Abstract

The HITECH incentive program, legislated within the American Reinvestment and Recovery Act (ARRA), subsidizes physicians’ and hospitals’ adoption of certified electronic health record (EHR) systems. Through a combination of new regulations and financial incentives, HITECH has developed a strategy to stimulate EHR adoption with physicians and hospitals still using paper records. The method by which healthcare providers become eligible for these financial incentives is referred to as ‘Meaningful Use’, signifying that the EHRs are being used in proscribed, effective ways according to published criteria.Meaningful Use criteria details the tasks and functionalities that must be offered within any certified EHR, but the criteria does not clarify one of the most important aspects of the entire process — how to facilitate physician transition from older, manual clinical documentation to the adoption and use of EHRs. While the structured data and narrative text so highly sought after within EHRs is essential for continuous record use and reporting, it dramatically slows down the physician because current input processes disrupt the physician’s natural workflow. While Meaningful Use has accelerated the transition from older, manual medical record systems for many providers, it is also meeting resistance from many physicians who are rightly concerned about the productivity loss associated with adopting an EHR. It is unrealistic to expect a high rate of EHR adoption if it requires changing physicians’ current behavior by requiring them to exclusively enter into form fields, check boxes, and drop-down menus to create structured data and narrative text.  Capturing both structured data and narrative text is critical to deriving the benefits of electronic records. Thus new processes that can leverage emerging technologies, without disrupting the physician’s natural workflow, are essential for protecting productivity while also achieving Meaningful Use. For specialists in particular, dictation is still one of the most commonly utilized forms of documentation in medicine today.

Why We Call Entrada the ‘Expressway to Meaningful Use’

Entrada’s solution provides an ‘expressway’ to Meaningful Use, which facilitates rapid physician adoption of an EHR system without the once inevitable decline in productivity.  Entrada’s technologies and services allow physicians to continue their familiar practice of dictating while ensuring they meet the criteria for Meaningful Use.  Entrada combines state-of-the-art digital dictation capture with voice processing and editing services to produce narrative text that can automatically be returned into the physician’s existing EHR system. The ease and efficiency of the Entrada solution has proven to accelerate physician adoption of EHRs, while ensuring regulatory reporting requirements are met. The Entrada Desktop™ and Entrada Mobile™ platforms also produce more comprehensive and higher quality patient data. Since physicians tend to document more clearly and with more detail when verbally dictating, providers capture a deeper understanding and context of the patient than could be achieved with pre-assigned checkboxes, illegible handwriting, or hurried typing into text fields. Entrada’s solution enables physicians to efficiently document with the specificity and attention to detail that ultimately leads to an improvement in patient safety and care.

Entrada Desktop™ & Entrada Mobile™ Voice Capture

ENTRADA SUPPORTS THE FOLLOWING MOBILE DEVICES:

• iPhone, iPad, and iPod Touch
• Microsoft Windows Mobile

Dictation has been tethered to the telephone for years. However, given the explosion of mobile devices managed by sophisticated operating systems, the question naturally arises as to how to leverage this new technology.Entrada Desktop™ and Entrada Mobile™ sync with a provider’s existing practice management software to build the physician’s active work list, pre-populated with their patient’s demographic information and organized by ‘job type’ (e.g. Office Visits, Surgery, Consultation, etc.). Through a simple, natural user interface on their computer or mobile device, physicians can securely use this list to capture high quality voice dictation files. Then, with a tap of a finger, these voice files are processed, edited, and then tagged with essential, searchable data that facilitates EHR data capture. Also, if a patient cancels an appointment, the physician’s work list updates in real time on all of his devices, providing a significant benefit to the physician and ultimately enhancing the clinical workflow.

Entrada’s Suite of Technologies and Services

Three Levels of EHR Integration

Entrada has created three levels of integration that automate the capture and flow of data and documents into customers’ EHR systems. Customers can use the levels in a progressive manner as a migration path to physician adoption or start at any level that conforms to their EHR roll-out strategy. Level 1: Traditional Narrative Report Sent to an EHR Based Encounter Level 1 enables clinical documentation that was dictated and completed with Entrada Desktop™ or Entrada Mobile™ to be returned into either a patient encounter within an EHR or into a field location. This allows for the creation of a typical report managed as a document within the EHR, which can be used for collaboration with other healthcare providers through Entrada’s ExpressShare™ technology or through health information exchanges. Use of captured dictation along with Level 1 transcribed report integration is natural to physicians and helps facilitate EHR adoption (a necessity for achieving Meaningful Use) because very little behavior or process changes are required from the physician to accomplish the integration.

