Hello everyone, thank you for joining us for the TRANSFORMS surgery scheduling process from paper to paperless webinar. A few housekeeping notes to get us started. All attendees are enlisted and only known. We will be using the Q&A function today to gather questions for our speaker. We will not be using the raise hand function. Please submit questions through the Q&A and interact with other attendees by posting comments to the chat. When using chat, just be sure to select all panelists and attendees from the drop down above the message box before submitting your chat so everyone can see it. This webinar is being recorded. Please know we will be sending all registrants the webinar recording and PowerPoint slides via email in the next couple of days. Our speaker for today is Scott Kolstad, CEO of Chippewa Valley Orthopedics and Sports Medicine. Now I'll turn it over to Scott to get us started. Thank you so much and welcome everybody. Thank you for making time. I have to admit I'm a bit humbled by all of this, but I hope you find it valuable. We've certainly been on a journey to tackle some of the problems I think you all have. So with that, my intention today is to go through a little bit of introduction about our practice and what we viewed as our challenges and I'll describe the solution. We'll go into a demo and then hopefully leave time, a good amount of time at the end for Q&A. So with that being said, just a couple of disclosures. We will be viewing our live production environment and I'm taking all reasonable precautions to eliminate any disclosure of PHI. And so as a result, I'll be simultaneously stopping the share screen function, navigating to parts of the app and then re-sharing the screen in such a way that allows me to mitigate or minimize any potential disclosure. That being said, if there is something inadvertent, we just ask that that's kept confidential that you don't disseminate any of that. Like I said, we'll toggle the screen so it might appear a little bit clunky. We do view this as proprietary, but we're kind of sharing this so that we can just help all of you think about ways to improve the ways in which you do your work as well. Little bit about our practice. We are an 11 physician practice in the West Central part of Wisconsin. We have eight orthopedic surgeons, a podiatrist, a neurosurgeon, and one interventional pain management physician. We've been around for almost 70 years and although our principal service area is in the Eau Claire Chippewa Falls area, the red circle on this map illuminates the principal service area we have, which extends about 75 miles from our home location. That outreach location adds a level of complexity that many of you probably experience too with respect to getting information back into your home office. We serve about 80,000 people in this 75 mile radius, and of course it's incumbent upon us to move information more quickly, particularly as things like authorization requirements are getting more stringent and more time consuming. Like I said, we've been around for 70 years, but the organization really hasn't evolved into some of these more modern applications in part because it's focused all of its time and energy on serving patients, right? And so this was an opportunity for us to move the bar a little bit and improve the way in which we conducted our business. Our problem, I'm assuming, is the same as yours. We had a heavy reliance on paper and fax machines. These processes were difficult to manage and measure. If we wanted to track down the status of a case that was being scheduled, it was literally like rifling through folders and stacks of paper on individuals' desks. That became problematic. It was difficult to manage. We couldn't measure our performance. It didn't encourage collaboration either. Individual people owned individual stacks of paper and there was very little sharing, in part because it was too hard to copy paper and move it across the organization. It also introduced errors because we were constantly retyping and transcribing and transposing data from one handwritten piece of paper to another typed form and then doing that several times over. I'm sure none of you have experienced what we experienced, which was, gosh, some people had good handwriting and some people's handwriting was absolutely atrocious, which made it more difficult to not only read what we were doing, but then it introduced the opportunity for errors. It delayed downstream interventions because people had to wait on us to do our part of the work stream and that then delayed their ability to do the work later. Information wasn't broadly disseminated and you needed to be tethered to one physical location to do the work. That was difficult. As I mentioned before, we were doing processes over and over again, up to and including even doing three and four redundant processes just because we were so tethered to paper. Of course, I don't have to read all of these bullets, but it promoted unwarranted variation in our practice. Then, quite frankly, our employees were kind of tired of working with processes that just weren't conducive to them doing their jobs successfully and efficiently. This is at a high level, our reliance on paper, and all of these red boxes represent individual pieces of paper that somebody had to manually create or manually deliver. The care teams would write on a piece of paper and then that would either get faxed to somebody or they would walk it down the hall or downstairs, or they would put it in an inner office mail system that took two to three days, or they would spend time at a scanner and scan it