How Primary Care Physicians Are Significant in the US Healthcare System

08-April-2019 MTS TEAM Medical Transcription Company

As a medical transcription company, we know that accurate patient data is crucial for providing optimal patient care. When a patient falls sick, he/she first goes to a primary care physician. Primary care physicians are the logical basis of an effective healthcare system that assures high quality care, good patient satisfaction and efficient use of resources. Moreover, primary care physicians also have the right patient data that can be shared among multiple providers that may be treating the patient. A strong physician-patient relationship is essential to ensure better healthcare and patient satisfaction. Proper communication and trust helps to build good rapport between the patient and the doctor and it also helps the patients recover quickly.
pcps-are-significant in-us-healthcare-system
According to a study published in JAMA Internal Medicine, receipt of primary care is linked to high value care and better patient experience. According to David M. Levine, MD, MPH, Brigham and Women’s Hospital, Harvard Medical School, Boston, and colleagues, receipt of primary care is associated with more high-value care, and better respondent access and experience.

There are many countries that organize their healthcare system around primary care. The value of primary care is still a debated topic in the US Healthcare sector. The study mentioned above was conducted to know whether receipt of primary care affected the quality and experience of outpatient care in the United States. The researchers gathered data from adults aged 18 years or older. They compared 49,286 adults who received primary care to 21,133 who were without primary care during the study period 2012 to 2014. They compared the performance in 39 clinical quality measures and seven patient experience measures. The outcomes were aggregated into high- and low-value quality composites, an overall patient experience rating, and experience composites.

From the study they found that for each year the frequency with which healthcare was used by adults with primary care was similar to that of adults without primary care. The mean number of the groups were, emergency department visits (0.2 for both; P = .17), outpatient visits (6.7 vs. 5.9; P = .11), and inpatient encounters (0.1 for both; P = .92). Patients with primary care received significantly more high value care in 4 or 5 composites than those without primary care did. This included high-value cancer screening, recommended diagnostic and preventive testing, high-value counseling, and among those with diabetes, high-value diabetes care. There was no significant difference in the proportion with and the proportion without primary care who received high value medical treatment such as statins for dyslipidemia.

With these findings, the healthcare system leaders and policymakers are looking for new ways to improve value in primary care. Allan H. Goroll, MD, Massachusetts General Hospital, Harvard Medical School, Boston suggested that underfunding primary care is the major reason for the poor performance by the US Healthcare system. The findings by Levine and colleagues show the valuable contribution of primary care in the US healthcare system; they recommend that additional investments and practice reform can help use primary care to its full potential.

Goroll suggests some ways to use primary care:

Changing the primary care payment model: The current payment model is retrospective fee for service structure which is undervalued. This should be changed to a risk adjusted, comprehensive prospective structure with enough resources to provide primary care.
Diversion of funds: 3 percent net investment in US healthcare spending to primary care could maintain a high-performing primary care system. This diversion of funds should be attainable by making small reduction in wasteful spending.
Relying on outcome measures rather than process measures, and providing more interdisciplinary training to improve physicians’ understanding of how the multidisciplinary, team-based model improves healthcare and workflow.

Primary care is important for patients as it provides a place to which patients can bring a wide range of health problems for appropriate attention. It also facilitates an ongoing relationship between patients and clinicians and fosters participation by patients in decision making about their health and their own care. A good doctor-patient relationship is vital to good health. Accurate medical documentation is also imperative. Today, most healthcare organizations hire medical transcription services to ensure reliable medical records. They offer customized services at affordable rates and also help physicians and other healthcare professionals focus more on providing quality patient care and service. The valuable time saved via outsourcing medical documentation also helps in building a strong doctor-patient relationship.

Could Virtual Care be the Future of Healthcare Services?

04-April-2019 Julie Clements Healthcare News

Virtual care or telehealth service is rapidly gaining popularity in the healthcare industry, which allows patients to seek medical advice and receive prescriptions through flexible channels from a medical practitioner without leaving the comforts of their home. The evolution of virtual doctor significantly helps in quick access to medical care, improves chronic diseases management, and ensures cost-effectiveness. E-visits help parents of children and older patients avoid traveling to the hospital, and save both time and money. virtual-care-future-of-healthcare-services Virtual visits are very useful for urgent care; these can truly provide an initial medical assessment of any injury or any temporary problems such as acne, tick bites, sinus, seasonal allergies, eye irritation, and strains and sprains that are clearly not life-threatening. With increase in the use of telemedicine and virtual visits, there will also be a consequential increase in the trend of outsourcing medical transcription for telemedicine.

