PALABRA: THE SOFTWARE ONCOLOGISTS ACTUALLY LOVE CASE STUDY CONTRIBUTORS Dr. Stephen Z. Sack, MD, Radiation Oncologist Tyleen A. Smith, BSN, RN, Clinical Manager Dr. Charles Stewart, MD, PhD, Radiation Oncologist Saint Francis Cancer Center Combines MOSAIQ, Epic and Palabra for a Perfect Documentation Workflow
Our doctors were on board right away especially when they saw how Palabra could help them do far more than Dragon alone. Palabra had all the features required to meet our needs. Tyleen A. Smith, BSN, RN, Clinical Manager, Saint Francis Cancer Center ABOUT LOCATIONS The Saint Francis Cancer Center, also known as Natalie Warren Bryant Cancer Center, is part of the Saint Francis Health System. It is located in Tulsa, Oklahoma, and has provided state-of-the-art medical oncology and radiotherapy technology since 1975 and is accredited by the American College of Surgeons as a Comprehensive Community Cancer Program. PATIENT DEMOGRAPHICS Comprehensive community cancer center with largest patient concentration in breast, digestive and respiratory cancers Over 2000 patients treated annually TECHNOLOGY PROFILE Elekta MOSAIQ with Palabra for all clinical documentation Epic electronic medical record for additional hospital/administrative tasks CUSTOMER TESTIMONIAL 2
Overview As part of a larger technology upgrade, Saint Francis Health System decided to phase out all paid transcriptionists leaving its cancer center s radiation oncologists in a tough spot when it came to completing clinical documentation. Fortunately, on the recommendation of a technology consultant, the clinic deployed Palabra and has revolutionized its clinical documentation processes while enabling the use of both MOSAIQ and the hospital s Epic EMR. Since implementation, Palabra has streamlined workflow to save physicians hours of time and effort every day. In addition, by eliminating the cost of transcription entirely, the center was able to hire a new front desk administrator to further improve productivity. CASE STUDY When its parent hospital decided to go fully paperless in 2016, the Saint Francis Cancer Center knew it was headed toward the conclusion of a massive technological undertaking. A few years earlier, the hospital had deployed Epic as its general electronic medical record and had since been encouraging its departments to move away from transcription and toward Dragon for voice-dictated data entry into the new system. Now, the hospital was taking the final step and eliminating all paid transcriptionists. There was no turning back. Yet while the goal of this move was to better equip the hospital for a changing technological world, there were still a few troublesome side effects for Dr. Stephen Sack and Dr. Charles Stewart, the cancer center s radiation oncologists. Epic and MOSAIQ: Looking for Balance Whereas many of the hospital s administrative, scheduling, medical and billing functions now took place through the Epic platform, Dr. Sack and Dr. Stewart preferred to rely on a different system Elekta MOSAIQ for their patient information, treatment plans, and clinical documentation. That s because MOSAIQ uniquely meets the needs of radiation oncologists and provides countless functions that a general-purpose information system like Epic cannot adequately perform. CUSTOMER TESTIMONIAL 3
Up until the final push to go paperless, Dr. Sack and Dr. Stewart had followed a relatively standard protocol for creating documentation. After patient encounters, they would dictate notes using a recording device. The recordings would go off to their in-house transcriptionist, who would transcribe the audio into a clinical note. The note would route back to the doctor, who would make corrections and then continue the process of entering the documentation into MOSAIQ and submitting it for approval. At the same time, the transcriptionist would essentially copy and paste every note into Epic, so it was accessible there as well. The process was lengthy and tedious, but it worked so long as they had a transcriptionist. With transcription phased out, however, the doctors knew they would have no simple way to get documentation started, let alone into any of the information systems at play. Using Dragon, as the hospital suggested, would automatically transcribe speech to text but to the radiation oncologists, that was merely providing voice assistance and little else. Palabra Answers Every Need With transcription phased out the doctors knew they would have no simple way to get documentation started, let alone into any of the information systems at play The cancer center needed an efficient tool that would replace its lost transcriptionist while going beyond the basic capabilities of Dragon. If the doctors were going to go paperless and become truly efficient, they wanted to do it right. As such, the site had several important criteria: First and foremost, the radiation oncologists had to be willing and able to use the system. That meant it would need to be incredibly easy to navigate, and doctors would need to be immediately productive with the tool so as not to waste time or effort. It would also need to be extremely accurate, with personalized templates capable of producing high-quality notes. There could be no compromise to care and no frustration on the part of the doctors. It would have to work the way they wanted it to, for every kind of note. Finally, it would need to function well as part of their larger technology system. The tool would need to integrate deeply with MOSAIQ, so the doctors could expand their use of the system, while not interfering with the hospital s use of Epic. To help sort through the changes and find the right software, the management team at Saint Francis brought in a technology consultant, who quickly recommended Palabra as a solution to the department s documentation concerns. Tyleen Smith, the site s clinical manager, was instantly intrigued. CUSTOMER TESTIMONIAL 4