into somebody's folder. Then our schedulers would get it and then they would manually retype all of that information into one or more of these documents. And then they would collate and aggregate all of this paper and then they would fax it to the pre-op clinic and they would fax it to the surgical facility. If there was, for example, if somebody was having a total knee replacement and needed a preoperative CT scan for a MAKO procedure, as an example, then that was another piece of paper that had to be created and faxed and produced. And so you can see all of these manual processes just took time and they were very difficult to manage. Today these red stars indicate where we've automated this. So every morning I get a file from our data warehouse and that goes into a database. The care teams, instead of entering the information or handwriting the information on a piece of paper, they just enter it into this, we call it the app. And then a whole bunch of work goes on behind the scenes, automatically push information to our schedulers, and then they do work inside of this app. And then we're automatically creating records. So we've minimized how much time people have to reenter information. We've pushed it to the source of truth, and then we let everything flow from there. Of course, we can go back and change things if we need to, but we've pushed it to the source of truth in such a way that we're entering information once and not multiple times. So what did that mean for us? Well, we've reduced our processing time by 30 to 45 minutes a case, which is translated into just shy of $100,000 in labor cost or productivity improvement. For us, we didn't reduce headcount, but prior to this, we were actively exploring bringing on one to one and a half additional FTEs to manage this process because it was so cumbersome and labor intensive. So we were able to reduce the intensity of our work and become more efficient and therefore accommodate more volume with the same amount of labor. It's really engaged our workforce. It demonstrated a very responsive way to address their concerns about working smarter, not harder. And so while we were able to increase volume with the same cost, I'm no longer having discussions about people being frustrated at work or wanting to leave. In fact, they're excited about how this has evolved over time. And then, of course, I've always joked that people saying that the cry room has been eliminated and just for your reference, those were their words, not mine. But people are no longer overwhelmed with the volume because we've been able to do this in a way where it's made people more efficient. It's encouraged collaboration. And that's really been unprecedented, which is my next bullet. And then finally, we've accelerated our downstream processes in such a way that the people that need to act on our information get it almost as soon as we do. A couple of comments here. When we went live with this, we tripled the attendance at our preoperative total joint education class because the folks scheduling the cases had, and those education seminars had the information weeks in advance, giving patients much more time to attend the class and ask the questions that they needed to. So we've seen incredible improvement in that regard. Also to give you just a, this just happened last Wednesday, I believe. One of our care team members talked to a patient. The care team member entered the information into the computer. She stepped out of the room to do something. It was gone no more than 10 minutes. And by the time she came back into the room, the surgical hospital, which was, which coordinates our education classes, was on the phone with the patient scheduling her preoperative education before the patient even left the room. That was an example of something that's, you know, it improved the patient experience. We now know the patient will go through that education class with plenty of time. It just demonstrated an ability to work together and collaborate, which has been really helpful. This is a screenshot of what our home screen on this app looks like. It's not pretty. I'm not a graphic designer, but it does the trick. And so I'll walk through a few steps here, and then we will get into the app. So for example, if somebody wants to add demographics, which is the kind of the start of the process, we can, they click on this button. We can look at surgical cases. We can look at MRI and CT and visco supplementation injection orders to authorize. But let's say that they click on calendar. This is a cool feature that our doctors and care teams like, it's accessible on their mobile phone. I mentioned earlier that there were people that would hand write a piece of paper saying schedule Scott for a knee replacement, and then they would hold onto that for a while. And then they would fax scan, walk it down the hall, whatever, get it to somebody to do something with. And then they would take that and then they would write it in to a, a scheduling book, a paper scheduling book, and then they would go one step further and enter it as an appointment on the physician's calendar, like on their mobile calendar. So three different steps right now, once it's in the system, they can see all of these cases. So I know for today we have 23 cases on the books. And if I wanted to, I've blocked out patient's names, but, and the patient's date of birth, but I could click on this button and identify, I could filter on say Dr. Carlson or Dr. Berg, or I could click on any other day and identify where we had cases. So that's been a cool feature. They can ask, physicians can access this