Windows CE and Dictate and Rx+ software offer mobility to physicians, improve efficiency

Published: July 2002

Using Microsoft®Pocket PCs and TouchWorks Dictate™ from Allscripts Healthcare Solutions, physicians at Scott & White regional clinics in Central Texas save time, reduce errors in medical record number entries, benefit from mobility, streamline workflow, and increase practice satisfaction. The solution, built on Microsoft Windows® CE, is a key step in helping Scott & White achieve institution-wide goals of a reduced reliance on paper records and increased efficiencyand accuracy.

Company Overview

Scott & White is a leading-edge health care system based in Temple, Texas. Founded as a two-physician partnership in the late 1890s, Scott & White today is a sophisticated, nationally respected organization providing health care to residents in 27,000 square miles of Central Texas. Scott & White includes a 486-bed hospital, a 500-physician practice offering primary, specialty and subspecialty care, a main clinic, 18 regional clinics, and a health maintenance organization (HMO) with 185,000 members. Its clinicians handle 1.5 million patient visits annually. Scott & White's teaching relationship with Texas A&M University System Health Sciences Center College of Medicine helps advance its research activities, which draw top physicians to the system. Efficiency and accuracy are among Scott & White's stated values, and it is committed to achieving a near-paperless system and electronic charts within the next five years.

Business Challenge

Scott & White physicians asked administrators for tools to help them practice more efficiently and improve clinical documentation. They especially voiced interest in using handheld computers for dictation, scheduling and prescribing. At the same time, administrators sought methods for achieving two other institutional goals. They wanted to improve turnaround time on transcription, and they wanted to appropriately increase prescribing of generic drugs for members of the not-for-profit Scott & White Health Plan in order to slow double-digit increases in pharmacy costs.

Solution

Scott & White family practice physicians at two regional clinics began using three modules of the TouchWorks™ suite of applications from Allscripts Healthcare Solutions in June 2001 (a third clinic was added earlier this year and a fourth is currently underway). The modules areTouchWorks Dictate for wireless dictation, TouchWorks Rx+ for prescription and medication management, and TouchWorks Pocket Library for drug reference material. The applications run on Microsoft Windows CE, installed on 6.3-ounce handheld devices connected wirelessly to the main server applications, which run on Microsoft Windows 2000 (or Windows XP) and use Microsoft SQL Server 2000 as the database.

After four months, the physicians gave Dictate their full blessing, says Richard Spencer, who's directing the project at Scott & White. "All our physicians are pushing for any way to help them practice medicine better," he says. "They love it because they can go out in the hall or anywhere and dictate as soon as the patient leaves."In the first 12 months, physicians dictated more than 23,000 documents.

The three software modules work together to deliver benefits from the device, says Ron Coots, Assistant Executive Director IS Applications. Physicians like using the Pocket PC because of the speed, mobility and flexibility that Dictate offers and the prescribing safeguards Rx+ provides, he says. Without the TouchWorks software modules, physicians prescribe generics40-to-45 percent of the time. Scott & White hasn't yet compiled data on changes in prescribing patterns, but even a small shift would carry an impact large enough to demonstrate a major return on investment.According to Allscripts, similar organizations deploying the Rx+ module have seen 10-to-15 percent increases in generic prescribing.

Benefits

Physicians select a patient name from the TouchWorks Dictate drop-down list, hit the Dictatebutton, choose the document type from a drop-down list--and start dictating. The process saves the half-minute to minute of keypad-punching that precedes phone dictation. With traditional phone dictation, physicians press a string of 22 digits to reach the dictation server and enter the user ID, report type, patient medical record number and location. Entry errors can result, which transcribers or other support staff must spend time to correct.

The Dictate software guarantees a match between the selected patient and medical record number. Moreover, it enables physicians to dictate on the go instead of remaining tethered to the telephone. "We have anecdotal comments about Dictate from the physicians," says Coots. "Number one, they love it, and number two, they feel it is less likely to create errors because they're not having to key in the medical record number."

Physicians who completed an Allscripts survey after six months'use said that Dictate saved them one hour to three hours per week. Some reported seeing more patients. Other physicians reduced their overtime, freeing them to spend more time with their family.

"Physician satisfaction is not to be undersold," Coots says. "That, to me, should be considered right along with your other benefits."

Scott & White chose a Microsoft Windows CE/Pocket PC environment over Palm for several reasons, including the superior memory of the Pocket PC, which allows for hours of off-line dictation; the availability on a variety of form factors, including but not limited to the Compaq iPaq; the open standard on the drivers for wireless; the color and clarity of the screen; and compatibility with the institution's existing technology. "Meaning, it looks like Windows," Coots says, "so there's some immediate learning curve that is foregone."

For More Information

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