Let's just call it PAM for now until we get a better name Discussion: --current paradigm is start with document and code to not get audited--defensive and missing out on potential earnings --if you start with end in mind, documentation can improve to meet a more appropriate/advantageous billing level--PAM will insure that if audited will never find we are upbilling because documentation will always support the billing level Considerations for PAM: Clinic flow: Demographics will be input by patient, reviewed and verified by receptionist--physician won't touch Physician in charge of creating and/or verifying accuracy of clinic note Can PAM be "widget" application with operability within the EHR or a "skin" that then documents directly into the EHR? Will PAM be able to scan previous charting and diagnosis codes to guide billing/coding to direct where the documentation of the visit goes? Big picture stuff--This is not a scribe service, but I see this as a billing/coding tool with some scribe-like features--we could call it "predictive documentation", but needs to be more than just a billing tool or there won't be physician buy-in --An accurate Chief Complaint/s will be imperative for aiming where the billing could be (ie. CC of vaginal discharge-quick visit with swab/culture, goes home with a prescription vs abnormal uterine bleeding with pelvic pain--gets workup with ultrasound, possible biopsy, leading to treatment anywhere between prescription medication to surgical intervention) and then documentation to follow --We need to be obsessed with radical simplicity--no one else is doing this --why isn't documenting in an EHR as easy as using our phones or an iPad? --CTT- "clicks to task" how many clicks does it take to accomplish a given task within the EHR--have to be dedicated to this