Studies show that majority of patients and clinicians perceive no loss of communication when using virtual visits or e-visits as compared to traditional office visits. Only one-quarter of the consults typically result in a referral to the emergency department. A specialist or primary care doctor can direct the patient to the right facility through telemedicine. This helps in resolving urgent cases like wound lacerations, respiratory infections etc, even when the office is closed. Virtual visits are considered convenient and affordable, and also help in providing an effective diagnosis regardless of the specialists’ location. However, these cannot completely replace the existing healthcare continuum as yet because most of the e-visits are done for primary care or follow-up services of chronic conditions. Dermatology e-visits are also done by sending a close-up photo of the area. If the e-visits are providing high-quality care, more patients will demand it.

There are some legal challenges that physicians face when using telemedicine. In a 24/7 virtual clinic, majority of consults are done by videoconferencing to treat dozens of common issues. In order to capture the information for electronic medical records, physicians need to make sure if their systems are secure and HIPAA-compliant. Before instituting a telemedicine service, physicians should check with their liability insurers. Insurance claims for treatment of minor illnesses which were done through e-visits will be reimbursed. All private health plans, Department of Veterans Affairs, Medicaid, and Medicare now cover some e-visits. More health centers and hospitals are launching virtual health centers because the costs of virtual visits are less than in-person visits. However, according to health economists, e-visits could add costs rather than limit them if doctors and patients schedule e-visits unnecessarily.

The virtual care impact has made patient care more reliable than ever before and has simplified the consultation process. Doctors and consult experts from around the world can analyze detailed patient history and research conditions, even in the absence of any sophisticated medical facilities. There is no doubt patients also value the quality time they get with the doctor without having to travel all the way to the provider’s location. Researches show a large majority of patients rating virtual visits at 9 or 10 on a 10-point scale. This suggests that not seeing a doctor face-to-face may not after all, significantly impact the quality of care. For patients who live in remote locations and those who don’t have to visit a physician frequently, telemedicine and virtual visits could be really beneficial. Virtual visits are not appropriate for all patients in all situations, that is true. However, clinicians agree that virtual visits are better than office visits when it comes to scheduling of patient appointments and improving efficiency.

Medical transcription services for telemedicine, which would reduce the documentation burden on physicians, could also gain increasing popularity in the coming years if telemedicine/virtual care is adopted more widely across the healthcare spectrum.

Warm & Welcoming Physicians Can Help Improve Patient Health Outcomes

01-April-2019 Rajeev Rajagopal Medical Transcription

Finding different ways to improve the relationship physicians have with their patients is essential to create an entirely new environment for patients and staff. If a patient feels more valued and engaged, then he or she can bond better with their care providers, and quickly recover from their illness. A good patient-doctor relationship is essential for providing better patient care and to build up the relationship, doctors need quality time free from documentation hassles. A reliable provider of medical transcription services can take care of the medical documentation, allowing physicians to spend more quality time with the patients and focus on their individual requirements. Doctors must be good listeners too if they are to provide personalized care for their patient community.

physicians can help improve patient health outcomes

According to a study by researchers from Stanford University, doctors who are warm, welcoming and reassuring can actually improve health outcomes. Small things that doctors say and do to connect with patients can make a huge difference. A recent study was conducted at Stanford in this regard that included 76 participants. The participants received a skin prick test, a common procedure used in assessing allergies, and the pricks made their skin itchy and red. The doctor examined the allergy reaction. For one group, the doctor did not interact much whereas for the other group the doctor shared some words of encouragement. The group that was given assurance by their doctor reported that their reactions were less itchy. The doctors did not in fact give any medication to the participants. This shows that a doctor’s words might be more powerful than we normally realize.

Another study was also conducted to know whether the same words from a doctor influence patients differently depending on how warm or competent the doctor seemed. Again a group of participants were given a prick test. One group met a physician who was warm and competent, called patients by name, smiled, chatted and maintained eye contact with the patients. The other group met a physician who sat glued to the computer, did not introduce herself and asked random questions related to the allergy prick. For both groups, the physicians gave the same cream, a hand lotion, to reduce the allergic reaction and itching. The study revealed that the first group that went to the welcoming and warm physician experienced reduced itching and the other group who went to the less friendly physician had no effect even after applying the cream.

