Thursday, September 13, 2007

Dynamic Data Exchange (DDE)

Thanks to a technology known as Dynamic Data Exchange (DDE) ,information contained in a database can be exported from that database and imported into another software application for use in a spreadsheet or word-processing program. By having computers import and export data between applications, there is less risk of human error in the process of transferring information. Thanks to computers, reports which could never before have been imagined are now generated with remarkable ease and efficiency.
For example: A hospital's computers will, no doubt, contain a database of all patients who have been and are currently being treated at that facility. Among the many fields in that database will be the patient's address, phone number, billing information, medical record number, and insurance carrier. Although the database may be written in one software program, and maintained primarily for financial purposes, it can also be used to track a patient's whereabouts and scheduling for special procedures.
A hospital's digital dictation system works very differently and logs different kinds of information . However, the database on the hospital's computers and the database created by the digital dictation system usually share a common field: the patient's medical record number.
With these two identical fields maintained in separate and disparate databases, DDE technology enables transcriptionists whose word-processing software is linked to a computer network to access the information on the hospital's computers and have data such as the patient's age, sex, date of birth, and primary care physician imported into the headers of the reports they transcribe.
With two sets of data that can be massaged by management information specialists, hospital administrators now have a means of riding shotgun on physicians who are delinquent in their dictation.
How does this work?

Let's say the Chief of Surgery at a hospital is furious about the inability (or unwillingness) of certain surgeons to dictate their preoperative histories and physicals in a timely manner. No amount of nagging, complaining, or subtle threats has been able to get these surgeons to cooperate.

The Chief of Surgery knows that the only way to force these doctors to toe the line is to hit them in their wallets and remind them that "Money talks while bullshit walks." In desperation, he turns to the Chairman of the Medical Record Committee for help.
The hospital, of course, uses a digital dictation system with powerful reporting capabilities. With a copy of the surgery schedule in one hand, and a report from the digital dictation system in the other, it quickly becomes apparent to the Chief of Surgery that each database shares a common six-digit field: the patient's medical record number.

It doesn't take long for him to realize that if he takes Tuesday's surgery schedule and matches it against the log from the digital dictation system, he will be able to identify those preoperative histories and physicals which have or have not been dictated by a certain deadline.

With that information available to him as ammunition, he informs his surgeons that if their pre-op H&Ps for Tuesday's surgery schedule have not been dictated by 10 p.m. on Monday night, their operating room privileges for Tuesday will be revoked. Without access to the operating room, their scheduled surgeries will have to be canceled and the surgeons will not be able to bill patients for whatever procedures they had anticipated performing.
By making good use of the reporting capabilities of the hospital's digital dictation system, the Chief of Surgery has found a potent way to keep his surgeons in line.

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