Allscripts – Stanley Crane

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Stanley Crane shows Dr. Eric Fishman what’s new at Allscripts

Category: Allscripts, Featured, HIMSS11
Date: March 9, 2011
Views:14,100 views

Dr. Eric Fishman: This is Eric Fishman and we have the pleasure of speaking with Stanley Crane, Chief Innovation Officer of Allscripts, and as usual, Stanley has a lot to tell us, and quite a number of gadgets. So, Stanley, let’s get started. What are you going to show us first?

Stanley Crane: Well, thanks. It’s a pleasure to be here today. So, one of the things that we are working on pretty much all day everyday, 24 hours a day, is we work on how do we go from where we are which is a system that really relies on your memory, which then gets translated to paper, which then goes into a file folder, which then will help the doctor and eventually get it back to you when you need it so that they can make a critical medical decision about you and your audience. So, what we are trying to do is we are transforming. What you see here, the excitement in our group today is really all about the transformation to move from paper to electronic and what that’s going to get. Now, as a patient, what does this mean for me, what’s in it for me? So, the first thing you will see is a device that looks something like this. Always do that backward. This is like a thumb reader. So, put your hand right here, and what this guy is doing is he is reading the veins in your hand to understand who you are. So, it’s like a fingerprint reader. It’s actually more accurate than a fingerprint reader.

Dr. Eric Fishman: Does it know who I am now?

Stanley Crane: It knows who you are. This is how a patient would check in. This is how we could then register you as a person going to the doctor.

Dr. Eric Fishman: So, the patient would have their demographics on the screen. They would do this once to register themselves in the system the first time and after that each subsequent time that is their check-in process.

Stanley Crane: That’s their check-in process. Now we know who you are. You didn’t touch anything here. So, there is not a sanitary issue and then while I have done it I don’t like that ‘laser in the eye’ thing.

Stanley Crane: Exactly – “it’s okay. Don’t worry about it. Welcome to our practice.” Now, while you are here, we have this new intake form we would like you to fill up.

Dr. Eric Fishman: This would be a Shareable Ink.

Stanley Crane: This is Shareable Ink. This is a digital pen. There is a little camera right there that raises the dot pattern here and this dot pattern is a pattern that you can actually print a piece of paper the size of Texas and it would know exactly where you are within the nearest thousandth of an inch. So, as you are a patient, you can check things and – of course, we are not really going to do it here – you can fill in the blank, you can confirm the medication. It will even do handwriting recognition. It is recording not only the stroke but also the order. So, a Capital ‘B’ and an ‘a’ looked alike but you don’t make them alike so we would know this is a Capital ‘B’ and not an ‘a’.

Dr. Eric Fishman: So, this can turn handwriting into data, as I understand.

Stanley Crane: Handwriting into discrete data. So, as a physician, “18-month Well-Baby check, here is your form. You check, check, check” and now that data flows into the EHR.

Dr. Eric Fishman: I thought the ‘check, check, check’ is old news. That could be data a long time ago. The handwriting is, I think, more impressive.

Stanley Crane: You can write prescription that way. If I want to write my regular amoxicillin, I can check mark it and write the electronic prescription which would then be verified with drug interaction check to make sure it’s the same prescription and then we send it off to the local pharmacy.

Dr. Eric Fishman: Do you find a lot of physician acceptance with this?

Stanley Crane: We are just rolling this out.

Dr. Eric Fishman: Okay. Very good.

Stanley Crane: How do you get started? If you are with Allscripts, how do you get started? This could be a way that you would transition to use it. We watch your patterns of how you view things and then when you launch the EHR in electronic form, then you get to see even more.

Dr. Eric Fishman: More gadgets. This one I have seen.

Stanley Crane: You have seen this one. This is your classic iPad. So, I want to show you the new thing which has a code name and not the real name and as soon as Marketing tells me a different name, I will use it.

Stanley Crane: This is the Wombat. So, here we are, here is your patient schedule. Would you like to do the demo? Pick a patient. The green ones are the more interesting ones. Well, you can pick whichever you want.

Ann <> – so, here is her records. The key to <> is right here. Touch ‘medications’. So, it expands – we are revealing in layers. We will show you little bits and then little bits and continue to show more and more information deeper into. So, here is the information you may need at a high level. You want to drill down? Here is how you drill down. Touch the plus signs. I want to write a prescription for methadone and just continue. So, my allergy medication from a year ago, let’s try it again because it worked a year ago and now it’s allergy season again. How do I get it back? So, that’s how you write a prescription.

If I wanted to discontinue all med, the red minus sign. If I want to change the sig, change the dose, I click the green ‘Rx’. They don’t work yet, but that’s the process where you build this, show it to physicians to get feedbacks, react to the feedback, build it again, show it again, validate it and continue. Notice there is no button in here for entered in error.