The study shows that the words and attitude of the physician who projected desirable qualities, warmth and competence, had a positive effect on the patients. In other words, doctors who take an effort to connect with the patients can ensure successful treatment. With advanced technologies such as AI (artificial intelligence) and ML (machine learning) being introduced in the medical field, you don’t need to go to the doctor and meet them personally for minor treatments. However, we should not underestimate the value of personally interacting with the doctor. Physicians should listen to their patients and treat them well and at every stage they should explain about the treatment, medications, tests etc., and keep patients informed about the possible consequences. Sometimes physicians find it difficult to build a good rapport with the patient during short visits but it does not take too long to obtain information about the patients. The time spent to develop a closer relationship with the patient is time well-spent because it will ensure positive outcomes in terms of improved health outcome for the patient and improved patient satisfaction for the physician.

With the introduction of the EHR, doctors are forced to spend most of their time on medical documentation and related jobs. Busy physicians can hand over the medical documentation process to a competent medical transcription outsourcing company and enjoy the advantages such outsourcing brings.

What Makes the Emergency Room Vital for All Hospitals

28-March-2019 MTS TEAM Medical Transcription Company

An emergency room or ER is a medical treatment facility for critically ill patients when they have had some type of accident or emergency. The severity of their condition and the treatment is determined through a process called triage, which is immediately done by triage nurses and physicians in ER. Since the ER was commonly used for emergency medicine services, hospitals developed the department of emergency medicine. Gradually the emergency medicine service was recognized as a medical specialty for patients who present without prior appointment for treatment for any acute illnesses or injuries. The emergency rooms are the entry points to their medical care. The ER service also records patients’ clinical data/ER reports for which outsourced services from medical transcription companies are often utilized.

emergency room hospitals

Components of EMS System

The emergency medical service includes information system management, medical direction and evaluation, governmental legislation and regulation, integration of health services, and prevention awareness.

Critical Conditions Are Handled in the Emergency Rooms

ER physicians treat conditions such as physical trauma, mental illness, asthma and COPD, myocardial infarction, cardiac arrest, and heart attack, among others. Emergency care has a significant role to play in healthcare delivery and almost half of all hospital-associated medical care is provided in emergency departments, as surveys and studies confirm. This large volume of medical care provided in emergency rooms could be due to reasons such as the quick access to healthcare, and patients’ trust in the comprehensive care delivered by emergency departments. Another reason for overcrowding in ERs may be lack of insurance coverage. Patients are allowed to visit the ED even if they don’t have insurance coverage. ERs are open round the clock and accept patients regardless of insurance coverage and regardless of the payer.

The emergency room is a place connecting all providers and organizations involved in the care of the patient. In fact, the ED provides support to primary care practices by performing complex diagnostic assays and also by handling overflow as well as after-hours and weekend demand for care. When patients are treated in an ED, it is a great support for office-based physicians, especially patients with complex and potentially serious conditions.

Emergency Room Vital Procedures

A medical screening exam is conducted in the following manner.

An emergency room physician examines you and asks questions.
Diagnostic tests are prescribed if necessary. These include electrocardiogram (ECG), CT scans, x-rays, blood work, etc.
Consultations are also coordinated with other specialists.

Demand for Hospital Emergency Departments

The importance of the emergency room is felt in many rural areas where shortage of doctors often causes these departments to function erratically. The lack of doctors, and closure of emergency rooms along with an ever-growing patient registry could be a serious problem. Overcrowding is another concern in emergency rooms.

Emergency departments could be overcrowded because of an inability to treat all patients in an adequate manner, if there is lack of emergency room physicians or nurses. Usually, they will do their best to provide you with privacy and the best quality of care. Crowding also occurs when the emergency patients are held in the emergency department until inpatient beds are available.

In some areas, access is blocked to emergency departments because of overcrowding. However, RAND researchers reviewing such incidents point out that if patients are given timely access to primary care and less expensive forms of care, it could reduce the number of non-urgent visits to emergency departments. The operations of emergency departments must be integrated into both inpatient and outpatient care systems. For this, more use of interconnected health information technology, better coordination of care and case management, and more collaborative approaches to medical practice are necessary. When these steps are taken patients would be given better access to non-emergent care, and you can minimize duplicative testing, and avoid unnecessary hospital admissions.

