The last session in this afternoon's adventure is a discussion of how OCR was used to populate an EMR.
It's a good talk.
He reviews how a paper template can be used to provide decision support and improve the quality of data entry.
They developed the concpt of "adaptive turnaround documents."
Aftern the patient checks in, a form is generated (based on a patient questionnaire that the patient fills out – and patient demographics) that the nurse and then the physician will fill out. So the clinical staff get a custom developed form that helps them focus on issues that the rules engine thinks are important.
So the kid with asthma gets a different form from the adult with diabetes.
- Patient checks in
- Patient gets the survey
- Nurse gets the patient (with the form)
- Nurse gets the form and scans it into the "Digital Sender" (HP4101mfp) and the device e-mails the scanned image to the OCR server.
- System reads the form and determines it slevel of confidence about each item.
- The system then creates a form based on the inputs from the patient survey
They did a fairily thorough of QA and observation of how the system worked from a workflow standpoint. Research findings:
- 224 forms completed in a 6 day study period
- 98% or so were completed
- 98% were accurately scanned
- It took 25 seconds to generate the form
- 43% of the forms required some correction
- The software prompted the nurse for corrections and/or confirmation – the average was about 1 .4 fields per form.
- This took about 10 seconds per form.
Here's the punch line .. they can now alert the doc to clincial problems. The doc is prompted: "John has a BMI of 12 – you may want to consider malnutrition."
Interesting. He's got other thoughts about faxing forms to teachers for ADHD evaluation, etc. Cool. Medical Informatics with paper.