The concept of a DRT-enabled EHR is simple. Physicians would be allowed to continue to dictate their findings and clinical assessments in their own words, but the transcribed output would be entered directly into the EHR as discreet recordable data. Using this methodology, physicians would not have to change the way they practice medicine or the manner in which they interact with patients. Instead of reviewing a paper chart, the physician reviews electronic clinical data that have been created via the aforementioned data entry methods (eg, data conversions, data interfaces, data entered by the patient or nurse, and ICE) before entering the room with the patient and then follow their usual workflow. The physician talks with the patient, performs the required physical examination, and then discusses their clinical interpretation and treatment plan as per their usual protocol.

After the physician dictates their findings, they plant it directly into the EHR as an electronic wave file, which would be transmitted to a local or remote transcriptionist for electronic transcription. Since 63% of the typical transcription is already gathered electronically via the various data collection methodologies, the cost for the creation of the final note is cut by more than 50%-an average of $6,000 annually per physician who has elected dictation over handwritten notes. More importantly, the transcription comes back into the EHR as discreet clinical findings, thereby improving clinical documentation, coding, and outcomes. A DRT-enabled EHR allows physicians who have elected to dictate in the past to continue this practice while cutting their transcription costs in half and generating a clinical note via the EHR.

Two companies that are pioneering DRT-enabled EHRs are CureMD and McKesson Practice Partner. Both of these companies have embraced the concept of extracting discreet clinical data from dictations. Using this novel method of data entry, physicians can use an EHR without having to perform any data entry. Although the concept of a DRT-enabled EHR is quite new, numerous physician focus groups have shown that a high percentage of physicians (87%) are extremely interested in the DRT-enabled EHR concept; thus, it may be an answer to boosting adoption rates. Regardless, if the EHR marketplace is not revolutionized by 2012, we might still be looking at EHR adoption rates of less than 20% across the nation.

Mark R. Anderson
AC Group

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