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Innovation Blog

Blog posts are written by Russell Kohl, MD, FAAFP. Dr. Kohl is the Chief Medical Officer and Chief Operating Officer at TMF Health Quality Institute. He works across the company to support quality improvement efforts, leads the Innovation Team and has served as lead physician for the Comprehensive Primary Care initiative.


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If Only the Tricorder Had a Scribe…

May 3 2017 - Russell Kohl, MD, FAAFP

With everything going on in the world today, it might have been easy to overlook a press release about medical devices from April 12, 2017. The Qualcomm Tricorder XPRIZE competition was won by Final Frontier Medical Devices, who took home $2.5 million for creating a device that turned Star Trek’s Dr. McCoy’s medical tricorder into a real tool. Able to diagnose 13 conditions (and the absence thereof) and capture five real-time vital signs, independent of a health care worker or facility, the devices submitted to the contest were truly amazing in their capabilities. Reading about these devices, I couldn’t help but be reminded of the saying, “The future is already here, it just isn’t evenly distributed.” For me, working with practices across our country has most definitely driven that point home.

In many practices that I observe, physicians serve as some of the highest paid data entry clerks in the country. With a minimum of 11 years of medical training, physicians use half their working time to record documentation. This wasn’t what Star Trek promised us! The procession of Star Trek doctors, from McCoy to the holographic “Doctor,” was never seen spending hours completing charts. Of course, I realize that the Star Trek series is fiction, but I still believe it offers us an insight into what our society recognizes, requires and appreciates within our physicians—which is not their penmanship! The fact that our engineers and innovators have been able to bring the tricorder to life, but still haven’t developed an electronic health record (EHR) interface that lets a provider focus more on actual patient care than documentation, speaks volumes about how difficult a task a change to our current infrastructure truly is.

This difficult infrastructure change can be seen nowhere better than in the utilization of the Medicare Chronic Care Management codes. My experience has demonstrated that the provision of Chronic Care Management services is far more widespread than the billing of them would suggest. The challenge is in the documentation of these services in a manner that supports the billing. We at TMF are just beginning a Special Innovation Project to help practices implement a streamlined documentation approach to capture and bill for the valuable and appropriate services for which many primary care providers are not being paid. As we have these discussions and work across a variety of EHR platforms, I can’t help but find myself wondering if maybe we overlooked a key to the mythical Star Trek medical system beyond the tricorder—auto-documentation. Perhaps that could be our next XPRIZE…

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