2009 Digital Demos
The 2009 AAN Annual Meeting in Seattle will offer Digital Demos: Technology Solutions That You Can Afford, a free event on April 27, 2009. Featured presentations cover topics such as e-Prescribing, managing personal health records, and the benefits of effective chart scanning.
- Voice Recognition Software
- Secure Online Communication
- Scanning Solutions
- Smart phones
- E-Prescribing
- Personal Health Records
Voice Recognition Software May Now Be Sound Investment
As with many technology advances, voice dictation of notes, reports, or memos to a personal computer was for a long time more hype than help. But new breakthroughs in voice recognition software (VRS) have made voice training much less cumbersome and, as such, most programs are ready "out of the box."
Physicians can dictate into a Word document that can be uploaded to an electronic medical record (EMR), or they can dictate directly into various EMRs. The time savings compared to typing are readily noticed: specifically, a note can be transcribed in less than one-half the 
time it takes a fairly good typist to generate a note. Also, the initial investment in both the software and a computer or laptop is the only cost. Therefore, dictation costs become negligible after this initial investment. There is little productivity lost when using VRS; it can be implemented into workflow quite easily with minimal effort.
Kenneth J. Gaines, MD, FAAN, a member of the Academy's Practice Management and Technology Subcommittee, has been using VRS since 2005. He will discuss options in voice recognition software at the Digital Demos presentation.
Physician-Patient Communications Increasingly Move Online
Playing phone tag may soon go the way of the rotary dial telephone as more patients and physicians take advantage of secure email messaging. This is accomplished with an encrypted email portal that enables a two-way, secure communication between parties. Patients are discovering the advantages of communicating with their physicians at their convenience and without the hassles of being placed on hold or waiting for a return call.
According to Steven J. Zuckerman, MD, "The advantages of an asynchronous form of communication have been demonstrated. This approach saves time for physician offices and the convenience this offers for patients is greatly appreciated. Despite concerns to the contrary, physicians are not inundated with frivolous—or worse—medically emergent messages. In fact, office phone calls are significantly reduced when such a secure system is in place."
Zuckerman, who will speak on secure communications at the Digital Demos program at the Annual Meeting, is a member of the Academy's Practice Management and Technology Committee and has long held a keen interest in medical informatics. His master's thesis for the Royal College of Surgeons in Bath, England, evaluated the ways in which technology is changing how patients and physicians have traditionally communicated. Now the Chief of Neurology and Medical Information Officer at Baton Rouge General Hospital in Louisiana, Zuckerman is an MDNG Healthcare IT Advisory Board member.
Chart Scanning Offers Versatility, Saves Time, Space, and Money
Current time studies show that the cost of handling a paper chart—from initial phone call to re-filing the chart—is $8.00. Paper records can be misfiled, lost, or inadvertently destroyed. The scanning of medical charts and records can result in long-term cost savings and increased efficiency in helping neurologists obtain the patient information they need—more quickly and less expensively.
William Henderson, FACMPE, administrator of Upstate Neurology Consultants in Albany, NY, knows this firsthand. His medical group of six physicians has been scanning patients' medical charts, all paper billing records, and all business documents for the last four years.
Scanning options include both stand-alone applications and scanning modules integrated into an electronic health record (EHR). The scanned image, usually stored in a graphical format such as JPG or TIFF, also can be converted to a searchable OCR (optical character recognition) document. The costs for scanning solutions vary by the chosen type of implementation, with stand-alone systems beginning at $5,000 to more integrated solutions that can cost in excess of $50,000.
Henderson, whose practice has been on a fully integrated EHR system for three years, will be one of the presenters at the Digital Demos session at the Annual Meeting. "We will review several types of scanning options, demonstrate how documents are scanned, review methods for classifying scanned documents, and show how scanning can store the billing and business records of the practice."
