Coeur d’Alene Pediatrics speeds documentation creation and turnaround

Dragon Medical One saves time and simplifies workflow with real-time documentation in Greenway Health EHR.


  • Complicated, inefficient documentation process
  • Delayed documentation review disrupts clinician workflow and train of thought


  • Nuance® Dragon Medical One
  • Nuance PowerMic™ III


  • Documentation reviewed in real time supports quality, improves workflow, and shortens turnaround time by up to 48 hours
  • Fivefold adoption increase in just 18 months
  • Transcriptionist assigned to a more value-added position

Simplified documentation eases clinician burden Coeur d’Alene Pediatrics, a certified Patient-Centered Medical Home, has been providing primary care and pediatric consultation services to children who live in northern Idaho, western Montana, and parts of eastern Washington for over 30 years. The group’s 14 providers working out of three locations sought an easier way to document patient encounters without compromising their mission to provide convenient, cost-effective, high quality medical care. Dragon Medical One and PowerMic III not only streamline the documentation process, but also allow for real-time review of records when exam details are more easily captured.

“I’m definitely more satisfied using Dragon Medical One. I find I’m creating more detailed records since I can easily add little bits of information into the templates. It saves time.”

Dr. Mary Jo Shaw, pediatrician, Coeur d’Alene Pediatrics

When documenting patient encounters in their Greenway Health EHR, Coeur d’Alene Pediatrics providers were either typing quite heavily or dictating into digital recorders and sending audio files to the on-staff transcriptionist. “Dictation is an efficient means of capturing data, but our transcription process was quite involved and inefficient,” says Devin Berend, director of operations. The organization chose to implement Dragon Medical One, a secure, cloud-based speech recognition solution hosted on the Microsoft Azure HITRUST CSF-certified platform. When clinicians began completing their documentation in the moment, they both streamlined their workflow and eliminated the inevitable transcription turnaround time. Meanwhile, the transcriptionist could serve in more value-added roles.

Flexible training, improved workflow, and rapid adoption

Providers began using Dragon Medical One with PowerMic III, quickly adapting to the new, streamlined workflow. “Training was easy and straightforward,” says Berend. “The flexibility of the trainers has been outstanding—they worked with each individual user to ensure they were maximizing Dragon Medical One’s functionality and felt comfortable moving forward.” Initially rolled out to two physicians and one nurse practitioner, Dragon Medical One licenses have grown fivefold in just 18 months. “Our clinicians review their documentation in real time,” says Berend. “In most cases, the providers sign off that same day. When they sent their notes to transcription, it took one to two days for an authenticated patient record to be accessible or shared.” By shortening the documentation time frame, Coeur d’Alene Pediatrics can support good practice relations through timely communication to referring physicians as well as achieve financial integrity with shorter billing and coding cycles.

Documenting in the EHR and beyond

Dr. Mary Jo Shaw uses Dragon Medical One to create documentation in Greenway Health EHR as well as notes and letters. “Back when I was dictating longer histories on a recorder, I might lose my train of thought if I got interrupted because I couldn’t see the dictation in front of me,” she says. “What’s worse—occasionally our tapes were lost.” With Dragon Medical One, Dr. Shaw can complete patient charts the same day she sees them. Before, she had to wait for returned transcriptions. Patient records couldn’t be signed, closed, and sent to referring physicians until the next day. “I’m definitely more satisfied using Dragon Medical One,” says Dr. Shaw. “Not having to review transcriptions is a big plus.” Beyond the immediate turnaround time, Dragon Medical One makes it easier to capture more thorough documentation. “I find I’m creating more detailed records since I can easily add little bits of information into the templates,” says Dr. Shaw. “It saves time.”

Nurse practitioner Krista Adamson, PNP, achieved similar boosts in productivity and convenience. Before Dragon Medical One, Adamson would type and click boxes in the EHR. When a patient record required extensive narrative documentation, Adamson would dictate and send the file for transcription. The next day, when the transcribed text was available in the chart note, Adamson would review the content and sign the note. “Before, I spent more time typing,” says Adamson. “Now, I spend less time completing my chart notes because I use Dragon Medical One for smaller batches of text and annotations. It is also useful for letters and tasking staff instructions.”

Convenience, efficiency, and value

Although the cost savings are hard to quantify because of the reassigned in-house transcriptionist, Berend is pleased with the convenience, efficiency, and value of Dragon Medical One. “With Dragon Medical One, our clinicians can continue to dictate the way they were used to, but now they can log information in real time,” says Berend.

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