from their mobile phone. If they go back and they want to click on adding a case, for example, they click on this button. This is a file that I get every morning, like I said, at five, I think maybe I said this, we get it at five o'clock every morning and it loads all of the patient demographics for the patients scheduled that day. So if they just, if our care teams just enter the first few letters, they can pull up anybody with the last name of starting with K-U-L-S. This is of course me, and this is my dog. So I'm not really worried about P-H-I here. From this, then they identify whether they need to use, whether they want to create an MRI or create a surgery. So we'll just use my dog here and we'll pretend that we're clicking on create a surgery, but this is where I will switch screens. There's a question that came up. Did we develop it internally or what software platform did we use? I'll get to that, but this is all based on the Microsoft power platform suite. So we've got a whole bunch of stuff going on in the background, power apps, power automate, power flows, a whole bunch of stuff. So if we clicked on create surgery, this screen would show up. Now this filter allows us to quickly and easily go through a whole bunch of documents and a whole bunch of records really, and identify where a case is in the process. A couple of, just to orient you with our process here. So we can search on scheduling date, filter all of the cases between certain dates. We can identify where is it in the process? Is it started? Has it been started yet? Is it assigned? Is it completed? We can search on our physicians, any number of other filters we can search on. So let's say that we're going to work with this. Let's say we're going to work with this record. All of that took, I mean, we stopped and talked a little bit, but that whole process of creating this record took probably 10 seconds. So then we just go into the app and you can see that all of the demographics came over. Nobody had to retype this. This came in automatically, and then they just come here and they will go through an exercise where we assign the case, we're going to assign it to Dr. Berg, we're going to identify the case as being on Thursday. I'm not going to pick this location because it will literally send this over to the hospital and then that'll trigger their workflow. So I'm just going to, I'm going to add, we created a dummy location here called, whoop, stepped off of it. Just call it PTO, right, total knee. And I'm going to, I'm going to say that this is a, a Mako case just to show you a few things. We want to do a pre-op three weeks out in advance. This is one piece I should stop here. We have it also worked out with a primary care group that if we select this, if we select one of these primary care clinics, it automatically goes over to them and then they schedule the patient, goes over, they schedule the patient for the pre-op physical. So that work gets done much sooner. If they have a follow-up appointment, just for the record, you know, we can say it's on July 7th at 8 a.m. at our Altoona location. We can say that the labs, because we create lab orders from this. This is a knee Mako and it's with Stryker. There's no CT, no preoperative X-ray. All the insurance information came over from our data poll. If I have any comments, if like the care team has any comments for the scheduler, they can add them here. And then we just hit save. Notice the success bar on top. Now, if I come down to Lucille, you can see that the data surgery is reflected on May 25th. We call this our checklist. Gives us a chance to know how we're working in the process and where we are. So just visually, there's a bunch of visual indicators here that tell us where this is going. A couple of things I wanna point out. I'll show it in this record. So this little visual icon says Oakleaf Clinics, Eau Claire Medical Clinic. Had I sent this over to Oakleaf Clinics for the pre-op, that would have illuminated right down here. And again, that's just a way for us to improve care coordination because now that primary care clinic will have the information and they will start the process of scheduling that patient for preoperative physical and clearance. It's been helpful because now the patients don't wonder, well, are you gonna schedule it for me or am I gonna schedule it? No, we've taken that away. And we just said, don't worry about it. You guys already have it. I don't know if you can see this on my screen, but because I was added as the scheduler, a little email pop-up says, hey, by the way, there's a case added. And I'll show you what that email looks like in just a second. More visual indicators. This blue means it's assigned. I can see when the record was created. I can see who did it, who the scheduler is and who the doctor is, date of surgery, can see the location. Here's the principal procedure. This little robot icon illuminates that it's a MAKO case. This comment icon shows up to alert people that there is in fact a comment in the box. And so our schedulers are now drawn to that and they will take a look at that. Couple of these buttons down here actually create documents for us. But let's assume that our schedulers now are actually ready to work. They'll work this case. They'll come over to the checklist and they'll say, okay, well, we've uploaded the insurance record. I'll just make this up. They can upload documents here. I won't go through all of this, but let's just say we wanna upload an insurance card that can get saved. And so they say, well, we've uploaded the insurance and we've added this to our EMR and the