Smart Phones Help Physicians Work Smarter
Smart phones are to cell phones what personal computers are to typewriters. They go beyond their essential communications functions to access a vast world of knowledge and resources. Smart phones typically include email and personal organizer functions, often with a compact keyboard or touch screen. They can store or access specialized software applications and retrieve information through these applications or directly from the Internet. Many can play music, download video, take digital photos—and, of course, play games.
But games are likely the last thing on the minds of neurologists who rely on smart phones daily, like Neil A. Busis, MD, FAAN. Busis, the Associate Website Editor for Practice & Technology, a member of the Medical Economics and Management Committee and its Practice Management and Technology Subcommittee, offers a compelling story attesting to his smart phone's usefulness. A young man with cystic fibrosis was scheduled for a lung transplant when he suddenly developed seizures. No cause of seizures was found on exam, labs, or imaging studies. His surgeons considered cancelling the transplant. Busis was consulted and he checked his smart phone database for each drug the patient had been taking. "I identified half a dozen drugs that could cause seizures as side effects. I cleared him neurologically. His medicines were simplified and he went on to have a successful transplant, which gave him several extra years of life."
While most modern smart phones and PDAs have ample memory to accommodate a sizable collection of medical applications, either built-in (iPhone for example) or added on as an accessory (Blackberry models), battery life remains a stumbling block, according to Busis. He will discuss technological insights and options for use with smart phones and other mobile devices at the Digital Demos presentation at the Annual Meeting.
AAN members can experience AAN.com in a version designed for smart phones at m.AAN.com: and access the best of the Academy's website in the palm of your hand.
Electronic Prescribing Offers Speed, Convenience, Savings
Electronic prescribing software is either free-standing (not integrated into an electronic health record) or integrated (comes with the EHR). eRx that comes integrated with the EHR is more efficient because the allergy list, drug list, problem list, and patient demographics are fully available through the EHR. With a free-standing eRx module, some or all of this information may need to be re-entered by the practice.
A variety of EHR vendors and IT vendors now offer e-Prescribing software that is compatible with the SureScripts network for eRx. Among these vendors are Allscripts, Zix, DrFirst, RxNT, eClinicalworks, eMDs, and NextGen. Costs per month vary from free to as much as $20 to $30 per month per physician.
Currently, only 2 percent of the 1.47 billion prescriptions written annually in the United States are sent electronically. A study by Brown University has suggested that by using electronic prescribing software, practices can reduce staff time spent on refills from 87 minutes to 43 minutes per day. At present, federal law prohibits prescribing many sedative and narcotic drugs electronically, so not all drugs can be ePrescribed at present. However, steps are being taken to relax these federal restrictions.
Daniel B. Hier, MD, MBA, FAAN, a member of the Medical Economics and Management Committee, and AAN.com Education editor, has been an active user of electronic prescribing ("ePrescribing" or "eRx") for more than five years. He has investigated a number of these programs and will make a presentation on electronic prescribing at the Digital Demos program.
Personal Health Records: Evolution or Revolution?
Increasingly, consumers are logging onto the Internet to help them manage their health and health care decisions. Patient-centered and participatory health information technology engages patients in their care, giving them access to computer-based tools and new sources of data and information. Patients can communicate with their doctors, schedule office visits, and pay bills.
David C. Kibbe, MD, MBA, founding Director of the American Academy of Family Physicians Center for Health IT and an advisor to the AAN's Practice Management and Technology Committee. will be one of the presenters at the Digital Demos session at the Annual Meeting. He'll provide an overview of the several types of PHRs currently on the market, including those from Internet giants Google and Microsoft.
Other discussion topics will include some of the barriers to adoption of PHRs, ways to integrate PHRs with physician-owned electronic medical records, and the standards and protocols that are developing to exchange health data between providers and patients, including those involved in social media such as PatientsLikeMe, a popular website that specializes in Parkinson's disease, multiple sclerosis, and ALS.
Read a related article: Personal Health Records: Evolution or Revolution?
For more information on the Digital Demos, contact Corinn Sagsveen at csagsveen@aan.com or (651) 695-2810.