Doctors want to maximize revenue, cut costs. IMH
is a great way to see more patients and have the documentation
to increase reimbursement on patients
Doctors want to take best possible care of
patients. Want an EMR to improve quality. IMH is a way to
increase the information available to make a diagnosis. Osler’s
rule applies: 85% the time, a good history makes the diagnosis
Doctors want to be a person in addition to a
doctor. An EMR helps control their time, get them home. IMH
enables “point of care” documentation, so there’s no
documentation to do at the end of the day.
When is instant medical history useful?
minimum configuration should be:
Celeron® Processor 2.40GHz
256 MB Random Access Memory
20 GB Hard Drive
10/100 MBS Ethernet NIC
Windows XP Professional
(See Sample Report)
frequently asked by Physicians
1) What does this software program do for me?
Medical History™ (IMH) is a computerized patient interview about
the history of present illness, review of systems, and medical
history. IMH asks the patient questions to give the physician
more information prior to the visit. The information is
summarized and passed to Charting Plus, reducing the interview
time and documentation requirements for the physician. An AAFP
article shows it could save 5 minutes of physician time per
2) I like to interview the patient myself. Why do I need
with the doctor-patient relationship and the medical interview.
This software program simply gathers data. Data gathering
enhances doctor-patient communication by giving the physician
more information before seeing the patient to better evaluate
the problems. Physicians will still interview the patient to
get a personal feel for the individual. The software simply
helps start the process by giving the physician areas to focus
upon, and providing documentation of the negatives. Not many
physicians can remember all of the questions to ask about every
presenting complaint in medicine much less document them
thoroughly for third party review. Another helpful use it to
save the physicians from having to find paper forms for
standardized self rating scales and scoring them during the
3) How long will it take my patients to complete a computer
interview takes less than 15 minutes, but keep in mind that
patient entered data is free. It is patient time instead of
physician time. New patients may take longer, as the system
gathers family history and past medical history.
4) I don't usually gather the volume of information that
Instant Medical History™ provides. How do I handle that amount
Level of Detail settings to reduce the amount of information.
Learning to review the information presented by Instant Medical
History™ takes some time. After that, the assimilation of the
history of the present illness takes only a few seconds.
of Instant Medical History™ is absolutely essential if
physicians are going to be paid for their work. Only by
documenting to the highest levels will they be paid for the work
they actually do by third parties. Since the information from
Instant Medical History™ is gathered directly from the patient,
its authenticity is unquestioned by third-parties once reviewed
by the physician.
5) How does documentation by IMH affect my charges?
levels of care are rendered, higher fees are justified. The
higher levels require the extensive documentation which IMH
provides. For example, documentation of a majority of the
qualifiers of a symptom range from onset, duration, severity,
location, radiation, ameliorating factors, exacerbating factors,
and social concomitants. Documentation of a Review of Systems
requires notation of eleven of fourteen organ systems.
6) Why don't I just use a piece of paper and let the patient
fill out the questions?
on filling out forms versus computer interviewing is over 50
years old. If you go to the Mayo Clinic Proceedings January
2003, there is a review of the literature. It cites the
disadvantages of forms as (1) Patients do not complete the form
without skipping questions. The problem the clinician faces is
that if the form is not filled out completely the clinician is
responsible for ensuring that this is corrected. Mayo found
only a very small percentage of forms were complete. (2) Forms
do not branch enough. There is an excellent study showing how
Mayo failed trying to use forms to prepare patients for
specialties (3) Forms also have difficulties with changes. For
example, if there is a SARS epidemic you need to add four
questions to your histories. The American Family Physician in
one year had 44 forms to help clinicians practice better by
providing more data. IMH updates the questions each quarter to
stay up-to-date on medical practice.
7) What am I really going to get out of this program?
You may find
it easier to be a physician because a boring, monotonous part of
your job is done - data gathering and documentation. When you
gain confidence in IMH, you will find your efficiency of seeing
patients increases because you have an electronic assistant that
makes your job easier. This electronic assistant will ask
questions as consistently at 4PM on Fridays when the waiting
room is full as it does at 8AM on Mondays after you return from
a vacation. More
importantly Instant Medical History™ will help you have the
documentation recorded in your medical record to charge for the
services that you are performing
8) How will my patients feel about the computer?
LSU and the
University of Wisconsin have both published studies indicating
that almost 90% of patients want to complete Instant Medical
History. When you focus on patient satisfaction, communication
is the top issue. Because the questionnaires are about them,
patients perceive that the computer assists physicians in
discussing the most important items. Within the limited time of
a visit, physicians and patients communicate faster about the
important issues, creating a stronger physician-patient bond.
Practices using Instant Medical History find that their patient
satisfaction increases from this.