authorization status is in pending status. Let's just assume that our coders have come in and they have added a code and let's just end it there. So a couple of things you saw that I added, I checked off the box that this code was entered. So now we have another visual indicator that this was illuminated. Here are a few things. We can create a document. This surgery scheduling form, I'll show you what this looks like on my other record. So these two records are created automatically. One is our pre-op orders that gets pushed over to the clinic, to the pre-op, to the primary care clinic. And then this is the scheduling form that the hospital needed. Now there's still, they're still reliant on this piece of paper. And so we create it. Once this is created, all of these attachments and all of this information goes right over to the hospital. So we're no longer faxing any of this information. This just moves over automatically. Every time we add something, it automatically gets pushed over. So let's attach this document and I'll just show you what this looks like. And by the way, you saw me add a document earlier. This paperclip icon illuminates if there's one or more attachments in that record. So this, the automatic creation of this surgery scheduling form document takes about nine to 11 seconds when I look at the power automate flows. And so what you saw was when I just refreshed the screen only to accelerate it, what you saw was that this button became deactivated. And if I come back here, you can see that this document was now automatically created. I wanna show one other piece there because I created this as a CT case. I wanna stop sharing my screen for one quick second and I'll go to this MRI part of the record and just show you how that showed up. But I need to stop here for one quick second. Okay, I'm back. If somebody could, yeah, I can see it. Okay, so you can see this is the screen where the folks working on our MAKO or advanced imaging like CT, MRI, where their work starts and stops. So you can see that my dog, Lucy, came over. It was a Dr. Berg. It was a right knee. The surgery was on May 25th. Historically, this was another piece of paper that had to be created. And in this case, it wasn't, right? It was not necessary to create this. Very similar layout. We have a couple of different design features here. We can edit this form and I could assign it to myself. If say, for example, Dr. Berg was ordering this CT but he wanted to follow up with a different physician, we could enter that here. If I had any other comments for our authorization team, we can add this. Very similar layout, very similar workflow, adding comments to the authorization process, adding documents. We can look at the same checklist. What's this? Well, I can tell you that it's been submitted and it hasn't been completed yet. So if I just click this submit form, it comes now and I can see this case has been assigned to me. There's a comment, it illuminated so we know where this record is. I can see that the prior auth has been submitted. If I got all done and wanted to click this button to create the imaging order, I can do that as well. And then again, that takes about nine to 11 seconds so that I can, if I just refresh the data now, you can see that the document was created, paperclip icon illuminated. I come over and see it's right here. So at a very high level, that's what our system does. It has been remarkably helpful in a lot of ways. It moves information from person to person at the very time that we need to. I wanna look at something really quickly here. I'll try to share a different screen. Hold on. So these are all emails that have been created to alert various people of that activity. So now, for example, this, my team, in fact, while we were doing this, one of my team members said, oh no, Lucy needs another MRI. In any event, we have an email that alerts people, hey, this is out there, go to the app and look for it. It works out really well and all of these are created automatically. So there's no real risk that people are going to miss something because there's another check in the system. This tells me as the surgery scheduler, assigned surgery scheduler that this case has been added. All of the relevant information came forward, patient's name, date of birth, the physician, the date of the surgery, the length of the procedure, what we were doing, whether it's assigned and any comments necessary. And then of course it came to me because I was the assigned scheduler. So there's all kinds of email or notification mechanisms built in behind the scenes to alert the right people at the right time that there's work to do. So I'll try to do some brief Q&A. These questions are all questions that other members of AAOE have asked me offline. And so I thought I'd just put it out here. And then I'm looking at the Q&A and most of them seem to be focused on, do I pull it out of my EMR? Do your medical record stuff have to check the app for possible documents to release when they get a request? Does it sync with our EMR? Thank you, we're pretty happy with it. Angela, thank you for that, we're pretty happy. Does it create different forms for different surgical facilities? The answer to that is sort of yes and sort of no. It is customized. So if I send a form to Oakleaf Surgical Hospital, Oakleaf Surgical Hospital will be on the header. If I send it to Cumberland Hospital, Cumberland will be on the header. The information is organized the same way, but the way that this is designed is that if we needed a different form, we can create that and let Power Automate kind of do the magic behind