We all understand that the production of an adequate medical record is a substantial chore in most offices. Producing an eloquent report of which you can be proud has been an even more daunting task.

Why would a physician want to produce more than a marginal report? There are a large number of reasons.

Better reimbursement from third party payors

Improved ability to withstand a Medicare audit

Better medical care by offering suggested exam studies

Improved relationships with consultants

Better reputation in the medical community

Improved medical-legal documentation

With The Eloquent Physician most physicians should be able to produce a well written and exceptionally complete report for most of their patients in less time that it currently takes to produce a marginal report. Added to that are the significant benefits of immediate availability of the written report and inconsequential or non-existent transcription costs.

The Eloquent Physician is a software program which can be utilized to produce medical records for all patients. It is an overlay based upon the foundation of EloquentlyStated, a database oriented document creation assistant. EloquentlyStated offers two methods of document production: Voice or Keyboard & Mouse. EloquentlyStated and The Eloquent Physician may be used via keyboard or may be voice activated by Dragon NaturallySpeaking Medical Suite.

EloquentlyStated offers database reliability for maintaining patient information. The header information, including Patient Name, Date of Birth, and social security number. needs to be entered only once for each patient. Furthermore, the data content and format is readily modifiable by the physician or Value Added Reseller.

The Eloquent Physician has over 100 document templates to choose from. These templates are the beginning structure of each medical report. After choosing the patient about whom you wish to report, the physician is asked to choose what type of report is desired. Common choices include new patients or follow-up patients. Additionally, there are various hospital reports as well as correspondence with other physicians, attorneys, insurance companies and others.

Each of the document templates is fully editable by the individual physician to suit his/her specific preferences. Additionally, should the physician wish to produce his/her own document templates, this may be accomplished as well. While we're discussing his/her preferences, I'll note that with the use of The Eloquent Physician, one never needs be concerned about this methodology of discourse. This is because the database maintains the sex information of each patient, and will fill in the proper pronoun without any conscious thought on the part of the person producing the report. This is a long winded way of saying we make your life easy.

So far, however, we have only described the features of EloquentlyStated, the base upon which The Eloquent Physician is utilized.

The full power of The Eloquent Physician comes into focus as each of the individual topics is elaborated upon. For instance, when presented with the 'Interval History' portion of the exam, 30 'Insertables' are available to speed the report generation. An example of an Insertable follows:

"(firstName) has not undertaken any physical therapy since (his_her) most recent visit to this office. (he_she) indicates that the reason for failing to perform the therapy is {STATE REASONS FOR NON-ATTENDANCE AT THERAPY}."

Please note that each of the options within the parentheses are properly filled out by the database with this particular patient's information, and thus require no additional effort on the part of the person dictating the report. All phrases in capital letters within braces are individually dictated, typed, or most easily chosen from a default list by mouse, by the person producing the report.

The system has been designed in this fashion to allow for all standard information to be included with relative ease and to allow for all individualized information to be added as appropriate.

You may edit the list of possible default values according to your preferences. Further, and very importantly, you may choose 1 specific default from the list that will be inserted 'by default', when you choose Enter All Defaults.

The process really shines, for instance, in the Physical Examination portion of the report. With over 200 Insertables for the physical examination portion of the report it is anticipated that most standard examination findings will be available. For instance, if examining a wrist, you may choose one insertable for a normal wrist exam or another for a customizable abnormal wrist exam.

"Inspection of the wrists does not reveal any edema, erythema, or scar tissue. (He_She) has no tenderness to palpation over the scaphoid or other carpal bones, or over the distal radius or ulna. No gross instability is present. There is a negative Tinel's sign and Phalen's test bilaterally."

"Upon inspection of the wrists, there is no evidence of trauma, erythema, or edema. There {IS / IS NO} atrophy over the thenar eminence of the {LEFT / RIGHT / LEFT AND RIGHT} hand. There is {NO / MILD / MODERATE / SEVERE} tenderness to palpation over the {DORSAL / VOLAR / ULNAR / RADIAL} surface on the {LEFT / RIGHT / LEFT AND RIGHT}. The patient {HAS / HAS NO} point tenderness over the {LEFT / RIGHT} scaphoid. Peripheral pulses are intact. (he_she) has a {POSITIVE / NEGATIVE} Tinel's Sign over the {LEFT / RIGHT / LEFT AND RIGHT} wrist which describes a tingling sensation in the distal extremity when the volar surface of the wrist at the carpal canal is percussed. This suggests a hyperirritability of the median nerve. There is a {POSITIVE / NEGATIVE} Phalen's Test of the {LEFT / RIGHT / LEFT AND RIGHT} wrist. This test allows the wrist to flex passively compressing the carpal tunnel and median nerve. A positive test occurs when numbness or a tingling sensation is produced in the median distribution of the hand which indicates entrapment of the median nerve."

If the physician prefers, he or she may choose an 'a la carte' method of using Insertables. Thus, for an Orthopedic wrist exam there are insertables available for Tinels' Sign, Phalen's Test, Finklestein's Test, and Allen's Test, as well as for Range of Motion tests, reflexes, sensation and vascular status.

