Better Documentation and Audit Trail Methods

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Dr. Greggory DeVore: "I'm Dr. Greggory DeVore and we're at the AIUM Annual Convention. I'm interviewing Don Parker who is the founder of Sonultra, which is a corporation that provides material and programs for ultrasound OB reporting. Don, I know that you're not a physician and you were trained in the business world, so why did you become interested in OB reporting a number of years ago?"

Don M. Parker: "Several years ago I was asked to organize a group and put together an outpatient ultrasound facility. At that time we were looking for ways to develop better documentation and a better audit trail for keeping track of the information that was being recorded so that the physicians could have better communication between them and the sonographer that was doing the exam. Also, they would have something to compare when the patient returned for her second or follow-up ultrasound exam."

Dr. Greggory DeVore: "So this came about because you owned a practice as a business person and wanted to have a better reporting system so you could follow and track the patients. Is that the reason for it?"

Don M. Parker: "That was part of it, the other part is when we started the business one of the things that I think any practical business person should do is attend to their audience or their clientele. We interviewed several of the physicians in the community and we asked them what they were looking for from an ultrasound report. What we discovered was what they were looking for was not really being provided by the physicians or at least the radiologists that were doing the exams in the community at that time. They said they were looking for something that was more definitive so when they got a report they knew exactly what was going on and what to do without any kind of variability in determining what the report was saying. They were looking for a very specific diagnosis or direction on how to manage that patient."

Dr. Greggory DeVore: "I know that over the years, for example, many times obstetricians and even radiologists have provided simple paragraphs or one line reports saying the fetus is normal. Now with the accreditation occurring and with the insurance companies demanding evidence of a proper examination, reporting now has really come into the forefront. I'm curious, what's been your experience as you've gone in and shown your program that Sonultra has now currently developed to physicians who have not been exposed to an upscale report? What have been the responses when they've seen your particular system?"

Don M. Parker: "What we discovered is a couple of things; one is that many times physicians are not necessarily aware of the kind of documentation that some of these are looking for, whether it's the AIUM accreditation standard or what insurance companies want. Backtracking a little bit, what few people know is that the reason for this big push for accreditation and, of course, the insurance companies jumping on the bandwagon for regulating their reimbursement based on accreditation is because of a study done in 1997 by the American College of Radiology and some of the insurance agencies. What they discovered was that 80% of the reports that they reviewed were substandard. Based on that, the insurance companies thought they're not necessarily getting the kind of documentation they're paying for and that's how all the standards came about. We've always developed our system to enable the physician to do what they want whether it's a minimal report or as comprehensive as they want but all in line with the standards whether it's ACR, AIUM, ACOG, or the insurance committees. The physician is able to do what they want but it's all run by the fact that this 1997 study is pushing insurance companies to say - we want a standard that we can count on so that we can get the information we need to do an evaluation."

Dr. Greggory DeVore: "So it's reimbursement related if reports don't indicate what they've done, then why should they reimburse for the codes that the physicians have submitted."

Don M. Parker: "Exactly."

Dr. Greggory DeVore: "Now I know there are several companies who have systems similar to what you have developed at Sonultra, what are the differences you see currently in the playing field for reporting systems that you think your system highlights and others may not or are they all comparable? What are some of the differences and similarities?"

Don M. Parker: "I think the biggest difference is recognizing that each practice is different, and each physician has their own protocol and their own mechanism by which they do things. So our thought process was to develop a system that was fairly basic in its approach meaning you have certain things that everyone reports on and everyone follows. Then on top of that, integrate our system not only as a reporting system but a development tool that enables the end user to easily customize it to fit their particular practice needs, how they do their reporting, and what their workflow is. So our flexibility in how our system works enables the physician to maximize their workflow and get the type of report that they're looking for."

Dr. Greggory DeVore: "Do you have image acquisition or the ability to take and capture images from the ultrasound and put it on your report so they can go out to the referring physician?"

Don M. Parker: "Yes, we do."

Dr. Greggory DeVore: "One other issue that always is important as a physician and seeing patients and doing ultrasound is the question comes up, and you addressed this a moment ago, the use of time. What do you think the estimate is as far as the efficiency factor using a reporting system that you have developed versus a traditional dictation report that the radiologist or the specialist dictates? How much time do you think you can save them in turning around the report and processing patients by using this particular system?"

Don M. Parker: "If you're looking to compare apples to apples in terms of what our report can report on versus a similar dictated report, we could probably save between 50%-75% of the time. What we found is that we're able to integrate information from prior exams into the current one such as fetal trending. We also have discovered when people see the type of information that's included in our report they generally expand the type of information that they're reporting on. Additionally, we're able to gather the statistics necessary for them to evaluate their practice, evaluate it from referral patterns, and evaluate it in terms of organizing their data for accreditation. There's a number of additional benefits from using a reporting package that has a database that you can work with and gather a lot of information about your own practice."

Dr. Greggory DeVore: "Now if somebody wanted to look further at your particular program and evaluate it, do you have a free time period where they can download the program or obtain the program, use it, and see if they like it?"

Don M. Parker: "Yes, we have a philosophical approach that we started way back when the company first began in 1986, and that is we don't want anyone to use our program unless they're familiar with it or they purchase our program and they're familiar with it and comfortable. So if someone is interested in a reporting system, we will send them out a CD, we will support them, we will if necessary upgrade them during that time, address issues or concerns that they have, and we want to make sure that they're comfortable and familiar with the product before they make a decision to purchase. Nothing's more important than an educated consumer in our mind."

Dr. Greggory DeVore: "So then basically, I could try your program, see how it works, and it wouldn't cost me a dime other than installing the program in my computer?"

Don M. Parker: "There's no cost at all. It costs you a little bit of time; training takes about an hour over the telephone. You always have full support and, again, we're only interested in customers that are happy. Therefore, if you get to use the product, get familiar with it, implement it in your practice, and see how it helps your work flow then you decide whether or not you want to purchase it."

Dr. Greggory DeVore: "Do you have a website, and say I wanted to contact you on the Internet since we're viewing this video, how do we do that?"

Don M. Parker: "It's www.sonultra.com.

Dr. Greggory DeVore: "Thank you very much."

Don M. Parker: "Thank you very much, Gregg."