Medical transcription outsourcing companies assisting ER physicians would endorse the view that emergency rooms are vital for all hospitals. The ER offers hope and a positive outlook for patients and their families. There are so many reasons why emergency rooms are important not only to patients and their families but also to physicians and hospital systems. Appropriate measures must be taken to avoid ER overcrowding and physician burnout.

Study: Overlapping Surgery Safe for Most Patients, but Not High-risk Groups

21-March-2019 Rajeev Rajagopal Medical Transcription Outsourcing

General surgeons diagnose and treat surgical conditions affecting various areas of the body – the breast, lung, abdomen, thyroid, arm, legs, colon, rectal, skin, and more. Operative reports describe the indication, procedure, and any complications of the procedure and must be completed immediately after any operative procedure. Most surgeons prefer to outsource medical transcription to ensure timely documentation of dictated operative reports, which is crucial to manage the patient throughout the postoperative period. Such support can prove extremely valuable for surgeons performing overlapping surgery – scheduling procedures in more than one operating room at a time. However, a new study published in the Journal of the American Medical Association suggests that surgeons should be cautious about overlapping surgeries for high-risk patients as it may pose higher death rates and complications for this group.

The Case for Overlapping Care

In overlapping surgery, the main surgeon will move from one operating room to another performing the critical parts of one surgical procedure, while his or her team of trainee surgeons or physician assistants completes another patient’s surgery. For instance, the assisting team will close up an incision (a non-critical portion of an operation) on one patient as the senior surgeon begins surgery on another patient. Massachusetts General Hospital provides several reasons for using overlapping care:

Useful in emergencies – when many people are injured who need immediate surgery, overlapping surgery allows them to be treated by the hospital’s most skilled surgeons and their teams.
Cuts time waiting – Overlapping cuts the time patients may need to wait to have their non-emergency surgery as well as the time surgical teams must wait between cases.
Improves access – Overlapping allows patients greater and more prompt access to certain surgical specialties.
Ensures availability of important services – Overlapping enables more surgeries to be scheduled during the daytime hours when important areas such as pathology, laboratories and radiology are fully operational.
Promotes optimal use of resources – Managing operating rooms effectively helps the surgical team care for patients more efficiently.
Facilitates education of newer surgeons – Teams of less experienced surgeons gain significant knowledge from the attending surgeon has extensive training and experience.

Overlapping Surgery vs Concurrent Surgery

The American College of Surgeons (ACS) distinguishes between overlapping surgery and concurrent (simultaneous) surgery, and advises against concurrent surgery. According to the ACS,

Overlapping surgery is when critical portions of cases do not coincide, that is key elements of the first operation are finished, freeing up the primary attending surgeon to start an operation in another room while others finish the first operation.
In concurrent surgeries “the critical or key components of the procedures for which the primary attending surgeon is responsible are occurring all or in part at the same time.”

ACS guidelines state: “A primary attending surgeon’s involvement in concurrent or simultaneous surgeries on two different patients in two different rooms is not appropriate.”

Overlapping Surgery not safe for all Groups of Patients

The new study found that overlapping surgery is safe for most patients, but not for all. The researchers looked into the safety of overlapping surgery in about 66,000 patients at one of eight institutions included in the Multicenter Perioperative Outcomes Group registry. The surgeries performed included joint replacement, coronary artery bypass graft surgery, spine surgery, and craniotomy. A given surgeon’s overlapping operations for each of these types of surgeries were compared to non-overlapping operations he or she performed. The study found that:

For most overlapping surgeries, there was no increase in deaths or overall complications (major and minor surgical complications combined) compared to surgeries that did not overlap.
Major complications such as stroke and heart attack were slightly higher for overlapping surgeries.
In high-risk patients (those with a high risk of dying or developing post-operative complications based on their age and pre-existing health conditions), surgical overlapping resulted in slightly higher death rates.
In both overlapping surgeries involving coronary artery bypass grafting and those involving high-risk patients, mall errors in surgical care could have harmful effects.

“Overall, the study findings suggest that overlapping surgery is likely to be a safe practice for most patients, but the exploratory analyses do suggest potential areas for concern and further investigation”, the researchers concluded.

Need to Keep Patients informed

A 2017 U.S. study found that most people don’t know that surgeons are sometimes involved in multiple operations happening at the same time. Most of the participants felt that patients should be told before surgery exactly which components of their operation might done by a senior surgeon or by a trainee, or resident, surgeon or an assistant. The researchers said that surgeons should discuss overlapping surgery with patients beforehand and obtain their consent if this is part of their practice. ACS guidelines state:

“As part of the preoperative discussion, patients should be informed of the different types of qualified medical providers that will participate in their surgery… and their respective role explained. If an urgent or emergent situation arises that require the surgeon to leave the operating room unexpectedly, the patient should be subsequently informed.”

