Guest Columnist
Digital Pen and Paper Technology: An Alternative to Conventional EHR Note-Taking
By
Apr 11, 2011 - 9:34:21 AM

(HealthNewsDigest.com) - Healthcare continues to be an environment where paper is still the key medium for capturing information. Today, 80 percent of physicians still rely on traditional pen and paper to capture patient information. The HITECH Act, part of the 2009 economic stimulus package aims at inducing more physicians to adopt electronic health records (EHR). The act promises maximum incentive payments for Medicaid to those who adopt and use "certified” EHRs. Doctors who do not adopt an EHR by 2015 will be penalized 1% of Medicare payments, increasing to 3% over 3 years.

With the switch from paper to digital records continuing to gain national attention and increased acceptance in healthcare, a growing number of healthcare professionals are under pressure to find a way to make the transition, while at the same time not introducing new technologies that will require a lot of capital, training and operational costs.

Some have turned to tablet computing or laptops; however these solutions can be too complicated or too cumbersome because of the challenges associated with complex equipment, training, and support. Healthcare professionals are looking to find new ways to fill the gap around actually getting the data into the system and in digital form.

There is a simple solution gaining momentum within this industry – digital pen and paper technology. The benefits include cost savings, time savings, improved patient care and an easy migration path to electronic records. And because it's based on paper forms, this method of digitizing data avoids big workflow interruptions, training, and intrusion into the doctor/patient communication.

How it Works

Digital pen and paper is exactly what it sounds like – a mobile data capture solution in which the user device behaves like an ordinary pen, but actually “reads” handwriting and translates it into computer-readable code.

The software prints a subtle pattern of barely visible black dots onto the background of every form. To the naked eye, that dot pattern looks like shading on the form. But the digital pen reads the dots to determine which form is being completed and how to store the information. The system collects information at the point of service by allowing the organization's existing paper patient care forms to be converted and used as digital forms. Each user's written pen strokes are uploaded electronically to the provider’s computer system -- and selected handwriting instantly becomes text entries in the database to support research, tracking and accountability.

Once a doctor or nurse has completed a patient assessment form, for example, the pen data can be transferred instantly to a mobile phone or laptop – using Bluetooth® or a docking cradle – and then forwarded on to a central server. By eliminating the need to type up case notes electronically after a visit, digital pen and paper avoids duplication, increases accuracy and reduces the amount of time spent on administrative tasks.

Other benefits of digital pen and paper technology include:

o Digital pen and paper technology is much cheaper compared to other solutions such as laptops and tablets and requires minimal user training.

o Since the pen data is immediately available, reports and test results can be validated and, if necessary, acted on immediately.

o As details of patient visits are recorded simultaneously in both written and electronic form, a paper copy of the record can be retained alongside the digital copy. It can serve as a backup, to meet regulatory requirements or to keep patients and their families informed of the treatment provided.

o The system supports security and compliance requirements by ensuring that all stroke data remains encrypted throughout the workflow until it is decrypted by the Anoto Decryption Module (ADM).

Cost Savings and Benefits

Based on industry data, initial training time for a laptop system averages 60 hours per user, whereas initial training for the digital pen only takes 2 hours. Plus, the added efficiency enables the organization to serve more patients per day without adding resources, creating a direct positive impact on the bottom line. Another advantage of the pen is that it’s small and mobile. And, unlike laptops, it doesn’t interfere with the interaction between the patient and the clinician. The pen doesn’t have a user interface that a clinician can get lost in, taking his or her attention away from the patients.

Case Study: Speeding up Primary Care Patient Registration in Florida

Florida-based Brandon Healthcare has been seeing primary care patients for 30 years. Until recently, when patients arrived at the doctor’s office, they were asked either to complete new patient paperwork or to update their existing paper records. The nurse would then document vital signs and patient complaints on paper, to which the doctor would add handwritten notes about the patient’s condition and treatment.

With the implementation of Rover Technology Fusion’s digital pen and paper solution, it is now much easier and faster to document each patient’s complaint and treatment. As front office personnel no longer need to spend valuable time manually entering patient data, new patient registration now takes less than two minutes, compared with up to 18 minutes previously. An additional 10–12 patients can be seen every day by each doctor, while medical records can be digitized and kept more up-to-date and errors reduced.

Conclusion

When introducing EHR technology to healthcare, the first consideration, after ensuring quality of patient care, should be the needs of the end-users and their work processes. Often a relatively simple solution, such as digital pen and paper, can yield better results than more ‘sophisticated’ solutions that users find hard to get along with. That said, it is critical to take a holistic approach: only when the front-end technology can be tightly integrated with records databases and other systems can it deliver the greatest benefits.

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