The tech team at Eagle's Landing has just recently completed first round testing for their new EMR-lite product, eNotes. "We hoped to save the docs some time and money without sacrificing the quality of their documentation. We did this—it was even better than we'd predicted," says Elisa Comer, who had the idea for eNotes three years ago.

The management team at Eagle's Landing, while being experts at transcription, realized that new service options would be required as the nation moves to an electronic healthcare age. One kink was that many of their physicians would still need to dictate, a direct contradiction to what most template-driven EMR companies promise. But the biggest problem was seeing that quality was often sacrificed when a documentation expert, such as a transcriptionist, was removed from the picture. "It's next to impossible to force complex medical information into rigid templates," says Comer. "Many times, if it doesn't fit and the needed phrases aren't in the pick lists, then it's just not documented. This compromises the totality of the encounter documentation. As in nursing school...not charted, not done." The Eagle's Landing team decided that rather than turning their backs on technology in favor of transcription only, they would embrace technology and leave transcription a viable option, offering their clients a choice.

"We understand the documentation cycle so well because we have clinical experience on our team," says Comer. "We've taken care of patients, and we know that simply automating a paper process will not work. Someone has to stand in the gap and keep an eye on quality. That's where we come in."

The task was huge; provide template-based options without sacrificing quality. Tommy Foskey, lead software developer, has taken the project further with regard to functionality and security. "We wanted to give the doctors something they would use. If it doesn't do what they need it to do, they won't use it. If they don't actually use it, then we've really not helped them much. And, of course, it has to be secure. We want to make sure it's rock solid in that regard. Those were two areas we absolutely could not compromise on."

Beginning in March of this year, Eagle's Landing worked with two physicians to develop the charting protocol for orthopaedics. The transcription team identified dictation areas that could be considered for a template-based protocol, like procedure notes and surgical follow-ups. The development team took it from there, working with the physicians on exact phraseology. Keeping the transcription team in the loop has protected quality and appearance of the documented notes. Cyndy Woodall, Eagle's Landing Operations Director, oversees the transcription process. She adds, "Taking the documentation specialist out of the EMR loop just lends itself to errors in the documentation. We have decided to take a different approach, so that the documents are as correct as they would be if they were transcribed. In the end, our goal is to have a reader who cannot determine whether one of our notes was transcribed or if it was templated. I must say, these notes look really good and have passed all our quality metrics that we use for transcription."

After a 3-month trial, the numbers told the story. The physicians used eNotes about 27% of the time for their postop notes almost exclusively. These notes were processed at less than half the cost of regular transcription, and quality metrics met or exceeded the 98% accuracy required for transcription. Turnaround time was all but eliminated, given that the notes are available at the time of creation. The physicians reported that they did, indeed, save time, and one physician even reported that he gets to leave the office at a decent time now to attend his child's ball games. Interfacing into the practice management system was not a problem, and was completed along with the transcribed notes without a hitch.

"I would definitely call this a success," says Comer. "I have believed in our idea for years, and it's nice to finally see it coming to fruition. Our physicians believe in us and they trust us to take care of them. It's great to feel like we have made a difference for them and their patients."

eNotes, the EMR-lite option from Eagle's Landing, will be available in January of 2007. (Click on thumbnail at right for a sample.) It is a perfect solution for partnering templated notes with dictation needs, saving time and money for physicians and their staff. Rather than huge up front EMR costs, there is a small template charge and the pricing model is a pay-as-you-go protocol, done at a fraction of the cost of transcription. "When I looked at the numbers," says Comer, "I saw that the savings for the physician outweighed their cost for the month. That means we made a huge difference in their costs, and that means we met our goals."

If you would like more information on eNotes or if you would like an online demo, please contact us at 866-928-3587, or via our website.