Transcript

Micro-Practice Versus Multi-Million Dollar Enterprise

Dr. S. Moore: Behind me, are a bank of terminals that give us access to the vital sign information.

Woman: Okay, this is the patient’s live feed. They’ve just returned from the operating room from open-heart surgery. These first two lines is their EKG

Dr. S. Moore: We have the ability to access labs, our pharmaceuticals that we’re giving to the patients, have an ability to zoom in with cameras that are in the room in order to look at settings on monitors and settings on I.V. pumps that are delivering medications.

Woman: And this is real time. This is what’s happening to the patient now.

Man: When the bedside nurse decides she needs help, all she has to do is hit a button on the wall within the hospital or the patient’s room, and we are available to camera in and assess the patient.

Dr. S. Moore: I think the patient really gets an opportunity to have an extra pair of eyes looking at their case.

Woman: When the patient’s vital signs exceed or go below this baseline, it sends us an alert. Yellow are cautionary, and reds are the ones we need to respond to.

Dr. Betadpur: I can give you instances where we have intervened and made a big difference in patient outcome, especially in complicated cases -  of a patient who has had an acute bleed and we were there to pick up on that, or was in impending respiratory, and we were able to assess that. And for the provider, it certainly is satisfying to be able to be at the bedside, virtually be at the bedside, within 15 seconds of being called.

Nurse Kules: One day, I received an alert on my sentry alert screen for a patient whose oxygen was decreasing. I went into the room by live feed and found out it was even lower and that he was in severe respiratory distress. And within a minute, the nurse responded to the bedside, was able to clear his airway by suctioning and his oxygen went back up to 100%.

Dr. Geoly: I manage my kidney transplant patients. So in the morning, when I’m in my office, I log in to INOVA, and all the transplant data is online. So if I want to see a lab test on a patient from 1995, I can see that. Over the years, we’ve added different functionalities so that in the year 2000, we added transcription. So I can see any transcriptions -  histories and physicals, discharge summaries, operative notes, anatomic pathology and it’s eminently accessible down to x-rays at the primary care physician’s desk. All they need is an Internet connection. All the physicians at INOVA have is INOVA data. We haven’t quite worked out the protocol to bring in data from outside sources into INOVA’s database, if we do that at all.

Dr. Moore: You’ve got my e-mail already?

Woman: I’ve got your e-mail at home, yeah.

Dr. Moore: As a business model, this practice works because the information technology allows me to work with a lower staffing ratio. Therefore, the overhead’s down, so I don’t have to drive the productivity to a number of visits, the throughput that most practices need to make payroll. In many practices unfortunately, this drive for productivity to make ends meet, to pay the overhead and have a reasonable take-home, is a painful pressure.

What we have in the converse now is doctors who are thrilled at what they do, enjoying it immensely, as I am in my practice. That’s been just a huge turnaround for me.

Dr. Moore: I mean, if that’s a potent steroid, then the risk for you...

Dr. Moore: My practice is very small. I’m able to deliver same-day access, hand out my cell phone number, use electronic systems for reliability and outreach. People remark to me all the time about how little they have to wait around, how quickly they can get in...

Dr. Moore: Do you want to do 10:00?

Woman: Yep, that’s good.

Dr. Moore: How pleased they are that I share information with them, look things up on the Internet.

Dr. Moore: By the way, do you ever go on here and take a look at this?

Woman: The only thing that’s bothering me is when I cough.

Dr. Moore: I can come to work after I drop my daughter off at 9:00 and get home by 5:30 and be there with my kids and family. So I have a sustainable practice. I’m delivering the care at the level that I always hoped to in terms of the quality and the relationship.

Woman: (Thanks.)

Dr. Moore: (See you.)

Woman: (Bye-bye.)