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"You have turned my life around"
 

I am 87 years old, with a problem of the prostate gland. Before I met Dr. Baum, I went to the bathroom every 30-60 minutes. After Dr. Baum's treatment on my prostate, I go only 5 times per day and only 1 time at night! You turned my life around. I am so very grateful!

-Sidney Daigle


I want to thank you for your due diligence. You saved my life. I highly recommend you!

-Dwight Bastian


Thank you Dr. Baum! Because of you I'm back in the "rodeo"!

-Gerald Wallace

 


Reprinted with permission from Dialogue Medical, 1-800-482-7963.

The challenge of health care today is to improve clinical outcomes, increase access to the healthcare system, and reducing the spiraling cost of delivering our services. Medicine has made progress by changing the way we practice. But implanting change is a challenge to most innovators, researchers and entrepreneurs. The status quo consists of sustaining innovation where medical devices, pharmaceutical companies and even leading physicians accept the methods, treatments, and technologies that are currently in place and make an effort to enhance them by providing better service, improving the product by developing newer version of the same technology, medications, or devices. A disruptive innovation is usually a radically different approach to a problem that is simpler than a sustaining technology, is less costly, and solves the problem to the patient's benefit.

There are numerous examples in medicine and especially in urology of disruptive technologies. These include ESWL and percutaneous nephrolithotomy as a new approach to kidney stones. Today laparoscopy is a disruptive technology to management of so many urologic conditions and is slowly replacing the scalpel as a treatment option from adrenalectomy to radical prostatectomy. New technologies such as bladder tumor antigen (BTA) are also being introduced to replace cystoscopy as a method of monitoring bladder tumors.

Also new technologies are on the horizon to change the way we work in our offices and even the way we interact with patents. Examples of e-healthcare include interacting with patients through the Internet. We can now answer patients' questions, provide prescription refills, and allow patients to schedule appointments with our practices though E Mail. This gives patients access to our practices twenty fours hours a day, seven days a weeks (247). The paperless office was once a pipe dream and is now slowly being a reality and the patient's chart will soon go the way of the ledger card in the very near future. Using handheld personal digital assistants (PDAs), we can send patients' prescriptions to pharmacies when the doctor is at the point of care with the patient.

Another disruptive technology is the use of the computer to replace the operative note. At the present time a urologist must use hisher precious time to dictate an operative note, which then takes 7-14 days for the transcriptionist to type the operative note and place it into the physician's box in medical records to sign before the bill can processed to the insurance company. This is a loss of hundreds of thousands of dollars to a hospital each year. The doctor or hisher office must provide the patient with post-operative instructions and then create a letter to the referring physician letting himher know the outcome of the surgery since few medical records departments can be counted on to have a copy of the operative note on the desk of the referring physician in a timely fashion. If images are taken during endoscopy, laparoscopy or using the ultrasound machine, they often don't end up in the doctor's office chart and are seldom attached to the operative note even in the patient's hospital record. (Figure 1 is an operative note from a TURBT) Also, there are often delays and mistakes made in applying the proper ICD-9 code to the CPT code. Again, there is a loss of time for the medical records or your office to contact you to revise codes that do not meet the proper criteria for accurate coding. This also represents a loss of revenue for the doctor and the hospital when inaccurate codes are used or there are rejections for improper coding and delays are costly as the insurance company is holding your money while you are correcting the codes and resubmitting them to the payor.

Computers are now available to take the place of the Dictaphone, the transcriptionist and the coder to provide an operative note, a letter to the referring physician, patient instructions, and include images from fluoroscopy, endocoscopy, or the ultrasound machine. All of this can be done in seconds at the point of care, that is, right in the operating room and have all of the notes printed for the chart, the patient, the referring physician, your office and the business office of the hospital even before the patient reaches the recovery room. These notes contain an electronic signature that does not require additional reading and signing before they can be submitted to the insurance company or before the hospital can process the bill. These operative notes provide accurate documentation of the appropriate ICD-9 and appropriate CPT codes that can go immediately to the billing office so that a "clean claim" can be submitted the same day the procedure was performed. Just the savings on the reducing the transcription costs, which are approximately $15,000year for one, busy urologist, can more than make up for the cost of the program.

This disruptive technology for computerized operative notes is available from cMoreMedical. Other disruptive technologies include: 1) Greenway Medical is an electronic medical records program that also contains a practice management system. Now there is no double entry to create a record from the PMS program to the EMR. 2) CompuMedic provides an electronic billing program that "cleans" the claims submitted to Medicare and Medicaid using Microsoft Windows platform. 3) MD Logic offers an electronic coding advisor to assist the physician in recommending the proper E and M management code for each patient visit. 4) MedicWare is offering an EMR for the Palm Pilot and will soon allow access to patients charts from anywhere, anytime.

These are just a few examples of disruptive technologies and how they can impact your practice. So now you can not only expect disruptive technology in the clinical way you practice medicine but also in the way you conduct the business of your practice.