within the first 3 months, more than 30 physicians had dictated at least 100 or more minutes each with M*Modal Fluency Direct and the heaviest users are currently clocking between 200 to 800 minutes per month. These power users really like the new system. Once we have additional licenses, we plan to introduce M*Modal Fluency Direct as part of the HIM orientation for new physicians, says Hickey. Even though it s still early, the impact can already be felt. The M*Modal systems, in combination with electronic documentation, have led to the number of minutes transcribed falling by about 4,000 minutes a month on average or a 7% reduction for the first 7 months. West Tennessee Healthcare can already see that physicians progress notes created in M*Modal Fluency Direct are providing a more complete story and enabling physicians to complete their documentation more efficiently. Physician satisfaction: a solid measure of success From our perspective, a successful implementation can be measured in the high level of physician satisfaction we re seeing, says Hickey. They appreciate being able to complete necessary documentation in a more timely and efficient manner, touching their reports just once. Somewhat surprisingly, we are also finding that staff members with heavy accents are easily recognized by M*Modal Fluency Direct. For example, one of our hospitalists has a strong foreign accent, and was delighted to find that the system recognized him so well, allowing him to make rounds and get all the notes done at the same time. As he says, it loves me! case study: West Tennessee Healthcare & M*Modal Fluency Direct / M*Modal / pg. 4
The Future M*Modal Fluency Direct is currently being introduced in Jackson-Madison County General Hospital with plans to implement in multiple other facilities across West Tennessee Healthcare which also use Cerner EMRs. The goal is to increase the number of licenses to get more physicians on board. When the physicians are typing, it takes them longer and may leave out important details due to time pressures. With M*Modal Fluency Direct the physician can provide richer, more detailed content, quicker, driving more timely completion of accurate documentation, thus improving coding accuracy for ICD-10, It loves me! and reducing the need to query physicians for clarification. Dr. Odeh - Hospitalist West Tennessee Healthcare at a glance 2 Benefits achieved The anchor hospital, Jackson-Madison County General, has: The voluntary roll-out of M*Modal Fluency Direct for physicians has been well received. 635 licensed beds Staff members with physical challenges 395 physicians on staff including macular degeneration and missing A 23-room Operating Suite with in-house anesthesia coverage and a 62-bed Emergency Department fingers are able to complete documentation more quickly. Treated nearly 84,000 ER patients during its last fiscal year which ended June, 2013 The initial licenses have rapidly been filled due to strong physician interest; West Tennessee West Tennessee Healthcare has: Healthcare is in the process of acquiring more. 806 licensed beds Within the first 3 months, more than 30 physicians 550 medical staff had dictated at least 100 or more minutes each of dictations with M*Modal Fluency Direct The project and the heaviest users are currently clocking Jackson-Madison County Hospital has: between 200 to 800 minutes per month. These Currently ~ 60 physicians trained power users really like the new system. Cerner Millennium as the system of record In combination with electronic documents, M*Modal Fluency Direct the M*Modal systems have led to the number M*Modal Fluency for Transcription of minutes transcribed falling by about 4,000 Challenges faced The hospital: minutes a month on average. Physicians progress notes created in Had gone live with Cerner Millennium PowerNote and was encouraging physicians M*Modal Fluency Direct are providing a more complete story. to enter their patient information by completing electronic notes Physicians appreciate being able to complete necessary documentation in a more timely Was experiencing increased coding delays due to challenges of physicians with limited and efficient manner, touching their reports just once. keyboarding skills case study: West Tennessee 2. http://www.uthsc.edu/utfamjac/wth.php Healthcare & M*Modal Fluency Direct / M*Modal / pg. 5
M*Modal Fluency Direct at a glance M*Modal Fluency Direct uses the power of Speech Understanding the more intelligent approach to fully leveraging the physician s narrative. Going beyond simple speech recognition, M*Modal Fluency Direct is the ideal way to enable physicians and other clinicians to automatically populate EHRs and all of the systems that help document patient information, power the revenue cycle and comply with government initiatives. M*Modal Fluency Direct provides real-time speech understanding, and command and control capabilities, for speech-based documentation and interaction with athenahealth, Cerner Millennium and Allscripts Enterprise EHR systems. During time-constrained patient encounters, physicians can efficiently capture a more complete patient story, which leads to: Improved quality of patient care during and immediately after the initial visit Less time keyboarding, more time analyzing and communicating with the patient instead of with systems. Physicians can plug in a microphone, log-in and verbally annotate story details and care directives as time permits. This increases the physicians ability to stay on schedule and to capture thought processes that continue to unfold after the patient leaves the facility. Use of free-form, unstructured narrative to improve documentation quality, coding accuracy and patient care. This goldmine of information figuratively falls to the exam room floor because it is difficult to quickly capture in EHR systems. Capture that gold and you allow medical transcriptionists, coders, and radiologists to swiftly resolve questions as they refine and add to the patient story. Improved collaboration with consulting physicians. With access to the complete patient story, receiving physicians can deliver the same or better quality of care faster, and both physicians have more time in their schedules to devote to live patient encounters. Receiving physicians can be provided complete transcripts, rather than missing critical information or depending on intermediaries to fill in critical information gaps. Uptake by EHR technology vendors, including M*Modal partners, who are embracing our technology to speech-enable their products and increase their product adoption rates. M*Modal Fluency Direct facilitates improved clinical documentation and other organizational benefits for ACOs and other emerging forms of coordinated care. About M*Modal M*Modal is a leading healthcare technology provider of advanced clinical documentation solutions, enabling hospitals and physicians to enrich the content of patient electronic health records (EHR) for improved healthcare and comprehensive billing integrity. As one of the largest clinical transcription service providers in the U.S., with a global network of medical editors, M*Modal also provides advanced cloud-based Speech Understanding and Natural Language Understanding technologies and data analytics that enable physicians and clinicians to include the context of their patient narratives into electronic health records in a single step, further enhancing their productivity and the cost-saving efficiency and quality of patient care at the point of care. M*Modal has been recognized as one of the fastest growing technology companies in North America, placing in the top third of Deloitte s Technology Fast 500 for 2012. For more information, please visit mmodal.com, Twitter, Facebook and YouTube. 2013 MModal IP LLC. All rights reserved. case study: West Tennessee Healthcare & M*Modal Fluency Direct / M*Modal / pg. 6