I sat down with orthopedic surgeon Dr. Mark Casillas to discuss how he uses Mobius Clinic at his medical practice in San Antonio. This is the second of three posts that tell the story of how a suite of software applications helped one physician make their practice more successful, efficient and fulfilling.
On an average work day, Dr. Casillas captures over 120 medical images and stores them in patient charts. This is partly because of his specialty as a foot and ankle surgeon, but it also reflects the values he emphasizes in his practice: efficiency and excellent patient care.
“As an orthopedic surgeon specializing in the lower extremity, alignment is a very big part of what I do. So I like having that documented,” Dr. Casillas explains. “But I can also capture images from an outside PACS system – whether it’s on a CD or the internet – and pick out the most important images that I feel make the case for the patient.”
Dr. Casillas is describing how he uses Mobius Capture, an app that lets practitioners take photos for profile images or clinical documentation and have them safely stored in the patient’s chart. Whether on a desktop or mobile device, Mobius Capture quickly saves selected images form any picture archiving and communication system (PACS) to an EMR. The app can also securely save images from emails and text messages, eliminating HIPAA concerns around having PHI-images stored on personal accounts.
Mobius Capture facilitates a function that is central to Dr. Casillas’ sought after San Antonio-based practice: securely and easily saving images to the patient’s chart. Dr. Casillas uses this for direct clinical documentation – improving the medical record by taking photos of a patient’s alignment or deformity – but also to save key images from a PACs for quick reference from the EMR.
“Before Mobius Capture it wasn’t possible to integrate images into the patient’s EMR,” Dr. Casillas explains. “The only software option was a jotter, which had very limited utility. I could literally have drawn stick figures on a desktop to point to where a wound was.”
“We have literally gone from stick figures to retinal quality images that can be manipulated and shown on an iPhone and saved to the EMR with a click.”
Using Mobius Capture all sorts of images become part of an enriched patient record. For Dr. Casillas, this means taking pictures of a patient’s foot or ankle on his iPhone and having those images saved directly to the patient’s chart. But he also saves pictures that patients bring in to explain their injury.
“When a patient shows me pictures on their phone and says, ‘Here’s what my ankle looked like after the motorcycle accident’, I just say, ‘Hold that for a second’ and I take a picture and I’ve got things documented. As a surgeon that makes the medical case more sound, and I can refer back to those images in the operating room as needed. I can move on knowing I’ve got fantastic documentation that frankly was impossible before.”
Dr. Casillas also uses Mobius Capture to efficiently organize and store copies of films or scans from an X-ray, CAT or MRI. He explains how before Mobius Capture storing and reviewing images from a PACS was a hassle: “Everyone has a different PACS system, so patients would come in with a CD of CT scans from a community hospital and a different set of X-ray films from a radiology practice in town. We used to store all those images on the desktop or a CD, but then when I would go to operate I’d have to pull up 120 cuts and find the few images I could make use of.”
With Mobius Capture, Dr. Casillas cuts out most of those steps by saving the most important images directly to the patient’s EMR. “Now I just go in and simultaneously while meeting with the patient I put in their CD and look at the images. I still have to review 120 cuts, but I save the 2 or 3 that are important. With Mobius I just click an icon on my desktop, outline a box on the screen, and Capture knows which patient I’m looking at and saves the image in the patient’s record for the day.”
Enriching the EMR with images has lots of benefits for Dr. Casillas’ practice. Pictures captured during patient visits document injuries and alignment more thoroughly than previously possible, leading to higher patient satisfaction and better outcomes. Dr. Casillas also feels more confidence when interacting with patients because, as he puts it, “I know that what I’m using to make a decision – my information set – is better documented in the chart.”
Mobius Capture also makes Dr. Casillas’ practice more efficient by eliminating the need to frequently review dozens of images stored in separate PACS systems. “I don’t have to go back to an MRI or a CT scan with a hundred cuts. It’s just one or two pictures placed in the chart. The point is to be efficient and make good use of the documentation.”
As with the operational efficiencies created by other Mobius Clinic functions, Capture helps physicians get from their EMR what they wanted in the first place. The innovation is simple and elegant, but as Dr. Casillas summarizes, it’s a huge leap forward: “We have literally gone from stick figures to retinal quality images that can be manipulated and shown on an iPhone and saved to the EMR with a click.”
Dr. Casillas sees Mobius Capture as one of the most functional pieces of software he uses in his practice: “I’ve gone from drawing stick figures with a jot system to taking ten pictures in the room, five more pictures from the patient’s MRI, another picture from their phone showing the injury, and putting them all in the EMR. These are the things that keep people as customers.”