Introducing the OpNote Consultants: Dr. John Mattson

While creating our surgical reporting product, the OpNote, we at mTuitive have been working with many highly skilled surgeons.  These surgeons are from a diverse group of specialties and backgrounds and help to shape the future and efficacy of the OpNote.  We’re introducing these consultants to all of you in the coming weeks.

Dr. John Mattson is an orthopedic surgeon who specializes in knee arthroscopy, ligament reconstruction and sports medicine.  Operating out of Berkeley, CA, Dr. Mattson is both a member of the staff of Alta Bates Summit Medical Center as well as working with his own private practice – the Berkeley Orthopaedic Medical Group, Inc.

Dr. Mattson graduated from Northwestern University in Evanston, Illinois and completed his medical and Orthopaedic training at the University of Michigan in Ann Arbor.  Dr. Mattson joined Berkeley Orthopaedics in 1983 and was Chairman of Orthopaedics at the Student Health Service of the University of California at Berkeley from 1990-2004. Dr. Mattson is a member of the clinical faculty at the University of California San Francisco Medical Center.

Dr. Mattson specializes in knee arthroscopy and Anterior Cruciate Ligament Reconstruction. He uses minimally invasive state-of-the-art arthroscopic allografts (donor grafts) for ACL Reconstructions. Dr. Mattson has one of the largest series of soft tissue allograft ACL Reconstructions in Northern California.

How did you get interested in medicine/surgery?  Why orthopedic surgery?

I became interested in a surgical career as both my father and uncle were surgeons and I strove to emulate them.

I was fortunate to be accepted to the University of Michigan medical school where I graduated in 1972. While in medical school, students rotate among various clinical services and are introduced to both the nature of the specialty and to the personalities who were attracted to that particular specialty.

I was immediately drawn to Orthopedic Surgery as I enjoyed both the nature of the specialty and the individuals who were residents. It seemed a comfortable fit.

I’m sure you’ve been approached by other Health IT organizations before.  What about mTuitive – or the OpNote product itself – did you find appealing?  What got you interested in working with us to develop the OpNote?

Number one – I’m sort of a computer nerd and drawn to innovative advances using technology.

(Laughs)

And I like the idea of being able to create an operative report that is complete and comprehensive in a very rapid and efficient way.   I review a number of medical legal reports, both for the medical association and for various attorneys, and have been struck by the disorganization and deficiencies of non-standardized dictations.  Basic information about the procedures done are often missing or incomplete. In working with OpNote, it became apparent that a complete, standardized report could be generated in a rapid and intuitive manner.

With all of the talk about EHRs, electronic reporting and Health IT – spurned on by government initiatives and funding – what do you hope is actually accomplished with this push?  What do you think of the current Health IT scene?

Larger systems are all transitioning to EMRs – like Kaiser, for example.  Because they have the capital to do that.  Our hospital is gradually making the transition but it is awkward and thus far incomplete. I doubt that any cost efficiencies have been realized to date.

[My office doesn’t] intend to put in an electronic system now for a couple of reasons.  The initial capital outlay is substantial and there is no standard available to be assured of buying a system with long term viability.

Medicare is approaching EMRs in a haphazard manner with small carrots available for electronic Prescription Drug usage and eventual penalties for not utilizing EMRs. The timetable of the transition does not even come into effect until 2012 to 2014 and standards have yet to be determined.

The Joint Commission provides some standards & requirements for operative reports – Medicare has some as well, other bureaucracies have their own pre-requisites.  But there is no definitive, or universal, list stating, “this is what has to be included in an operative report” for all physicians.  What do you think about developing standardization in reporting?

I’m very much in favor of standardization.  I think it’s really important to document the exact procedure performed with built in coding and the important details of how the procedure was done and to include all relevant details.  Our hospital does have certain requirements – such as identifying the patient, the surgeon, the procedure performed, pre- & postoperative diagnoses, anesthesiologist, type of anesthesia used, whether tissue was sent to pathology.  But it really has no standard at all as far as describing the operation itself.

I currently could dictate an incomplete operative report in thirty seconds which would include all the required details but be unclear about the exact nature of the procedure.

I’m very much in favor of the standardized electronic report such as the OpNote.  I think it’s great and will certainly be very cost effective.

Do you have any horror stories of billing, coding, transcription – or just times when that process has caused you problems in the past?

I have seen examples of operative reports in which I had no idea what was actually done and others that describe details which were not, in fact, accurate. Many transcriptions leave blanks in the report if the transcriptionist cannot understand the terms used – which results in confusing and incomplete reports. I regularly have to fill in the blanks in my current dictations.  OpNote eliminates all those variables and leaves no blanks or inconsistencies. I believe that most surgeons would actually enjoy completing an efficient and intuitive report with minimal time required and producing an immediate product for both medical records and billing purposes.

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