A physician rapid workflow platform based on keywords. It is designed by MDs for maximum ease of use and rapid access. Phrasefire quickly shows information that admitting MDs would commonly refer to during the admission process. These include user-defined assessment/plans, notes on meds, studies, reminders on compliance initiatives. These are presented rapidly and shared easily across hospitals. EMR agnostic. The user saves on time and error.
When the patient comes into the hospital with some sort of ailment. It is up to the doctor to discover the reason why you are ill and the best therapy to fix it. That is the assessment and plan.
During the 1st peak of the covid19 pandemic one of our medical centers had a shortage of hospitalists to treat the volume of patients in need of admission. Psychiatrists, pediatricians, orthopedic surgeons and others volunteered to help. They made use of paper templates with sample assessment+plans for covid PNA and lives were saved.
Our hospitalist department created the paper templates based on the typical covid admission workflow for these doctors to use under supervision. The doctor shortage was ameliorated here because of them.
This experience highlighted for us the opportunities of a workflow platform specific to physicians. The sharing process could have been streamlined and improved with an online platform. Our Phrasefire platform would allow the sharing of assessment+plans more efficiently and electronically. There are many benefits that we have identified in testing--reduced typing, reduced physician error, and burnout. Improved compliance with hospital initiatives.
1st, save assessment/plan templates from other users or type your own. There are good general templates for common admission diagnoses shared on the platform, however they are not recommendations on treatment of a specific patient. You must make the medical decisions and documentation as the MD. Only licensed MDs or med students/NPs/PAs under supervision of MDs are allowed to use the platform. Trigger these A/Ps and attached info by use of simple keywords (sob, chf, etc.) into the dashboard text field. Save various reminders with the plan--document sepsis diagnoses and fluid administration timing, abx timeout, curb65, NIH stroke scale, etc, also treatments, links to EBM. Note making and information recall becomes easier and less error prone.
Assessment/plans are easily shareable within the Phrasefire community. Attendings can easily share admission A/P templates with their resident/intern teams. MDs can easily share across EMRs and around the world. Hospitalists working multiple hospitals can access their medical knowledge info at all facilities.
Studies show that doctors now spend more time typing into the EMR than interviewing our patients. This imbalance highlights the large amount of tasks asked of MDs in interacting with the EMR and hospital systems. This does lead to fatigue and burnout. Phrasefire can help.
https://www.medscape.com/viewarticle/868421
Yes, according to this study (and there are others) doctors now use 55% of time in the EMR, only 27% of the time with our patients. https://www.acpjournals.org/doi/10.7326/M16-0961?articleid=2546704
Forbes summarizes it well.
https://www.forbes.com/sites/brucelee/2020/01/13/electronic-health-records-here-is-how-much-time-doctors-are-spending-with-them/?sh=2f3865a35172
In early testing we have seen over 20 minutes saved per 10 patients admitted or seen in clinic. Assuming 7 on/ 7 off hospitalist schedule and 182 day work year this equates to 3905 minutes = 65 hours = 2.7 days/year
According to this study, medical error could be prevalent enough to be the third highest cause of death in the U.S.
Medical errors are an under-reported and under-recognized cause of death.
https://www.hopkinsmedicine.org/news/media/releases/study_suggests_medical_errors_now_third_leading_cause_of_death_in_the_us
The website works with mobile devices, but is optimized for desktop use. That is where the bulk of our admission workflow is done in the hospital.
Patient sensitive data is NOT allowed onto our system. We instruct users to input generalized information, non Patient Health Information (PHI) only. Our team reviews this and any user violating this policy is removed from the platform.
Users are encouraged to save EBM articles directly in the assessment/plan. Reminders, notes, treatment considerations are good candidates for this.
By having evidence-based medicine articles directly linked to the assessment/plan as well as the ability for the attending to set specific plans for top diagnoses, it is likely that there will be an end or at least a reduction in the practice of “pimping” that is unfortunately known all to well within the medical training community.
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