Introducing the OpNote Consultants: Dr. H. Walter Kaess

March 9, 2010 at 11:32 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. H. Walter Kaess attended medical school in Cologne, Germany, and Vienna, Austria, and graduated magna cum laude from the University of Cologne in 1970. He started his surgical residency at the University of Bonn and continued his training at Rhode Island Hospital, a Brown University Teaching Hospital, where he completed his residency in 1979 as Executive Chief Resident.

In 1979, he moved to Cape Cod and began his almost thirty year career at Cape Cod Hospital.  During that time he was actively involved in Medical Staff Quality Assurance committees, served as Chief of Surgery and two three-year terms on the Board of Trustees. Dr. Kaess practiced the wide range of Vascular and General Surgery, with a special interest in Breast Surgery.

How did you become interested in medicine?

You start out with a very difficult question!  But when I think about it, I think it had something to do with the fact that medicine was always familiar to me growing up because my mother was sick.  My mother spent a great deal of time in hospitals and eventually passed away.  When she got sick, I was less than 10 years old.  And when you are at that formative age, and you walk into hospitals and the smell of disinfectant becomes an everyday occurrence to you, then I think that sort of breeds a certain familiarity with medicine.

My high school advisors told me that I was good in natural sciences and that I should become a physicist – which I tried…for one semester.  But I found that much too dry.

I had always fought against going into medicine, because my father’s second wife was a medical general practitioner and everybody had expected me to go into medicine.  When you’re in that rebellious stage, you say “No Way!”  Nevertheless, at some point my interest in natural sciences and my familiarity with medicine became strong enough that I decided I wanted to go into that field.

And how did you decide to become a surgeon?

I did a mixed internship – 6 months of medicine, 6 months of surgery.  The first six months of medicine…I was bored to tears.  That was the worst rotation I’ve ever had in my life.  All people did was talk – they never did anything with the patient.  I’m not a desk person – I’m a doer!  So, all of a sudden, I went into surgery and said, “I like that!” You know, interacting with the patient, doing something.  So, I became a surgeon.

How did you first find out about mTuitive, and the OpNote?  Was it through Dr. Chabra or Dr. O’Toole?

Oh, Roger [Chabra] gave me a call.  I have an  interest in electronics and I’m familiar enough with software that I thought “Hey – why not?”  OpNote is a good idea, and working on it keeps me intellectually stimulated;  prevents my brain from rotting out by doing something creative!

How did you decide that the OpNote was something you wanted to work on?

In the beginning of our cooperation, I had my doubts that this would ever fly – just because surgeons are such an individual breed.  You can’t ever get five surgeons together in a room and have them agree on how to perform an operation.  There is more discussion on how to do an operation than is absolutely worth it.

But ever since [mTuitive] put this “individuality” into the program, where people can express themselves in their own words while retaining the structured data – I became convinced that this is the way to go.

This program allows even the prima donnas of surgeons – who are so set in their ways – even they can use it.


What are your thoughts on standardization of reporting?

I’m a proponent for a portable health information system.  I’m a proponent for patients going to a physician with an ID card that has all their pertinent medical information.  And if we want to eventually get there, we’ve got to have standardized information – and a standardized operative report has to be a part of it.

There is a big push in funding for EMR development and adoption – what do you hope comes out of it?  What will come out of it?

The privacy advocates are going to fight it tooth-and-nail.  Having been in practice for 30 years and depending on information that was passed on to me to take care of a patient, I must admit that the past doesn’t work.  It’s too time consuming and not accurate enough to depend on the (pardon me) referring physicians to give me all the information.  Some referring physicians are very good, some are very bad – but there is no guarantee or consistency in the information you get.

And the system of faxing the information just doesn’t work all the time.  So, it would behoove us all to have portable information with all the pertinent data, all the information that I need to make my decision – particularly in this day and age when the work-up is fragmented.  In the days when it was hospital-based, I could retrieve the information myself.  Now the patient goes to a privately owned endoscopy center, the pathology gets done in Texas, there are other specialists that are involved who know the patient much better than I – and I am faced with trying to make a decision about whether or not this patient needs this operation and what I need to do to prepare for that.

It’s a very cognitive kind of thing to meet a patient with a difficult case for the first time and put all the pieces of the puzzle together, so you can make the right decision.  So I think EMRs are of the utmost importance.

What do you think are the main recurring problems in the dictation & transcription process?

The biggest problem is with transcriptionists who are learning – where you truly have to read every sentence that you have dictated to avoid the blunders.

If you have a good transcriptionist, you know those operative reports reflect exactly what you’ve dictated.  But if you’re unsure about that transcriptionist’s ability, then you have to spend that much more time reviewing what’s supposed to be “your words.”


Entry filed under: EMR, OpNote Consultants, Standardization. Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , .

Introducing the OpNote Consultants: Dr. Roger N. Chabra HITECH – One Year Later

1 Comment Add your own

  • 1. HITECH – One Year Later « Reports From The O.R.  |  March 12, 2010 at 4:20 pm

    […] to any physician where ever/when ever that individual seeks treatment.  This is the ideal that Dr. H. Walter Kaess and Dr. Roger Chabra spoke of when I interviewed them recently.  GE has illustrated this idea […]


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