Regardless of whether surgeons provide overlapping surgeries or not, outsourcing medical transcription can ensure accurate and timely operative reports. An experienced medical transcription company in the USA would have professional transcriptionists who are knowledgeable about the diseases and operative techniques relating to general surgery and its subspecialties. They can provide error-free EHR-integrated surgical reports, helping providers focus on their core tasks by freeing up their time.

ECRI Report Lists 2019 10 Top Patient Safety Challenges

18-March-2019 MTS TEAM Healthcare News

Running through March 17, 2019, Patient Safety Awareness Week (PSAW) is focusing on culture of safety and patient engagement. This is the right time to discuss the top patient safety concerns in 2019 as listed in a recent report from the ECRI Institute. Medical transcription companies ensure accurate and timely EHR documentation to help in the delivery of safe and effective patient care. However, the ECRI’s annual safety report named improper management of test results and diagnostic tools within EHRs as the top patient safety concerns in 2019. The report listed provider burnout and mobile health snags as other top patient safety worries.

The number one patient safety concern, according to the report, is diagnostic stewardship and test result management using EHRs. While most healthcare providers rely on EHRs for clinical decision support and test result tracking, ECRI says that they should remember that these systems are only part of the diagnostic process. The report states that the diagnosis, the treatment plan, and the follow-up plan must be clearly communicated in the EHR so that future clinicians can understand it. Faulty information or missing test results can lead to diagnostic errors. To avoid this, the report notes that providers:

Must properly utilize an EHR designed to meet their practice’s unique needs
Understand the importance of clear communication, both among caregivers and between caregivers and patients
Have all the information and test results available in the EHR
Know when and where to find this information to make the right diagnosis

ECRI’s 2019 report lists antimicrobial stewardship in physician practices and aging services as the second most important patient safety concern. Organizations need to be able to implement and support antimicrobial stewardship programs. Patients expect an antibiotic to help them get better. Unnecessary antibiotic administration puts patients at unnecessary risk of adverse drug reaction and overprescribing leads to antimicrobial resistance. To cut this threat, physicians need to manage patient expectations. Antibiotic stewardship does not mean withholding necessary treatment. It means determining an antibiotic’s appropriateness for the patient being treated. ECRI recommends that in some cases, the best policy is to give patients a prescription for what to do, what to watch for, and follow up with them.

Many studies have shown that physician burnout negatively impacts patient care and safety. ECRI lists healthcare provider burnout as the third patient safety concern. “Burnout is indiscriminate,” notes the report. “It affects physicians (including trainees), nurses, allied healthcare providers, and organizational leaders alike. And it can no longer be ignored.”

By ensuring efficient EHR-integrated clinical documentation support,medical transcription outsourcing can reduce physician burnout significantly. Besides EHR documentation, the report identifies the factors responsible for burnout as:

The high expectations that physicians have for their own performance
Keeping up with the rapidly evolving healthcare scenario
Time pressures and limited resources
Treating an increasing number of patients with complex medical conditions

To address burnout effectively, the report notes that organizations must address providers’ concerns about workload, performance criteria, and suboptimal resource allocation. Moving to a safety culture that rewards and recognizes a job well done is necessary, the authors point out.

According to ECRI, the number 4 patient safety concern relates to mobile health snags. Mobile health technology is transporting healthcare into the home, but ECRI notes that it comes with the following patient safety risks:

Lack of government regulation of new technologies
Barriers to ensuring that providers are accurately receiving the data a device collects
The possibility that a patient is not using the technology correctly or is not using it at all

The report recommends the following measures to address mobile technology usability concerns:

Ease of use
Establishing methods for informing clinicians about user error and inactivity
Identifying the right candidates for mobile health
Clearly defining goals before recommending any care plan featuring mobile health technology
Matching patient health conditions to the right piece of technology
Assessing the likelihood the patient will accept mobile technology
Providing training for both providers and patients on how to use a device

The next patient safety challenge on the ECRI list is reducing discomfort with behavioral health. Patients with behavioral health needs are present in every care setting, the report states, and they need to be treated with dignity and respect.