Similarly, Insertables are available for each of the successive topics in each of the document templates. As with the Document Templates, each of Insertables is fully editable. Furthermore, as we are developing the program to be more comprehensive for each of the individual subspecialties of medicine, we offer to produce up to 10 custom made Insertables to each customer's specifications. These will then be included in all future editions of The Eloquent Physician. It is our intention that there will be many thousand Insertables within 1 year from the release of the first edition. All purchasers of The Eloquent Physician will automatically receive free updates as they are produced during the first year. Obviously the Insertables above are for Orthopedics. However, similar Insertables are currently available for Family Medicine. Other specialties are rapidly being developed.

We understand that many physician's do not like 'cookie cutter' reports, and that previous programs which offered similar features were dauntingly difficult to utilize successfully. Voice recognition programs were known to be inaccurate and cumbersome.

The Eloquent Physician was designed by a practicing Orthopedic Surgeon who has been involved with voice recognition software for 5 years. Therefore it was designed to be as intuitive as possible and to allow for as much flexibility as possible. It minimizes significantly the effect of the 2% - 5% error rate which is inherent in current state of the art voice recognition systems.

This is accomplished in a number of unique ways.

First, the large number of Insertables are organized in a methodical fashion and are invisible when they are inappropriate. Thus, when writing scheduling a return office visit appointment only 27 Insertables are available. All others are hidden from view. Moreover, while other programs will have a standard phrase for returning to the office and merely ask you to insert the words '1 day', '1 week', etc., The Eloquent Physician has entirely unique Insertables for each return period. For example:

The Insertable for returning in 1 day is as follows:

"Because of the urgency of this patient's condition, I would like to see (him_her) back in the office tomorrow. I have asked (him_her) to call if there are any problems in the interim."

The Insertable for returning in 2 months is:

"I'd like to see (firstName) here in the office in 2 months. (He_She) has been instructed to make an appointment for 2 months from now. (He_She) was also told that in the event that an earlier appointment is desired, (he_she) need merely call the office and an one will be scheduled."

Second, the Insertables are systematically categorized such that, for instance, when discussing return visits the person dictating first chooses whether the return appointment is in days, weeks or months, and only then are the subcategories such as 1 day, 2 days, 3 days presented.

Of course, should you wish to add additional Insertables offering other wording for returning to the office in 1 day, for instance, this can be easily done. In fact it would be quite easy to produce an entire menu system for different reasons to return in 1 day - such as for routine follow-up, for stitch removal, for wound check, etc. Once these are set up, each Insertable can still be called up as easily as any of the Insertables which ship with the product.

Third, in the event that you dictate extremely repetitive documents, it is quite easy to create your own document templates which contain a substantial amount of 'boiler plate' text already included. While we do not send the package this way, it can very easily be modified so that you can merely edit the finished document with any specific information particular to the patient about whom you are dictating. Most reports which are produced by The Eloquent Physician do not have this 'cookie cutter' feel to them. However, again, if speed is your primary concern, extremely lengthy reports can be produced exceedingly quickly. In fact, in our offices we have produced comprehensive 3 page reports for patients with lumbosacral pain in less than 60 seconds. Yet when reading the report it appears quite personalized.

Fourth, the substantial use of database fields to fill in information such as gender related pronouns, personal names, ages and dates of injury minimizes the number of words required to be spoken to complete any individual report.

Last, the ease of the database entry system, as well as the referral source system, allows all header and footer information to be printed automatically. Thus, footers with your office name and address show up automatically. Similarly, in addition to the patient demographic information such as name, date of birth, etc. which is at the top of the first page, headers show up at the top of all subsequent pages with the patient's name, the date of the exam and the page number.

We readily admit that The Eloquent Physician is not for everyone. For instance, if you insist on dictating your office visit notes in the exam room in front of your patient, this is not a satisfactory solution. If you dictate your office notes in the car on the way home this program will not help. If you are unwilling to sit in front of a computer screen while you dictate or mouse around, you will not be able to effectively use this program. There are standard voice recognition products which we carry which can be used under these circumstances. However, because of the extensive pre-formatting of these reports, users are required to maintain visual contact with the computer screen during the preparation of the report.

If every one of your patients is entirely unique this program will be of only moderate benefit. For instance, if you practice in a university setting or a tertiary referral setting taking care of inordinately complicated patients, you will find that the Insertables, particularly those for History, Assessment and Plan may not assist you very much. Of course the physical examination section as well as the return appointment sections can still be used within the framework of the document templates. However, you will derive less benefit from the program than will most physicians.

If transcription costs you nothing, because your wife is a medical transcriptionist, or because your hospital or office pays all of the costs, you may not wish to take the few weeks that are required to master the use of voice recognition software in conjunction with The Eloquent Physician.

However, if your practice is similar to that of most physicians in that the overwhelming majority of your patients fall into certain patterns, and transcription is a substantial cost to you, this program can drastically simplify one of the most tedious of the medical office tasks.

Please call 1.888.519.3100 for more information.