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Clinical Documentation Tools: Saving the Doctor-Patient Relationship

Practicing medicine has always been both a science and an art — a delicate blend of data and ongoing discussion. Simply put, the key to diagnosing diseases and preventing future problems often lies in patients’ stories, not just their lab results. Yet, without the right clinical documentation tools, important details can get lost in the shuffle.

Good doctors know conversation improves patient care and satisfaction. Eighty percent say patient relationships are the most satisfying part of practicing medicine, according to research from Nuance Communications. But today’s physicians are busier than ever. Healthcare reform has led to more insured patients and stricter laws around medical documentation. With heavier patient loads and more administrative demands, physicians only spend about 13 percent of their workdays interacting with patients, while the majority of their time is dedicated to documenting patient visits into electronic health records (EHR).

In order to get back to the patients who need them, doctors are looking for ways to become more efficient by using tools that will help reduce the administrative burden that has been placed on them. Restrictive and clunky formats, such as drop-down menus and check boxes, can make documenting the full patient story difficult. This is a big problem, said Jonathon Dreyer, director of cloud and mobile solutions marketing for Nuance’s healthcare division.

“Unless you can capture the richness of a patient’s story, that person becomes a series of unconnected data points,” Dreyer said. “Technology should play a supporting role in healthcare. Patients should be center stage.”

That’s why software companies like Nuance are developing mobile clinical documentation tools that facilitate conversations, not distract from them.

Preserving the Doctor-Patient Relationship

The average doctor’s office visit now lasts 12 minutes, according to Nuance’s study. Forty percent of patients feel rushed in the exam room. Hoping to spend more time with patients, many doctors are multitasking, using desktop and laptops to enter information into EHR during consultations. This lets physicians capture insights while they’re still fresh. However, it also tempts them to look down at screens when they should be looking into patients’ eyes, listening, empathizing and connecting with those who rely on them for both medical and emotional support during tough times.

To help physicians and patients get the most out of their limited time together, Nuance created PowerMic Mobile, a new mobile app that turns smartphones into secure wireless microphones, enabling doctors to dictate, edit and navigate within the EHR simply by speaking.

“Hundreds of thousands of physicians already use voice dictation software through their desktops or laptops, using wired microphones to capture and transcribe patient information,” said Dreyer. “PowerMic Mobile is a cloud-based technology that sends high quality audio from the mobile device, through the medical provider’s desktop clinical speech recognition software, and straight into the EHR as transcribed text. By removing the wired connection — a physical barrier between doctor and patient — they can have more fluid conversations in the exam room. And with voice dictation, patients hear what’s going into their records, so they feel more involved in the process.”

Earlier this year, New Jersey-based Meridian Health rolled out PowerMic Mobile to its physicians. Many staffers already accessed EHR through dedicated workstations with hardwired PowerMic II microphones, but this required them to find available dictation stations and record patient notes after rounds. Now that physicians can access the medical speech recognition software through their smartphones, users are reporting higher productivity and a more flexible workflow. They’re also keeping more thorough records because information can be captured while it’s still fresh in their minds.

Clinical Documentation Tools Get Even Smarter

Along with smartphones and tablets, many physicians now use wearable devices to organize their work and lives, and to deliver connected care for patients. Recognizing this trend, Nuance has collaborated with Samsung to develop a proof-of-concept PowerMic Mobile app for the Samsung Gear S smartwatch. “Especially on smartwatches, where space is premium, voice becomes extremely valuable,” Dreyer said.

Nuance also recently showcased Florence, an intelligent virtual assistant for physicians, on the Samsung Gear S. Revealed at HIMMS in 2015, and received very positively by the visitors to the Samsung booth, this technology provides a series of voice-driven clinical workflows that help physicians record vital signs, interact with patient alerts, document telephone encounters and place medication or lab orders.

“2015 has turned into the year for the Internet of Things and the phenomenon is becoming firmly entrenched in healthcare,” Dreyer said. “We are very excited to leverage our deep experience in this domain and to work with Samsung to bring the power of voice to a new class of documentation tools that bridge conveniences found in clinicians’ personal lives to the healthcare environment.”

To learn more about mobile solutions for healthcare providers, visit Samsung’s Knowledge Center.

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Taylor Mallory Holland

Taylor Mallory Holland is a professional writer with more than 11 years of experience writing about business, technology and healthcare for both media outlets and companies. Taylor is passionate about how mobile technology can reshape the healthcare industry, providing new ways for care providers to connect with patients and streamline workflows. She stays on top of emerging trends and regularly speaks with healthcare industry leaders about the challenges they face and how they innovate using mobile technology. Follow Taylor on Twitter: @TaylorMHoll

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