iPads help USF take the 'hate' out of electronic physician documentation

By Neil Versel
04:51 am
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Dr HoyteiPads might not be ideal for all medical practice settings, but Dr. Lennox Hoyte, CMIO and director of urogynecolgy of the University of South Florida (USF) Morsani College of Medicine in Tampa, believes they are a lot better than desktop computers in exam rooms or at the patient's bedside.

"We're moving toward 95 percent of physician activity going away from the desktop," Hoyte said.

According to Hoyte, desktop PCs force physicians to look away from patients as they enter data, making patients feel like their doctors are not paying attention. Traditional PCs placed just outside the hospital room also slow practitioners down, forcing them to write down vitals and other necessary documentation on paper, then go elsewhere to enter the same information into an electronic medical health record.

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Hoyte, who also serves as medical director for female pelvic medicine and reconstructive surgery at Tampa General Hospital, said physicians take just as long to see a patient as they do to enter data. "That's 50 percent inefficiency right there."

This hassle is exactly why physicians resist switching from paper to electronic records, according to Hoyte. "The only way to get people to do something new is to give them something they didn't have before," Hoyte said.

Many legacy EMRs found in major hospitals were designed for data storage and data access, with data entry a secondary consideration, and often are merely electronic representations of paper charts, with no real benefits beyond simplifying access.

"Getting data out is why people like EMRs," Hoyte said. "The pin in the tail feathers is getting data in."

Hoyte said he uses four different EMRs at his various practice locations, including his office and at multiple hospitals where he has privileges. "The love/hate is the same at all," he said. "I love getting data out. I hate putting data in."

Hoyte, who spoke to MobiHealthNews at last week's Allscripts Client Experience users' meeting in Chicago, has served as a user consultant to the vendor, helping refine the newly released Allscripts Wand 2.0 iPad app. Allscripts representatives said Hoyte insisted the company add direct photo capture from the iPad's camera into to the Wand app.

Prior to the update, it was a "convoluted process" for clinicians in dermatology and reconstructive plastic surgery at USF to get photos from a phone or a digital camera into the patient's medical record in, according to Hoyte. Now, they can not only capture images right from the app, but also history and physical with a customized questionnaire and templates for documentation.

"The goal is when you walk out of the patient's room, you're done with your documentation," Hoyte said, and he believes the updated app allows this. He said medical assistants in the two departments save 6 minutes per patient by being able to capture patient vitals on an iPad rather than writing down values and later keying the data into a computer.

USF also is testing the app for documenting surgical procedures, and soon will try it in general pediatrics and general internal medicine, he added. "The goal is to build the small number of templates they need so they can get their work done," Hoyte said.

"Eighty percent of what I do is predictable," Hoyte added. For those routine cases, he can build documentation through templates. Only "exceptional things" should require the physician to type or dictate notes.

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