that. How do you share it with the hospital? Is it a share folder? Is it an autofax? No, I'll get into that. They actually have their own app. And when we push this information over, it's in their app. So they don't have to do anything else. It's just in their app. So we're not faxing anything over. Well, I shouldn't say that. During a bit of a transition, we are, but we don't have to. It literally all goes over. Every time we add an attachment, it just goes over there. That flow takes on average 11 to 12 seconds to get over there. So far less time than somebody standing at a fax machine, certainly less time than pulling pieces of paper and faxing it. I don't know how y'all are doing it, but we are or were sending 23,000 pages of paper out of this office via fax. A good part of that went over to that surgical hospital, which we can eliminate by virtue of this app. How did our clinic team respond? I'll get into that. We'll get into the surgical order. Who created the process? That was kind of me and talking to my team. I'm not a tech guy, but I just spent a lot of time understanding what our workflow is. In my intro, I know a few people that know that I teach in the MBA program at the University of St. Thomas in the Twin Cities. And one of the classes I teach is healthcare operations. So I've got a fairly good sense of the operational principles. Like we don't need to retype information several times over, right? And so just by virtue of eliminating that, by virtue of eliminating the amount of paper that we were producing in triplicate, just has saved an enormous amount of time. And it's reduced all the other kinds of things that we've already talked about. Who on the team initiates the surgery scheduling process? That's the doctor or a member of the doctor's team. I have one doctor that routinely enters cases into the app. It's not just his team. He actually is, he routinely enters information into the app. And he's asked me like, oh, well, do you want me just to add the MRI order right on here? Yeah, sure, that'd be great. So it's worked out very well, particularly when people are in outreach locations because that information then comes to the people that need to work on it right away. Some doctors have said, well, gosh, it only takes my team, I'm making up this number, but it only takes my team 15 seconds to write out this piece of paper. It only takes my team 30 seconds to write out this piece of paper, but it takes them 45 seconds or a minute to enter it into your app. And I say, yes, and. That piece of paper, that handwritten piece of paper has no value until it gets into the hands of somebody that can do something with it. And so for that process to work, we have to include then the transit time, the time to fax it to somebody, the time to scan it to somebody, the time to walk it down the hall, the time to put it in your folder and deliver it the next day. All of that time has to be considered. And once you do that, then this process is just far superior. Did I create this or did I do it myself? Well, I largely did it myself. I don't know that I would recommend doing what I did, which means that I spent way too much time making mistakes and covering for my own inexperience. I spent a lot of time just learning and hammering away at this. Now, if I had to replicate this, I could do it in much less the time, but I did pay for some phone a friend support when I couldn't figure something out or when I broke something. Would I do it differently? What would I do differently? I'm not sure. It's a bit of a catch-22. I wish I would have known how, I wish I would have known about some of the enhancements that we made along the way. But once I started to get into this, it morphed quickly and it became exponentially better as I learned. I do wish I would have engaged the hospital staff earlier on this. 90% of the hospital staff is engaged and 10% I think still feel like, you know, it's the who moved my cheese, right? I still want this piece of paper. They're working with us on it, but you know, all things equal, I wish I would have helped them upstream a little bit more than I, you know, in retrospect I did. How do our physicians like it? They're largely supportive. It took some physicians a while to just see how this was going to work, but all seem to acknowledge the challenges with the status quo. And I'm sure like your physicians, none of them are really terribly excited about adding overhead. So they do like certain functionality that they didn't have before. People like the calendar function. And, you know, behind the scenes, we've got over 3,000 records in our database right now. We've only been live for, well, we're going on five months now. We've got over 3,000 records in here. And the analytics that we can produce out of this has been extraordinary. We had a physician that went out on a short unexpected medical leave. And heretofore, if somebody wanted to know where the physician's cases were in the process, because we had to reschedule a few, several, that would have taken a long time. And when that question became a real thing, I had the answer in less than a minute because we're able to just use the app, mine the data. And with literally less than a minute, we had all of the cases that we need to work on. That was remarkably helpful. Where is this going? We're actively building an enhancement, which will increase our ability to scale this with more primary care clinics and more hospitals. And I'm expecting we'll push this to other organizations like PT, as an example. We'll do that internally as well, but for the patients that move out to go outside, we'll