By Ronald Vender, MD, Chief Medical Officer, Yale Medicine & Lisa Stump, Senior Vice President, Yale New Haven Health; Chief Information Officer, Yale School of Medicine
As outlined in a message earlier this year from Dr. Taheri and Dean Alpern, we have been implementing several technology initiatives to promote physician well-being, generate time savings, and allow physicians to spend more of their time focusing on patient care.
Over 1,500 clinicians are now using M*Modal in their practices and in the hospitals. M*Modal allows for voice recognition along with the ability to capture discrete data via natural language processing. Experiences to date demonstrate a significant reduction in time to complete and close encounters (by about one-half), and a reduction in the total time spent documenting. Some physicians have described it as “life-changing,” a remarkable reflection on the impact of this tool.
We have streamlined access to M*Modal by replacing the purple “SmartTalk” icon that you have been using for speech-recognition/dictation (M*Modal Fluency Direct) with the regular, Epic PRD white icon, which has been enabled for dictation. You will see the picture of a microphone on the icon to designate that speech recognition has been activated.
In addition, YM is now piloting the use of “virtual scribes” for physicians. The pilots are designed to help us better understand how the use of a virtual scribe impacts physician and support staff workflow, the quality of the patient interaction, and medical documentation. We have initiated pilots in several distinct practice areas. These clinical delivery sites were chosen by a working group of physicians who also helped craft the study design to best assess the relevant outcomes associated with these pilots. Operationally, the virtual scribe leverages a desktop portable microphone and Epic access. The trained medical scribe will listen in during the patient visit and assist the physician with chart navigation and data retrieval and display, perform chart documentation, and enter and pend non-medication orders. While it is very early in our pilot process, we are learning a considerable amount about our workflows and provider behavior. Over the next several months we’ll be reporting out on our assessment of this new technology.
In addition to voice recognition and virtual scribes, we are offering other improvements to make your work less frustrating. For example, as recently approved by the YM Board, Yale Medicine is purchasing phones equipped with Mobile Heartbeat (which streamlines care team communication) for all clinical faculty. Other initiatives being implemented include Tap and Go technology (to make it easier to sign in to Epic), EMR Optimization (to enhance specialty-specific and referral workflows), and the integration and automation of controlled substances prescribing and monitoring. All Yale Medicine physicians now have access to the state information repository for controlled substances embedded in the prescribing workflow in Epic. This saves physicians time, enhances workflow in Epic, and saves you from having to remember yet another password. There also is an embedded tool for evaluating risk for potential abuse/overdose of controlled substances by patients.
See an infographic showing the schedule and the progress-to-date for rolling out new technology initiatives for physicians.