e-QME
CALIFORNIA QME WORKFLOW — PROTOTYPE

From exam dictation to a complete, review-ready QME.

e-QME is being designed to streamline the medical-legal workflow: ingest case artifacts, convert physician dictation to text, structure the preliminary QME, identify missing evaluation criteria, apply a validated AMA Guides 5th Edition rules engine, and prepare the report for physician review and certification.

Physician-controlledRules-based ratingSource traceabilityHIPAA-ready architecture planned
QME Case Progress
01Intake / Form 110Complete
02Patient HistoryComplete
03Exam + DictationComplete
04AMA Rating Review2 criteria pending
05Physician CertificationLocked
WHY e-QME

Current state vs. e-QME future state

The goal is not to replace physician judgment. It is to remove repetitive clerical work and make completeness, rating logic, and source review easier to verify.

Current State

  1. Receive QME case documents and schedule patient.
  2. Review history and records across separate artifacts.
  3. Conduct exam and dictate findings.
  4. Send audio for human transcription and wait for Word output.
  5. Manually reconcile findings and missing criteria.
  6. Perform impairment rating and look up AMA citations.
  7. Assemble and review the California QME report.

e-QME Future State

  1. Upload intake package and patient history once.
  2. Automatically extract case, party, and report data.
  3. Conduct exam and upload physician dictation.
  4. Dragon Medical speech-to-text creates the transcript.
  5. e-QME structures findings and prompts only for missing criteria.
  6. Rules engine calculates applicable AMA 5th methods and citations.
  7. Physician reviews, certifies, and finalizes the report.
e-QME high-level workflow architecture
Dr. Douglas J. Abeles in a hospital setting
Douglas J. Abeles, MDFounding Physician • Orthopaedic Surgeon • QME / Medical-Legal Evaluation
PHYSICIAN-LED PRODUCT DESIGN

Built around Dr. Douglas J. Abeles’s real QME workflow.

e-QME is being developed around the day-to-day medical-legal workflow of Douglas J. Abeles, MD, an orthopaedic surgeon in Castro Valley, California. The objective is simple: reduce repetitive administrative work while preserving physician control over every medical finding, rating methodology, opinion, and final report.

Dr. Abeles has maintained an active orthopaedic practice since 1996. His public practice biography describes extensive experience in sports medicine, spinal surgery, general orthopaedics, workers’ compensation, and medical-legal evaluation; more than 4,000 procedures; and substantial litigation and expert-witness experience.

Orthopaedic SurgerySports MedicineSpineWorkers’ Comp / QMEMedical-Legal

Professional biography summarized from Dr. Abeles’s public practice website. Final external marketing copy remains subject to Dr. Abeles’s approval.

THE STORY BEHIND e-QME

A nearly 50-year friendship became a physician-software collaboration.

e-QME did not begin as a generic software concept. It grew out of a long friendship, a physician’s real-world workflow, and a shared belief that modern technology should remove repetitive work without replacing medical judgment.

1976

Two high-school friends meet

Doug Abeles and Richard Paczan met in 10th grade at Eleanor Roosevelt High School as members of the ERHS golf team. Their friendship grew around a shared interest in medicine, science, skiing, and a desire to become doctors.

High School Years

Medicine was already part of the plan

They took AP Biology together, ran the ERHS Ski Club during their junior and senior years, and both obtained senior-year internships at the NIH Cancer Research Institute.

Decades Later

Different careers, same problem-solving instinct

Doug built a career in orthopaedic surgery and medical-legal evaluation. Richard followed a different professional path, but the friendship remained—and so did a shared habit of asking how complex problems could be solved better.

2026

e-QME takes shape

Conversations about Doug’s QME workflow exposed opportunities in transcription, document handling, AMA rating support, completeness review, and report preparation. e-QME is being designed around those real pain points rather than asking the physician to adapt to the software.

e-QME design principle“Build around the physician’s workflow—not around a software company’s idea of how a physician should work.”
WORKING PROTOTYPE PREVIEW

Simple enough to use in the exam workflow.

Good afternoon, Dr. Abeles

Here are the QME cases that need your attention.

6Upcoming exams
3Pending review
2Missing criteria
4Drafts ready
Active CasesDemo data
PatientExamLocationStatus
Michael R.Sep 1Castro ValleyMissing criteria
Jennifer L.Sep 3Castro ValleyDraft ready
Robert C.Sep 8Castro ValleyScheduled

Create QME Case

Upload the artifacts Doug already receives. e-QME extracts the details.

Upload Case Artifacts

No files added in this demo.

QME Calendar

Prototype calendar. Future integration can use the scheduling system Doug’s staff already maintains.

September 2026
SunMonTueWedThuFriSat
16 QME exams
2
34 QME exams
4
5
6
7
85 QME exams
9
10
11
12

Prototype Patient

QME workspace • Castro Valley • Draft status

Pending Review

Case Information

Panel #: 1234567

Claim #: WC-DEMO-001

DOI: 08/01/2026

Representation: Represented

Artifacts

✓ Form 110 / Intake

✓ Patient History

✓ Dictation Audio

✓ Dragon Transcript

Needs Attention

2 AMA rating criteria require physician confirmation before the draft can be completed.

Patient History

This area will display the uploaded history and the structured history extracted for the preliminary QME. Important statements can retain source-document/page provenance.

Dragon Medical Transcript

RIGHT KNEE: Patient reports no current pain. Flexion measured to 120 degrees. No gross instability is appreciated. Alignment demonstrates valgus...

Prototype: original transcript is treated as a source artifact. e-QME-generated report text is separate.

Rating Readiness

✓ Pain — None

✓ Flexion — 120°

⚠ AP stability — physician confirmation required

⚠ Alignment — confirm 10° valgus

Method Comparison

Prototype values only until source-verified AMA rules are loaded.

AMA Authority

AMA Guides 5th Ed.
Ch. 17 • p. 549 • Table 17-35

Review AMA Source ↗
PRELIMINARY QME — PHYSICIAN REVIEW REQUIRED

Permanent Impairment

Based on the physician-confirmed examination findings, the preliminary impairment calculation is shown here with the applicable AMA Guides 5th Edition methodology and cross-reference.

AMA Guides 5th Ed. • Ch. 17 • p. 549 • Table 17-35 Review Source ↗
Finalization Locked

Dr. Abeles must complete missing criteria, review the entire report, and certify responsibility for the final medical opinions and accuracy before Finalize is enabled.