Dr. Eric Fishman: Does that happen a lot in your practice?

Stanley Crane: If it does, maybe when you did something different. I want to show you the other cool parts. So, one of the things I am excited about is physical exam, one of the most complicated thesis. So, I am going to pick a template. I am going to say “this is a cardiovascular detailed examination.” So, here is “normal”. I have already checked all the normal buttons. So, I could drill into ‘head and neck’ and pick something and check a few more check boxes, changes the text up here or I could go up here and I can change the check boxes right up here. It makes it really easier for you to document that physical exam which is one of the most complicated parts. How do you record what’s going on with that particular patient?

Let’s do the extra creative part of the assignment. One of the suggestions that I made when I was talking to you earlier was the idea of how do we escape the keyboard and mouse? How come your alternative is you want a battery or not; laptop or desktop or tablet PC? How come those are your choices? That’s not a very wide range of choices. If Volkswagen has a wider range, why can’t we have a wider range? How do we get to collect the data from you that allow you to implement a plan for a particular patient?

Dr. Eric Fishman: Okay.

Stanley Crane: Another cool thing – two fingers, sideways. Flips that page over to show you here is what’s going on with the patient, here is what they are going to order. So, they have already ordered a hemoglobin A1c, you don’t need to order it again; it’s already there – so, a quick reminder.

Medications – notice that it just turns it right over. I needed to be on that side with this microphone – amoxicillin 30 tablets q.i.d., 2 refills. Now, you type “I know you are not supposed to refill.” The idea is…and what is it that’s doing that? We have a voice recognition engine in the iPad that’s actually doing that voice recognition on your behalf so that we are capturing structured data from spoken voice.

Dr. Eric Fishman: Which voice recognition engine? Is it…

Stanley Crane: <> they call it M-Modal <>. They are specialist in doing just medical stuff. So, that’s the transcription. So, you are trying to tell me where you are going, how about you just take it out on the map? Now, I didn’t type ‘search’, I didn’t type ‘CBS’, I didn’t type ‘Walgreens’. So, that’s <>. This is in-office, what do you do with your EHR most of the time and things like <>. When will doctors be <> and <>?

Dr. Eric Fishman: Okay.

Stanley Crane: Okay, next guy. So, there is a theme here. The theme is how do we get information from you and how do we get information to you.

This is actually a Dell Streak which is an android phone. So, patient Myrtle Jones just called. Myrtle’s got chest pains and, as you can tell, she has got a number of very serious problems. I am going to pick an emergency room. Myrtle called at 3 o’clock in the morning while you were on the train, wherever you are, you have your Smartphone with you – you look up your patient, you see what they are doing, you pick it, you type a message to the emergency room doctor, you send that message electronically to that emergency room so when Myrtle gets there her records are ready for her, so they take better care of her. So, we see this especially in OB-GYN clinics, babies coming early before they had a chance to send the records over. Here is how they could do it while they are driving and they will be able to send their waiting form.

Dr. Eric Fishman: Now, Allscripts has been showing me mobility applications that look pretty similar to that for over a year. Does this have the new bell and whistle?

Stanley Crane: There is a new version that has ‘chart capture’ built into it. Under what circumstances are you practicing medicine outside the office? What are you doing? That’s what Allscripts Remote is for. It’s not practicing…oh, I guess that is practicing. That I am not sure…

So, we did a couple of things. First of all, what happens when you are on call – “I want to write prescription”. I want to send the information to the emergency room.” The thing that was missing was hospitals. So, your patient went to see the orthopedist. He did a complex procedure. Now, you are rounding. So, in addition to our Allscripts Remote product is this mobility thing and what this guy does is it allows you to pull up your rounding list to drop your charges directly against that patient and have him go into the normal billing process. So, you don’t forget anything because you did the work, you might as well get paid for it.

Dr. Eric Fishman: It’s fun being you, huh?.

Stanley Crane: Oh, I have a great time.

Dr. Eric Fishman: It’s fun doing what you do.

Stanley Crane: I suspect your job is a pretty fun job as well.

Dr. Eric Fishman: I like it.

Stanley Crane: What we are doing is very important work. This is moving our industry and the healthcare that my family and your family receive, moving it to the direction that we would like it to be moved into. So, I love my job.

Dr. Eric Fishman: Stanley, it was fun.

Stanley Crane: Always.

Dr. Eric Fishman: Eric Fishman talking with Stanley Crane, Chief Innovation Officer of Allscripts. We are in Orlando where Disney is held and Chief Innovation Officer sounds like an appropriate moniker for this community. Thanks.

Stanley Crane: Thank you.

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