Proper documentation of cardiology medical records is important for the successful management of a cardiology practice and cardiology departments in hospitals. It helps with easy and convenient medical coding and billing, gives facts, findings and observations during patient visits, and also becomes useful at the time of auditing. Accurate medical transcription allows cardiologists to maintain accurate medical reports of their patients. Cardiology transcription services help cardiologists to maintain accurate transcripts of their audio recordings. Given the complexity of this medical specialty, there is no doubt that any transcription must be done only by reliable, trained and experienced transcriptionists at a medical transcription company. This will ensure that all cardiology terms are accurately transcribed.
What about the cardiology terms doctors may use when talking to their patients? This often proves to be a major stumbling block in the way of effective communication. Clear and effective communication is necessary to improve patient satisfaction, and ensure improved health outcomes. The medical student learns up to ten thousand new words in the course of their medical degree, and as doctors they use these terms in patient communication. This naturally leads to misunderstood words and less effective communication. A transcriptionist may understand medical jargon, but a patient may not. Now, more emphasis is placed on communication skills at medical schools in the hope of reducing this type of jargon and using more simplified terms.
A study was conducted in the UK to evaluate patient understanding of commonly used cardiology terminology and doctors’ estimation of this understanding. For the study, questionnaires were distributed to hospital in-patients. They were asked to define 10 commonly used cardiology terms. The definitions they provided were graded individually according to their accuracy. Then doctors were asked to predict the percentage of patients who they thought would accurately define each term via an online questionnaire. The terms that were considered for the study were:
- Heart attack
- Heart failure
- Tracing of the heart
- Leaking heart valve
- Cardiac arrest
- Blood-thinning medication
- Blood pressure
Of the total 70 questionnaires distributed, 57 were returned. It was found that the most poorly understood terms were heart attack, echo, leaking heart valve, and heart failure. The patients seemed to understand only ‘blood-thinning medication’ and ‘stent’ that achieved partial or complete understanding of greater than 50%. The terms cardiac arrest and heart attack were frequently confused. The most common misunderstanding was that of heart failure. More than 25% of respondents defined this as cardiac arrest. Doctors need to exercise extreme caution when using the term heart failure and when it is used, careful explanation should follow. Around 40% of the patients opined that too much terminology was used and that explanations offered were inadequate. 26 doctors responded to the online survey wherein they were asked to estimate the percentage of patients who they thought would completely understand these terms. The study found that doctors’ estimations of patient understanding of the terms were generally inaccurate and prone to overestimation.
It is unfortunate that these terms are frequently used without further explanation and often without checking patient understanding. The study suggests that medical teams should ensure more effective communication with patients. Consultations should not ideally be limited by time constraints. Sometimes, doctors may overestimate patient understanding, thinking that such terms are obvious to the general public. Patients, on their part, hesitate to ask for explanations even when they don’t understand certain terms. Medical staff should ideally keep these points in mind during consultations so that patients are not left confused and in a state of misunderstanding, which could prove dangerous.