Our consultant told us that Palabra worked with MOSAIQ and could help our doctors with more than just dictation, Smith recalls. When the folks from PalabraApps came to our site, they showed us personally how easy the software is to use and everything it can do. That sealed the deal. Our doctors were on board right away especially when they saw how Palabra could help them do far more than Dragon alone. Palabra had all the features required to meet our needs. Teamwork and Innovation Makes for a Fast, Easy Deployment Implementation and training with Palabra went very smoothly, according to Smith. The team from PalabraApps came on site and, over a three-day period, worked closely with the radiation oncologists and the IT team to deploy the system and completely train all users. Palabra implementation staff worked with both doctors to personalize their templates and customize their Favorite commands, all tailored to their specific documentation preferences and needs. To address the issue of bridging the hospital s Epic platform with the doctors preferred MOSAIQ system, the IT team at Saint Francis developed several interfaces that would automatically feed the physicians documentation from Palabra and MOSAIQ into Epic as needed. Additionally, Palabra implementation staff worked with both doctors to personalize their templates and customize their Favorite commands, all tailored to their specific documentation preferences and needs. Palabra Enhances Documentation in MOSAIQ, without Compromising Use of Epic In implementing Palabra, Saint Francis Cancer Center gained a supercharged clinical documentation system that exceeded all expectations. The days of dictation and transcription are completely gone. In fact, documentation with Palabra is so fast and intuitive that the doctors can make even better use of MOSAIQ, without limitations. And thanks to the new interfaces, all the physicians documentation using Palabra including consult notes, follow-up notes, CUSTOMER TESTIMONIAL 5
on-treatment visit notes and more now flows automatically into Epic, with no manual intervention required. As such, the radiation oncologists are happy because they get to document in the system that meets their needs, while other physicians, as well as coders and billers, can see the cancer clinic s documentation without accessing MOSAIQ. And no one has to manually retype or force data from one platform into another, like they did before. Smith says she knows how pleased the doctors are with the new software because she sees them using it constantly. On any given day, they re using their Palabra templates for consults and follow-ups, she says. Powerful Templates and Magic Snip Features Make Doctors More Efficient Another important benefit is that Palabra templates can automatically pull information into the note from the nursing assessments so doctors don t have to spend time dictating or typing it in anymore, explains Smith. They can literally just load up a template as they walk between rooms and start reviewing information pulled in from the nursing note before they open the next patient s door. But Palabra doesn t stop with nursing assessments. In fact, the radiation oncologists can design their templates to automatically populate with virtually any information from MOSAIQ, as soon as they open the note. Consequently, doctors arrive to patient encounters faster and armed with a more complete understanding of everything from the patient s history and treatment progress to current health concerns such as pain levels. Our doctors love that the Palabra templates are so highly customizable, Smith states. Doctors can clip and paste an image of exactly what they re treating When things like that can be pulled into every note so easily, it s really just an incredible time savings for them. Tyleen A. Smith, BSN, RN, Clinical Manager, Saint Francis Cancer Center Palabra also leverages Magic Snip features to simplify the process of adding non-text elements into documentation, so notes can be more complete for everyone who views them with little time and effort expended by the radiation oncologists. For example, explains Smith, doctors can clip and paste an image of exactly where they re treating, so if a patient complains of a sore throat to another physician, they can see that we re irradiating the chest, and the patient shouldn t really have any issues with the throat. When things like that can be pulled into every note so easily, it s really just an incredible time savings for them. CUSTOMER TESTIMONIAL 6
Palabra Makes Life Easier with MOSAIQ and Epic As the Saint Francis Cancer Center has settled into its new paperless workflow, both of the clinic s radiation oncologists are extremely happy with how Palabra has made their work and their lives easier. In addition to saving hours of time each week, the clinic has eliminated its entire transcription cost while elevating its overall productivity. We were able to redirect the money saved and hire another front desk employee. She now helps handle referrals, phone calls and the day-to-day things that were really bogging down my other two people, Smith recounts. Smith also says the clinic is looking at adding in new products, such as Palabra Teleport, to further streamline documentation and improve efficiency. Palabra Teleport acts like a print driver, where everyone in the clinic can import just about anything from any source into MOSAIQ with just a few clicks. That s important to Saint Francis Cancer Center because the clinic still sees a fair number of patients outside the system. When we obtain outside medical records, like pathology, surgical records or imaging studies, we have to import all those PDF files into MOSAIQ so our physicians can have access, she says. We d definitely be interested in adding more functionality to simplify that process, she says. About Palabra Palabra is a supercharged clinical documentation system that delivers incredible efficiency through a perfect combination of voice, automation and personalized, super-powerful templates. About PalabraApps PalabraApps writes beautiful software that you can use to create high quality documents and elegant workflows without effort. We care about efficiency, precision, patient care and optimal results. Overall, Smith believes that working with Palabra has been a great experience. Even if we have a support issue, she says, there s no calling and waiting on hold for someone. With Palabra, we just email them. They re very quick to respond and work well with our IT department. I m very impressed. Smith also advises other cancer centers to make the move to Palabra even if they also use Epic. Palabra is such a huge time savings for the physicians, she stresses. Just keep your IT team in the loop, make a clear case for the features you need with your administrators, and create those interfaces between MOSAIQ and Epic for automatic feed of data. It s very doable and well worth it. Our doctors love their Palabra, and they can t imagine working without it anymore. palabraapps.com CUSTOMER TESTIMONIAL 7