Level 2:  ExpressNote™ voice capture directly into varied EHR Locations (occurs outside the EHR)

Level 2 starts with augmented dictation capture utilizing Entrada’s ExpressNote™ template driven dictation.  Templates guide the dictation process, allowing for multiple tagged fields to be sent as narrative text directly into corresponding, predefined text fields within the EHR. For example, input fields, such as History of Present Illness, Impression, Plan, and Procedure Notes, can be templated within Entrada’s easy-to-use digital interface. These templated fields are dictated within Entrada Desktop™ or Entrada Mobile™ and then voice processed and edited via ExpressEdit™ by either the client or Entrada’s own staff of professional editors. Next, the edited and transcribed reports are returned to the appropriate sections within the customer’s EHR. The creation of ‘tagged fields’ from physician dictations, which are inserted directly into text fields within your EHR, produces the type of narrative text that can be queried and reported upon and that meet the increasingly demanding Stage II and III Meaningful Use criteria. Entrada’s products are unique in their capability to create reportable, narrative text from physician dictations. Furthermore, the entire process can be facilitated from Entrada Mobile™, allowing the use of a mobile device to input data directly into text fields within the EHR, all without the physician having to be logged into the EHR. This level of integration and mobility is an innovation in information technology previously unachieved within the healthcare industry. Not only does the integration between dictation and EHRs sustain a physician’s natural workflow, it also enables providers to efficiently capture narrative text co-mingled with the structured data on which EHR systems increasingly rely.

Level 3: ExpressCapture™ Narrative Text into Narrative Text (occurs within the EHR)

Entrada’s ExpressCapture™ technology features web controls that are embedded within the EHR so that, wherever narrative text needs to be captured, the physician can quickly dictate a note, while Entrada does the heavy lifting of text creation.  Physicians’ dictations stream from the EHR to Entrada’s data center, where it is first converted to text via voice recognition software and then sent for further editing by either client or Entrada staff.  Text strings are then placed into their correct locations within the EHR. The benefits are obvious. Any clinician who dictates can work within the EHR with much less typing, accelerating EHR adoption while increasing the likelihood of achieving Meaningful Use. Analysis of future Meaningful Use criteria reveals that both ExpressNote™ and ExpressCapture™, along with the other Entrada products and services, will continue to be useable throughout Stage III of the program, as Entrada uniquely produces narrative text from dictation.

Entrada’s ExpressSign™ and ExpressShare™ Enable Increased Mobility and Distribution

Entrada streamlines the clinical documentation process, taking dictated notes and turning them into electronic files that you can easily access or incorporate into your EHR or distribute to other facilities.

Once the dictation has been processed and returned, physicians have the ability to view, edit, approve, and electronically sign the documentation from anywhere in the world through a web-connected device using Entrada’s ExpressSign™ technology. As soon as the documentation is completed, copies are automatically delivered to all requested facilities via Entrada’s ExpressShare™ technology, accelerating both chart completion time and revenue cycles.

MyEntrada™ Offers Unique Capabilities to Enhance EHR Meaningful Use

Complimenting Entrada’s robust set of technologies and services is MyEntrada™, a secure online portal where physicians can access, review, and sign their clinical documentation via Entrada’s ExpressSign™ electronic signature technology.  Because MyEntrada™ can be accessed from any web-connected computer or tablet, facilities have a tremendous amount of flexibility to complete charting remotely.

Entrada’s Expressway To Meaningful Use Productivity

Allowing physicians, particularly specialists, to continue with the familiar process of dictation is crucial to gaining widespread acceptance of an EHR that will achieve Meaningful Use and thus receive HITECH incentive funding. Entrada’s key technologies, combined with world class, cost competitive voice processing and editing services, accelerate EHR adoption while also protecting physician productivity. Entrada offers unrivaled flexibility and choice when deploying an EHR by giving physicians and facilities the ability to choose from a set of options for capturing narrative text. Instead of plodding through a difficult and painful EHR implementation process that will likely result in a productivity loss for care providers, Entrada offers a simple, efficient ‘Expressway to Meaningful Use’, ultimately resulting in an easier, quicker incentive reimbursement.

About Entrada

Entrada provides the next generation of clinical documentation and data distribution, creating an expressway for future EHR adoption and making existing systems more physician-friendly. We replace traditional dictation and transcription with an automated voice processing application, giving physicians a simple, fast, and more affordable way to continue dictating while they migrate to or use electronic health records, with no loss in productivity. Entrada enables organizations pursuing a health modernization strategy to meet Meaningful Use criteria.Entrada’s applications are available on iPhone®, iPad™, Windows® Mobile and PC platforms, saving time and money for doctors who don’t want to be slowed down using keyboards, pick lists, or desktop voice recognition systems.

FOR MORE INFORMATION, CONTACT:

Entrada, Inc.
109 Westpark Drive
Suite 480
Brentwood, TN 37027