bring this in and that will have more scalability. Who is using this today? I'll show you in the next slide. Primarily it's primary care clinics in our primary surgical center, although there are other hospitals that want in. How does this compare with other vendors? Well, I'm not sure what everybody else has experienced, but it's much less expensive for certain. The licensing costs for us will be about $1,500 a year compared to over $25,000 or more for some of the software as a service applications that are out there. Again, that all varies based on size and everything. So I'm not, I can't say for sure, but I just know that for us it would have been approximately $25,000 to $30,000 and we're into it for about $1,500 a year in license costs. Our productivity improvements justified this in very, very short order. And what people don't, what some of the folks don't appreciate is how quickly we're moving information from one place to the next, which has given other individuals on the patient's continuum a chance to do their work much faster. The pre-op education scheduling, the total joint pre-op education classes, getting the order for a CT scan right away for any of those cases that require a CT scan, say for a MAKO case. So that part has been remarkably helpful. And because we're getting information out of our EMR, that we're not retyping information and therefore we've reduced errors substantially. We used, one asked, we use two surgery centers and refer to other partners. Can you add others? Yeah, you can. It takes a little bit of effort, but we figured out how to add other partners along the way. The biggest challenge I would say is to make sure that the partner on the other side understands workflows and how to accommodate information that has to go back and forth in such a way that people are communicating. There's always a unique situation that requires somebody to pick up the phone and say, hey, this is in the app, but this is what's really going on. This patient just literally called me and I just need to get this to you right away and I don't have time or whatever it is, right? There's always a unique situation, but the more you can talk to your partners about workflow and understanding that, it'll help you. Somebody said, I can see how this would help if I incorporated other apps into our workflows. Yeah, we've actually added an app for contract management, tracking payer policies. We've added an app for our athletic trainers to enter information and help identify where, not where they're going necessarily, but how they're moving through our system. So our athletic trainers can enter information into an app. It's all secure, but they can enter it into an app. And then our teams, our sports medicine doctors and their teams get that information and can act on it without an athletic trainer, you know, sitting on the phone or having to text something later on. It can all just be visible right there. And it's everybody can take, everybody a part of the care team can take a look at it. And then this is the most delicate question that I, cause I felt really uncomfortable about this, but I've had it a lot. Have I thought about selling this to AAOE members or giving AAOE members a way to kickstart their own solutions? Yes, I, we hadn't really thought about it until recently, but if that's something that you're interested in, just talk to me offline. We're really not interested in, you know, becoming a surgeon, surgeon, what is it? Surgeon mate for 30,000 bucks a year. But if this could, like, I know that for me, if I would have seen this and I could have spent a few bucks to jumpstart this, it would have been well worth it. Cause there was, like I said, I made a lot of mistakes along the way. So anyway, this wasn't the purpose for the discussion, but anyway, if you're interested, talk to me offline. Going back to the EMR questions, we get information out of our EMR every day. At five o'clock in the morning, we have an automatic system through Azure that pulls information out of our EMR. Actually, the EMR sends it through an API, puts it into a data warehouse, and then every morning at five o'clock, this creates a file that we upload into our database. It includes all of the patients and their demographics for the patients scheduled that day. Now, in the ideal world, we'd pull it from the API right into our system, but that was an expense that I just didn't want to absorb right away. This whole process takes not more than 45 seconds, maybe a minute on a bad day, but it's very, very quick. And we're uploading the patients that same day. If we do need to add, if we do need to add, like somebody calls today at 1251 Central and they come in at one o'clock, so it's not in our database, we can just quickly click on this button, add their demographics. It's very, very fast. So we're not pulling information directly from our EMR just because we didn't want to bear the cost of the API and all of that big data expense. This is actually pretty reasonable. So we do pull it from the EMR. Do our medical record staff have to check the app for possible documents to release? They could, but they don't. What our team does is now that we've got all of those documents attached to that record, then what they do is they just spend like 16 seconds and upload those into the EMR directly as PDFs. So then the EMR still becomes our source of truth. We use Greenway's PrimeSuite application right now for our EMR and our practice management system. I'm expecting that we'll evaluate that and look to other systems. Where we will go in the future, I'm sure we'll have more connectivity to