Entrada

How Entrada Dramatically Improved Accuracy, Timeliness, and Efficiency of Clinical Documentation, Enabling a Seamless Transition to a Completely Paperless Office.

The Challenge

When Becky Miller, Practice Manager of Premier Orthopaedic, stood in the doorway of her office she was overwhelmed by the dramatic contrast between the highly innovative care the physicians and staff provided patients and the chaotic environment in which much of that care was provided. The office was in disarray as were the documentation management procedures that led to mountains of incomplete charts on administrators’ desks and weeks  of recorded physicians’ notes tucked away on mislabeled cassettes.

In addition to the physical disorder, the office lagged precariously behind on its patient documentation. Unprecedented patient volumes and disjointed documentation processes combined to create a six-week backlog which seriously delayed billing, all while the office was spending more than  ever on medical record documentation.

Miller knew the situation needed to be remedied with a move to an electronic system, but her staff and team of physicians could not afford the loss in productivity that she knew would accompany the implementation of an electronic medical record (EMR) system. While she dreamed of an office free of incomplete charts and loose-leaf notes replaced with an integrated system and current documentation, she knew the hoped-for gains in quality and cost containment would not follow quickly.

She needed a way to quickly restore order by getting current on documentation while painlessly initiating the shift to an electronic system.

An Immediate Fix

At the suggestion of a colleague, Miller approached Entrada for help with the overwhelming backlog of transcriptions. Within two weeks, Entrada had completely eliminated the backlog  with an average turnaround of four hours for new dictations.

A Long Term Solution

With order restored, Miller and Entrada turned their focus to initiating the transition  to a paperless office by introducing digital record keeping to the physicians and staff.

Eliminates barriers to EMR adoption
The Entrada solution was the logical first step in the clinic’s evolution to a complete electronic health record system. It automatically built a library of digital records, which were then routed to the patient’s electronic record once the practice implemented the Allscripts Electronic Medical Record system a few months after employing the Entrada solution.   

Plus, the intuitive design and ease-of-use enabled the physicians to get comfortable with using an electronic system, which helped pave the way for the eventual adoption of the Allscripts EMR. The physicians feel the Entrada system mimics their current work process and tasks by allowing them to continue dictating while easing them into an electronic, automated process. 

Complete front-end integration drastically reduces errors and saves time
 Via front-end integration, Entrada automatically imports patient demographics from the clinic’s Allscripts Practice Management system into a provider work list, which is prepared daily and updated in real time. The work list records all the patients scheduled for a visit each day, along with jobs for any letter or other related tasks. The physicians then simply click on  a job to begin dictating their notes for the patient visit. They do not have to enter any patient demographics or personal identifying information. This front-end integration saves time for the physician on each dictation and ensures finished jobs are never returned unidentified.

Integration and automation enables the elimination of three FTEs, saving over $120,000 annually
Completed jobs are now automatically routed to the correct patient file via full back-end integration with the clinic’s new EMR. This end-to-end integration has drastically reduced  the need for human intervention, dramatically cutting personnel needs. 

The integration coupled with the accuracy of the completed jobs has enabled Premier Orthopaedic to eliminate three full-time positions and reallocate the time of another  staff member, saving the practice $120,000 annually in personnel expenses.  

Drastically Reduced A/R Days Outstanding
The extremely quick turnaround for completed jobs has resulted in the physicians’ notes being added to the patients’ records without delay. This has had a positive impact on cash flow as  it has enabled bills to go out almost immediately versus up to several weeks after the visit.  The practice has seen a dramatic reduction in A/R days outstanding and a much more seamless relationship with the administrative office as Miller and her staff are no longer chasing down notes at the eleventh hour at the urgent request of the billing department.

Designed for Physicians’ Current Workflow
Because the Entrada platform is so easy to use, Miller reports that physicians have integrated dictation into their daily routine, and that many have shifted to dictating after each patient visit because it is easy and quick.  She estimates that Entrada has reduced dictation and review time for her physicians by at least 25 percent, freeing them to see patients and enabling them to better keep pace with the increased patient volumes.

A Solution for a Whole New World

The Entrada platform has proved to be a game-changing solution for Premier Orthopaedic, not only improving the accuracy and turnaround time of dictation but also enabling a smooth transition to a completely paperless office. 

“It’s been the most valuable change we’ve made since I’ve been with Premier, and that’s been four years,” Miller says. “It just got us out of the dark ages and into a whole new world.”