However, healthcare providers don’t necessarily recognize this, says the report. As a solution, the authors recommend options such as certified training, training led by internal experts or consultants, community behavioral health first-aid workshops, or a combination. Also, healthcare organizations can also develop internal and external support systems and should utilize community resources whenever possible.

The list of patient safety concerns in 2019 also includes: failure to detect changes in a patient’s condition, developing and maintaining clinical skills, early recognition of sepsis across the care continuum, infections with peripherally inserted IV lines, and problems with standardizing safety efforts across large health systems.

“Regardless of organization size, the goal is to institute structures that effectively allow patient safety leaders to support organization leadership in engaging with patient safety priorities”, the authors conclude.

Outsourcing medical transcription will allow healthcare providers to focus on resolving these patient safety concerns.

Telehealth – A Powerful Tool to Manage Flu Patients

14-March-2019 Julie Clements Medical Transcription Outsourcing

Recent reports indicate that the current flu season is far from over. The Atlanta Journal-Constitution reported that during February 2-9, the number of people seeking treatment for the flu peaked nationally since the current flu season began last October. Healthcare providers are resorting to a variety of techniques to handle the surge of patients, including medical transcription outsourcing to manage their documentation tasks. Experts say that telehealth is a safe and efficient option to combat the challenges of the flu season and provide better care.

According to the CDC, the impact of the October 2018 through February 16, 2019 flu season includes 8,200,000 – 9,600,000 medical visits, 214,000 – 256,000 hospitalizations, 13,610 – 22,300 flu-related deaths, including 41 influenza-associated pediatric deaths. Providers are having a tough time dealing with the situation with challenges ranging from controlling the epidemic, protecting vulnerable populations, increased workloads and staffing problems. They also need to educate patients about flu shot recommendations and ensure that supplies are available in places where patients can get them. A recent Medical Economics report highlights the role of virtual care in mitigating the spread of the flu virus.

Reduces infection points: The CDC recommends that people who are sick stay home so they don’t infect others. Telemedicine allows sick patients to get care without having their homes. As the article points out, the virtual care option can prevent the spread of the virus among high-risk populations such as such as pregnant women, infants, older adults, and patients with weakened immune systems.
Automation of the office visit increases efficiency: Today, providers can offer a virtual visit from a PC or laptop in a small room, while patients can access the services from even a smartphone. Digital health technology allows providers treat flu patients quickly and efficiently online, in a fraction of the time of a physical office visit. This gives clinicians more time for patients with chronic or high-acuity conditions.
Reduces provider stress: Telemedicine can help reduce the burden of disease management for physicians. With a virtual care system integrated into the practice’s EHR platform, providers are freed of the extra time needed for paperwork. The report notes that the improved efficiency provided by virtual care helps prevent provider burnout, which usually intensifies during the fall and winter months.
Helps track outbreaks by location: Telehealth platforms offer data on flu outbreaks in different locations, which helps systems monitor virus spread in their own communities. Areas where the virus is widespread can then staff up, increase communication about preventative measures, and set up more immunization centers.
Resolves staffing shortages: During the flu season, it often happens that healthcare staff falls sick. Virtual care allows affected providers to treat patients from their homes. Staying at home will ensure that they get the needed rest, so that they can return to their clinic or hospital sooner.

According to Dr. Mark Friedman, First Stop Health’s Chief Medical Officer, telemedicine plays a valuable in providing “surge capacity” for the treatment of victims of the flu epidemic. In a Telemedicine Magazine article, he noted that for most people under age 65, the flu can be diagnosed and treated by a doctor via a telemedicine consultation. This round-the-clock access to a physician via a virtual consult avoids the need for late-night visits by patients to over-crowded and expensive hospital emergency departments. It also eliminates the travel and long wait-times typical of day-time visits to urgent care centers or physicians’ offices.

Other benefits of telehealth for flu management include:

Early treatment: To be effective, flu medications must be started within two to five days after illness onset. With a real-time video consultation, providers can diagnose and treat the condition, ensuring that patients get the necessary early treatment.
Better inventory management: Telehealth service providers ensure that all the medical equipment and supplies physicians need are available on time. Providers can rest assured that patients will get the care they need without delay.
Improves access for patients in remote and underserved areas: Patients in rural areas may need to travel miles to see a doctor. With virtual care systems, providers can reach patients even in remote locations.