this, not less. Even some of the existing EMR and practice management platforms don't provide us the ability to see the cases in the aggregate. Like I can filter through all kinds of cases and see just at a glance, I can see where everything stands. And that's been a real help to our teams. So I'm assuming we're going to find a way to continue to work with this, even if we do get a new EMR. I want to make sure I'm getting all of the questions. How did the clinical team respond to using this on the app versus paper? The clinical team, like everybody, right? There were some that were still wedded to the paper, some that just didn't really want to dive in. And yet there are others that were so excited to get on this that, you know, they just jumped in. They were the people that helped make this better. Like I said, I have one doctor that routinely enters it himself. How do I get the surgical order into our EMR? That's a bit of a discussion right now. We're creating that from the orders that they enter on this, from the information that they're entering into the app. And then it's getting onto a piece of paper that we're automatically creating, and then the doctors are signing that. I think I mentioned the care teams and the doctors initiate this process. Sometimes it's a phone call that says to the surgery scheduler, hey, would you quickly add this? What if the other surgical hospital doesn't have the app? They don't have to have the app if they do. Like we built it so that they could use that and push information electronically. In our case, they love it. It's been pretty easy for them to use it. I've often said, if you can use an iPhone, you can use this app. But if they don't have it, then at a minimum, what we've done is automated the production of the information in such a way that even if people are still reliant on paper and fax, we've automated the production of some of these documents and the aggregation of them is much more efficient. So then it can be just faxed. Does the app have functionality to notify equipment reps? Functionality, yes. Does it work? I haven't programmed it, but now that I know how it works, it's like all of these power automation flows, all of these flows are driving activity in this thing. So there's a lot of activity that's going on right now. Like for example, I can tell you that, remember I told you that it takes about 11 to 13 seconds to move over. This moves the information over to the hospital and the average takes 12 seconds. And so I can see all of these were a success. There's nothing that failed. Could we add it? Could we add equipment vendors to this? Sure. We would just need to know the specs. It's pretty easy. It's in the cloud. Do you have unique credentials? Yes. Complex password policies. We're tied into the, you know, to multi-factor authentication. Do I have various security groups only? Yes. It's really at the user level and version 2.0 will not only do that, but it will actually be at the role level. So I may be able to see rows one, three, and four. But not rows two and six, for example. Do I have an IT that helps with these issues? Gosh, I really wish I did. No, I've learned a ton. So I don't really have an IT. That's where I had to buy phone a friend support. Can I describe the quick ad surgery process a little more? Do I manually add the demographic information? Yes, Dave. So, so let me do this. I'll just do it right here. If we're going to add, and this is on my MRI side, but let's just say I want to add a record. It's a very similar process. So I come here. If I know the electronic medical record number, I can add it. Your birthday is also, you can add whatever we need here, validating that there's no contraindications. I'll try to do this really quickly, and then you can see. Yeah, so Dave, I just added this, and it was pretty easy. We don't ask our care teams, if they're doing a quick ad, we don't ask them to add all of the demographic information. Our back office folks can do that. This quick ad process is really just to get a record into the system and going. So I don't know if that answered your question, but that's what we typically do. I don't know if there's any more questions that are coming up on the chat. I think I got them. Using Microsoft Suite, pull information, yes. Thank you. Thank you, Barb. I appreciate the comment. I'll put my information in the chat function if you want to get a hold of me or if you have any other questions offline. Thank you, everybody, for all of the comments. Thanks for participating. Hope you found this helpful. Oh, here's one thing somebody asked me one time earlier. I didn't include this in the Q&A, but they said, well, can you delete something? Yes, you can delete it. Confirmation, we want to delete it. Yes, I do. Here are the examples of people that are using this. We're pushing it to our clinics and to the surgical hospital. We'll be pushing it to a surgery center and then to other hospitals at some point. There's quite a bit of interest because all the hospitals have the same issue. They push paper, too. So anyway, that's my story, and I'm sticking to it. Let me know if you have any other questions, but I appreciate everybody jumping on. All right. Thank you so much to Scott for hosting this wonderful presentation today, and thank you to all of our attendees for joining us. Thank you again, and have a great rest of your day.

Scott Kolstad

Chippewa Valley Orthopedics and Sports Medicine

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paperless surgery scheduling

Microsoft Power Platform

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EMR integration