September 10, 2004

Letter generator aids doctor-patient communication

Featured Image

William Stead, M.D.

Letter generator aids doctor-patient communication

A new computer program developed at Vanderbilt University Medical Center helps doctors and clinics more easily communicate by letter with patients.

The patient letter generator is a new feature of StarPanel, a medical records and clinic workflow application developed at VUMC.

Vanderbilt doctors say that, compared with dictation, the letter generator is saving them time in their day-to-day practice. They also say that, because eliminating transcription eliminates the delay between the composing and mailing of letters, use of the letter generator results in fewer calls from patients who are anxious to find out their test results.

“This tool really has facilitated the ready delivery of information to patients about their health care,” said endocrinologist Lewis S. Blevins, M.D., associate professor of Medicine and Neurological Surgery.

The tool’s creators hope it will prompt more physicians to send letters to patients after each visit, helping to improve patient education, patient satisfaction and patient compliance with doctors’ recommendations.

“With this tool we can compose effective, informative lab letters in a fraction of the time,” said a partner in creating the tool, Jim N. Jirjis, M.D., associate professor of Medicine and director of the Adult Primary Care center. “It’s a matter of simply clicking some buttons to import test results and corresponding text, then doing some very light editing to help personalize the letter.”

Doctors can easily customize the letter generator to suit their work, creating and storing additional text or adopting another user’s text. The user writes and signs each letter with clicks of a mouse, and sends them off electronically through StarPanel messaging to a secretary for printing and mailing. StarPanel saves a copy of the letter in the patient’s electronic chart, which can be helpful down the road when the patient is seen by other clinicians. Secure access to StarPanel can be achieved from any Web connection.

The tool also saves money. Blevins said that, for his practice alone, in the first eight weeks that he used the tool, it saved his division more than $1,600 in transcription and document delivery costs.

In addition to follow-up letters regarding patient testing, Jirjis and Blevins said the letter generator will more generally assist patient education and disease management. Who needs a flu shot? Who needs his blood glucose tested? — StarPanel is designed to help users gather this information easily, and nurses already have begun using the letter generator to send letters to patients who’ve missed their clinic appointments and to patients with diabetes who are overdue for testing.

“It has been really exciting to see our doctors and nurses flocking to this new tool. It’s something we really needed,” said another of the partners in creating the tool, Sue Muse, an administrative assistant in the division of Internal Medicine. Muse tells of one technophobic doctor who was at first skeptical, then wound up happily knocking out 20 letters in his first day using the tool.

“StarPanel users designed the letter generator. It’s very important to the success of our applications to have users work with us to guide the design,” said Health Systems Analyst Programmer Jun Kunavut, who programmed the tool. The project director for VUMC medical records applications is Dario A. Giuse, Dr. Ing., associate professor of Biomedical Informatics.

Though patients value having personal medical issues spelled out for them in a physician’s letter, many doctors don’t bother sending letters after visits. These doctors might ask someone to call the patient with the results, but the staff members who are given this task may or may not have been hired for their ability to explain medical findings and answer patients’ medical questions. If test results are negative, there may be no attempt at all to inform the patient.

“It represents first-class service to write a letter to a patient after a visit, and this letter writer provides the wherewithal for Vanderbilt clinicians to do that conveniently,” said C. Wright Pinson, M.D., chief medical officer and associate vice chancellor for Clinical Affairs.

StarPanel users can learn to use the tool on their own; to view the training module on the VUMC intranet, point your browser to