Introducing the OpNote Consultants: Dr. Deanna Attai Part 1 of 2

February 18, 2010 at 10:30 am 1 comment

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. Deanna Attai is an accomplished breast surgeon certified in General Surgery by the American Board of Surgeons in 1997.  Dr. Attai is also a Fellow of the American College of Surgeons, certified in Breast Ultrasound and is an instructor in Breast Ultrasound Education for the American College of Surgeons.  She is affiliated with Providence St. Joseph Medical Center in Burbank, CA and runs the Center for Breast Care, Inc.  For more information on Dr. Attai, the Center for Breast Care, Inc. and breast health awareness, please visit her website.  Dr. Attai and I recently spoke over the phone regarding her background in surgery, interest in electronic reporting and why it is so important for surgeon to be aware of medical coding.

How did you get your interest in medicine?

My dad is a surgeon, my mom is a nurse – I guess I was always exposed to it.  I was good in science, I liked science, and I think it was assumed I’d go to med school and…I did!

And why breast surgery in particular?

I trained in general surgery and did a general surgery residency.  I practiced general surgery for 9 years.  I’ve been in several different practices.  Each time I wound up with about 50-60% of my practice being breast surgery (which is not uncommon in general surgery).

And as I was leaving my last practice and getting ready to go out on my own, I started looking into ultrasound. That seemed like it would make a lot of sense with the breast part of my practice going forward.  And then as that got busier, I just really said, “you know – I really don’t want to do the other stuff. I really want to focus just on breast.”

It just seemed like a natural progression of things; it was never a conscious decision.  My practice evolved that way and my own interest just evolved that way.

More on Dr. Attai’s background, views on coding and electronic reporting after jump!

Did your liberal arts education at Vassar College help inform your view and experience in medicine?

I didn’t take as much advantage of the “liberal arts” as I should have.  I was probably the only one – you went there?

Yup – graduated in ’04.

Yeah, so I was probably THE only one who didn’t take that Art History class – like Art History 101.  I was more science focused – that’s just how my brain works.  Now I wish I’d taken more advantage of it, obviously.  But I’m probably one of the least well-rounded liberal arts graduates out of there.

But I liked it – I got a good education there.  It certainly wasn’t an issue as far as preparing for medical school, or anything like that.

How did you find/hear about mTuitive or OpNote?

I think John [Murphy, CEO of mTuitive] found me.  I’m on LinkedIn, and I think through the American College of Surgeons group – I got an email from him through that.

We emailed back and forth a couple of times, and chatted a couple of times.  First time I talked to him and we were going through the product and I noticed they were really stuck on trying to fit the OpNote format into the CPT coding.  For breast surgery, there’s about10 different ways to call something a lumpectomy: you can call it a partial mastectomy, a tylectomy…this, that and the other.  They all mean the same thing.  So I said you shouldn’t have four buttons that say the same thing – just put them all in one.

Because, in reality, I’ve worked with some surgeons that are absolutely convinced – and I’ve told mTuitive this – that if you call [the surgery] a partial mastectomy you get a better reimbursement than if you call it a lumpectomy.  They just don’t understand that it’s the same CPT code so you get the same amount of money.  So I think I made a couple comments about how [mTuitive] needs to work with surgeons who understand coding and billing.

I’m sure you get a bunch of random offers from Health IT start-ups…

Mmm, sometimes…(laughs)

What is it about OpNote that you found interesting or worthwhile?

First of all – it seemed like they really needed some help! (laughs)  But [OpNote] does seem like it’ll make things easier.  Unfortunately, where the problem is going to be, no matter how much I love it…when we dictate our op-notes, that’s a hospital function.  I don’t need that dictated note – I can do some sort of documentation in my office for my billing, if I really need to.  But the hospital has got its format and so I think it’s a harder job to convince [the hospital].

But [the OpNote] does make sense, I like the idea that eventually mTuitive will try to tie in [the operative report] to pathology and cancer staging, and things like that that we need.  It’s all mandated that we have this stuff out there, it’s really the only product that I’ve seen that’s trying to tie everything all together.

And, perhaps selfishly, I would like to be able to say, “I helped create that.”

What do you hope comes out of this push for electronic reporting – not just the OpNote, but in general – due in part to increased government funding and initiatives?

Part of the problem is that everybody talks about electronic reporting and “wouldn’t it be great if we’re all on EMRs?”  A lot of us are on EMRs – but none of them talk to each other.  I’ve had this conversation with patients who don’t understand why one doctor’s office can’t get something electronically from another.  And then I tell them that there’s about five gazillion EMRs out there – and we all use the one we think is going to work for us.  I have a hard time getting into the hospital’s [system] where you can look up labs and reports, and also look up X-Ray images because they’re all digital.

But I have to use a different web browser to get into that system because my server and my security software for my EMR is not compatible with theirs if I go through Firefox.  So I have to go through the older version of Internet Explorer in order to access my patient’s data at the hospital.  Then, when I’m flipping back to my EMR, I have to change back to another browser – it’s crazy.

The problem is most practices use EMRs as basically an electronic chart.  And that’s not an EMR – I’m supposed to be able to talk to the pharmacy and to the referring doctors.  Well we do that, but we do it by sending out the EMR note as a fax.  It’s not like everybody can come in and look into my system.

There’s a ton more that needs to be done.  We have this phrase in surgery – “help the doctor.”  Part of the problem is that there’s this push for EMRs but nobody’s helping the doctor here.  “You have to get an EMR.” But it is just a horrible job to try and fine one – it’s worse than shopping for a new car.

It’s such a huge investment of money.  I’m $30,000 in the hole for my first one because it seemed like a fantastic system and it’s not until you get it that the sales people scurry away never to be seen again.  Support people that were promised are gone.  And it’s not nearly as functional, and it’s a lot more clunky and awkward than you thought it was.

For the past couple of months I’ve transitioned to a new company.  I have a server in my office, with all my data on it, and they are linked in to that.  I told them that I don’t want to put files into it, schedule in it, bill in it – [the server] is just where the data is because for those old patients coming back, we have to scan their stuff from the old system into the new one.

[The old EMR company was] trying to sell me a $10,000 viewer just in case I had problems opening some of the records.  There should not be any problems – as those are my charts, my patients, on my server that I paid for.  And only when I’m leaving do you tell me that you want $10,000 more just to be sure I can look at everything?

It seems like the biggest problems, for these programs, are issues of integration and communicating with each other.

So if you could solve that, that would be awesome.

——-

Part 2 to be published on Friday, February 19th!

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EHR – Part v. Whole Introducing the OpNote Consultants: Dr. Deanna Attai Part 2 of 2

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