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Instant Medical History

Patients using Instant Medical History respond to multiple choice questions that branch based on their answers.  Patients perceive a shorter waiting time. Because they are occupied with important information, their medical history, the time spent in the waiting room appears to go by quickly. Busy patients are able to enter their information online before the visit, allowing them to manage their time better. 

What are the benefits of instant medical history?

·         Speeds up the patient interview

·         Reduces data entry

·         Produces additional revenue from treating more patients

·         Improves documentation for coding and audits

·         Focuses patient and physician on the symptoms at the start of the encounter

Positioning instant medical history?

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.

How do I provide patients with access to instant medical history?

There are two typical implementation methods for Instant Medical History:

1.       Waiting room kiosk.  Many practices set up a computer in the waiting room for patients to use Instant Medical History.  The average interview takes less than 15 minutes.

2.       From home.  Practices can also deploy Instant Medical History via their web site.  The patient visits the practice web site, clicks on a link that connects them with Instant Medical History, and completes their questionnaire prior to arriving at the office for their visit.  More information will be available later on this functionality

When is instant medical history useful?

Instant Medical History is useful in 95% of the chief complaints seen by a family physician or internist.  The system includes a relevant questionnaire for 80-90% of the complaints seen by specialists.  Primetime is also able to add questionnaires very quickly for patient complaints that do not have existing questionnaires.  Research studies performed at the University of Wisconsin and Louisiana State University have shown about 85% of patients are able to use Instant Medical History.

Can I customize the questionnaires?

Instant Medical History includes level of detail settings to determine the number of questions and the amount of information collected.  These settings are specific to the types of questions, allowing practices to separately choose the level of detail for family history, history of present illness, review of systems, etc.  The ability to customize the questionnaires is a feature Primetime and MediNotes are working to develop.

Who is responsible for the setup, installation, and user training of instant medical history?

Primetime Medical Software will provide all setup, installation, and training services.  We will help with the interface configuration.

What are the requirements for Instant medical history?

The minimum configuration should be:

• Intel® Celeron® Processor 2.40GHz

• 256 MB Random Access Memory

• 20 GB Hard Drive

• CD-ROM Drive, minimum 16X

• 10/100 MBS Ethernet NIC

• 15” Monitor

• Windows XP Professional

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Use of the Internet version of Instant Medical History also requires an Internet connection at the clinic. 

What if I have additional questions about Instant medical history?

To learn more about Instant Medical History, contact us or call us at 310-877-5824.

(See Sample Report)
 

Questions frequently asked by Physicians

1) What does this software program do for me?

Instant 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 visit.

2) I like to interview the patient myself. Why do I need this?

IMH helps 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 patient visit.

3) How long will it take my patients to complete a computer interview?

The average 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 of information?

Use the 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.

The output 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?

When higher 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?

Literature 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.