Documenting flu symptoms and related signs accurately is necessary for proper patient care as well as for the submission of claims. In addition to vital signs, providers need to document respiratory complications, dehydration and fever, nausea/vomiting/diarrhea, etc. Medical transcription services are a useful option to document the patient’s medical condition in the EHR. Just like a virtual care system, a reliable medical transcription service company can prove a valuable partner for providers working to reduce the impact of the flu outbreak.

Study: Primary Care improves Care Quality, Access, and Patient Experience

11-March-2019 Rajeev Rajagopal Medical Transcription Outsourcing

Primary care providers are the key players in the healthcare system. The Institute of Medicine (www.nap.edu) defines primary care as: “The provision of integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community.” To provide high quality care, primary care providers maintain structured patient records with the help of medical transcription outsourcing companies. Medscape recently reported on a new study published online in JAMA Internal Medicine found that receipt of primary care is associated with more high-value care, and better patient access and experience. The study was led by David M. Levine, MD, MPH, Brigham and Women’s Hospital, Harvard Medical School, Boston.

Primary Care Model – Key Takeaways

Primary care covers family medicine, internal medicine, nursing, nurse practitioners, pediatrics, general ob/gyn, gerontology, pharmacy, behavioral health, community health, and the other professionals who meet a community’s general medical care needs. Primary care helps catching and treating problems early and lowers medical costs.

Primary care promotes better health care as well as better access to care, notes the American Academy of Family Physicians (AAFP). According to the AAFP, it has been found that an increase of one primary care doctor per 10,000 people can lead to:

5% decrease in outpatient visits
5.5% decrease in inpatient admissions
10.9% decrease in ER visits
7.2% decrease in surgeries

Further, the AAFP says that communities with better access to primary care have lower infant mortality, higher birth weights, and immunization rates at or above national standards, regardless of social disparities.

The authors of the study published in JAMA Internal Medicine point out that the value of primary care in the U.S. is “unclear” as the nation organizes its healthcare around hospitals and specialty care. To determine the effect of primary care on the quality and experience of outpatient care, the researchers analyzed data on participants in the Medical Expenditure Panel Survey. They compared:

49,286 adults aged 18 years or older who received primary care to 21,133 who did not receive primary care from 2012 to 2014.
Performance in 39 clinical quality measures and seven patient experience measures. Outcomes were aggregated into high- and low-value quality composites, an overall patient experience rating, and experience composites.

The study found that patients with primary care received considerably more high-value care in 4 of 5 composites than those without primary care did.

Levine and his colleagues conclude that value of primary care can be improved only by increasing investment. “Policymakers and health system leaders seeking to improve value should consider increasing investment in primary care”, they wrote.

Physician Burnout – Need for Effective Task-sharing in Primary Care

With their increasingly important role in enhancing care outcomes and access, primary care physicians also have a high risk of burnout. The causes of physician burnout are complex, but are mostly linked to increasing workload, time pressures, hectic work schedules, declining pay, and unproductive bureaucratic demands of health insurance companies.

Direct primary care (DPC) is one solution to this problem. In this model, the family medicine physician provides care directly for his patients in exchanges for a monthly fee. This system allows physicians to spend more time with their patients and reduces stress by cutting the time that would be needed for bureaucratic administrative processes.

Studies have found that team-based practices can ease the toll on the primary care team, significantly enhancing resilience and reducing burnout, improving patient outcomes, and cutting costs (www.primarycareprogress.org). In the team-based care, other primary care professionals such as medical assistants help in managing the increased workload, taking some of the burden off physicians. When it comes to efficient record-keeping, practitioners can rely on family practice transcription services. An experienced medical transcription service provider can help the primary care team maintain accurate patient records which are essential to maintain seamless communication and get a proper perception of a patient’s problems and needs.

Nurse Burnout – Major Causes and Possible Solutions

07-March-2019 MTS TEAM Medical Transcription

Burnout is a serious concern for healthcare providers such as doctors, nurses and other clinicians. It signifies physical, mental, and emotional exhaustion that is brought about by many factors and needs to be addressed at the earliest. Burnout is serious because it creates a sense of despair and undermines motivation. Apart from working long shifts, nurses may also be in charge of documentation, transcribing physicians’ notes or assisting with the EHR. Where physicians utilize medical transcription services, the documentation workload can be considerably reduced but this is not always the case. When nurses experience burnout, the impact filters down to the patients also, and hospitals with high burnout typically have lower patient satisfaction.

Studies and surveys list the following major causes for nurse burnout.

Long working hours: This could lead to fatigue and more chances of error in nursing.
High-stress environments: Nursing responsibilities have increased over the past decade because of advancements in technology and documentation. Often hospitals are short-staffed, which makes it very hectic for nurses. Many of them are stressed out and overwhelmed, which could ultimately lead to burnout.
Emotional issues that come with witnessing sickness and death: Daily exposure to illness, grief, and death could place huge emotional burden on nurses. This could wear them down and result in burnout if not addressed properly.
Selfless attitude: Nurses are dedicated and selfless and always put others first. They may neglect their own needs and become worn out with the passage of time.

According to a 2017 Kronos survey of registered nurses (RN) in a hospital, more than 63 percent reported burnout. The latest Press Ganey report, “Performance Insights: Resilience for a Multigenerational Nursing Workforce” points out some the factors that lead to burnout and its remedy “resilience.” According to the researchers, this resilience differs according to nurse demographics such as generation, role, and shift.

Decompression and Activation

Press Ganey introduced an eight item tool to measure resilience and the tool has two separate subscales – one, to measure the degree of respondents’ engagement with work (activation) and two, to measure respondents’ ability to disconnect from work (decompression).

They reviewed the activation and decompression scores of 17,483 nurses from 145 hospitals who completed the Nursing Excellence module of their organization’s 2017 Press Ganey Employee engagement survey. The results were categorized according to generation (millennial, 1980 to 2000; Generation X 1965 to 1979; baby boomer 1946 to 1964) day or night shift, and manager status.
The activation subscale is based on respondents’ level of agreement with the following statements:

I care for all patients equally even when it is difficult
My work makes a real difference
I see every patient as an individual with specific needs
My work is meaningful

The decompression subscale is based on respondents’ level of agreement with these statements:

I can enjoy my personal time without focusing on work
I rarely lose sleep over work issues
I can free my mind from work when away from it
I am able to disconnect from work communications during my free time

Apart from this, activation and decompression were evaluated using 2017 NDNQI RN survey results obtained from 161,451 nurses working in 643 hospitals. The following statements were used for the purpose.

I have what I need in my job so I can make a contribution that gives meaning to my life (activation)
Overtime hours in my last shift (decompression)

These results were categorized by the role of nurses such as nurse manager, staff nurse, charge nurse; and generation.

Important Findings

The researchers found that activation and decompression varied among nurses according to generation, nurse manager status, shift, and nurse tenure. The key findings of the report are:

Millennial nurses have the lowest levels of activation.
Nurse managers have better activation than non-managers.
Non-managers are able to decompress more than managers.
Millennial nurses working the night shift have an even further activation disadvantage.
Both non-managers’ and nurse managers’ ability to decompress is highly connected with their view of stress and the organization’s support of work-life balance.
Across all generations, activation and decompression are highly associated with nurses’ intention to stay in their jobs.
Drivers of activation and decompression vary by generation and manager status. Nurse managers that have a greater level of autonomy may report higher levels of activation than staff nurses. They may have lower levels of decompression because of the additional responsibilities associated with the role of a manager.

How to Address the Problem

According to the researchers, the following interventions can help promote resilience:

Meaningful recognition.
Interventions that meet different needs of different nursing groups like night shift nurse, millennials and nurse managers.
Resilience training for nurses at all levels.
Resilience-focused support and resources to all nurses in all shifts.
Focus on relationship-building activities and opportunities for better nurse social support.
Train nurse leaders to support staff nurses’ alignment with professional purpose.
Include resilience building burnout prevention strategies in the operational budget.

A medical transcription company assisting physicians, hospitals and other providers understands the value of reliable support for those in the healthcare industry. Just as other clinicians, nurses could also benefit from valuable support and increased focus on self care. They must give importance to their mental health and find time to relax and also ensure that they get sufficient sleep. Ideally, they should not ignore their feelings of stress or grief and must find somebody they can talk to freely. This will help avoid burnout to a great extent and make progress in their healthcare career.

Key Strategies to Improve Patient Satisfaction Scores in Surgery Centers [Infographic]

28-February-2019 Julie Clements Infographics

Studies report that it is important to examine the relationship between patient satisfaction and quality for surgical patients, along with surgical care. Poor patient satisfaction scores can affect a surgical center’s reputation as well as reimbursement. Surgeons should also focus on good documentation by considering medical transcription outsourcing, as it helps to maintain EHR progress notes and operative reports.

Read the infographic below