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

How Millennials are Transforming Health Care

25-February-2019 Rajeev Rajagopal Medical Transcription

Millennials now have a major impact on every industry, including healthcare. Reports say this group of people born between 1981 and 1996 could reshape the healthcare industry, especially telehealth, and are upending the primary care model. This demographic seeks the same digital solutions in healthcare as in other aspects of their lives. The majority of millennials want access to healthcare on their mobile devices, according to a Harris Poll survey (www.mobihealthnews.com). Physicians need to maintain accurate electronic health records (EHRs) to meet the needs of millennials and medical transcription services can help with this. Here are the ways in which millennials are transforming health care:

Are less likely to have a primary care provider: Physicians Practice recently reported that a new poll by the Kaiser Family Foundation showed that millennials are less likely than previous generations to have a primary care physician (PCP). In the poll, 45 percent of 1,200 random persons ages 18 to 29 reported they did not have a PCP. The reason for this is millennials’ preferences for convenience, fast service, connectivity, and price transparency, which the traditional office-based primary care model does not offer.To get the care they need, millennials are opting for alternatives such as walk-in retail or pharmacy-based clinics or outlets, free-standing urgent care centers that offer flexible hours, and virtual visits at telemedicine sites. A PNC Healthcare study showed that 34% of millennials prefer to go to a pharmacy clinic, while 25% prefer urgent care. Most retail clinics post their prices which are also affordable. Fast service and less waiting times are other attractions of these walk-in clinics.
Have an affinity for telemedicine: Telemedicine allows patients to link with physicians using a phone or interactive video conferencing from the comfort of their home. Reports say that patients have reported higher levels of satisfaction with the telemedicine visit compared to the traditional visit. Millennials are increasingly opting for telemedicine. In a 2017 Employee Benefit Research Institute/Greenwald & Associates Consumer Engagement in Health Care Survey, 40 percent of millennials reported that telemedicine is an “extremely or very important” option, compared with 27 percent among Gen Xers and 19 percent among baby boomers (Healthcare IT News).
Are avid technology adoptors: Gen Y loves technology and are “early technology adoptors”. A 2018 Pew Research Center study reported that more than nine-in-ten Millennials (92%) own smartphones, compared with 85% of Gen Xers, 67% of Baby Boomers and 30% of the Silent Generation. Also, the vast majority of Millennials (85%) say they use social media. This implies that, to target this group, healthcare providers need to understand the tech behaviors and preferences of this generation. They should be able to offer options such as online health portals, self-serve kiosks, online appointment scheduling, electronic medical record review, and online payment facilities.
Research online before making a healthcare decision: Generation Y relies on online resources including and their social networks to learn about their healthcare concerns and options. They google symptoms of their non-urgent health concerns online before they select a physician or fix an appointment. They may even self-treat. The survey mentioned in the Healthcare IT News report found that compared to baby boomers and Gen Xers, millennials are more likely to shop around and research healthcare options. Before seeking care, Millennials were more likely to have: checked on coverage for medications and quality ratings for a healthcare provider; discussed prescription and treatment options and costs with a physician, and used an online cost-tracking tool provided by a health plan to manage expenses.
Are very concerned about security of their personal health information (PHI): With millennials using online portals to send and receive as health care communications, they are also sensitive to data security concerns, according to a www.healthcarebusinesstech.com report. To minimize such concerns, portals used by hospitals and doctors will need to incorporate technology that promotes better privacy protection. When outsourcing EHR documentation tasks, they will need to choose a HIPAA compliant medical transcription service provider.

Physicians are adopting special strategies to cater to the expectations of this generation. According to a Beckers Hospital Review report, many primary care practices are hiring more physicians and nurse practitioners to reduce patient wait times. They are adopting patient-facing digital tools to better serve millennial patients and implementing other strategies to serve their needs, such as:

Replacing the office landline appointment booking method with scheduling software that will allow patients to book their own appointments online.
Sending text reminders on upcoming appointments
Greater flexibility in working hours such as keeping the lunch hour open for visits which is convenient for patients who can’t miss work.
Making it easier for millennials to get care by communicating with them on social media platforms
Ensuring more transparency in pricing and offering payment plans

Industry experts say that PCP practices that don’t refine their operations to meet millennials requirements could experience a fall patient volume over time. Partnering with an experienced medical transcription company in the USA can help providers manage their EHR documentation tasks as they strive to keep up with the demands of this demographic.

How Often Should Patients Meet Their Doctors? [Infographic]

21-February-2019 MTS TEAM Infographics

EHR-integrated medical transcription services can help physicians save documentation time and devote more time to patient care. While a good physician – patient relationship helps patients stay healthy and receive the best care, there is always a concern – how often should patients schedule visits to their physician? It is recommended that patients can visit doctors even when they are healthy to prevent any illness.

Read the infographic below

The Problem of Medical Care Overuse – When “More” is “Less”

18-February-2019 Julie Clements Medical Transcription Outsourcing

Medical records must contain pertinent and up-to-date information on the advice and/or treatment provided to a patient. Medical transcription outsourcing allows providers to ensure the patient record is an accurate and complete reflection of the patient encounter to facilitate continuity in patient care. Recent doctor visits, discharge summaries, lab and test results, medications, immunizations, allergies are all documented as soon as possible and to be compliant with relevant legislation and industry regulations. However, for years, one major concern has been that of medical overuse – medical interventions which are unnecessary and for which the potential harms may exceed the potential benefits.

Potential Areas of Medical Care Overuse

According to the Institute of Medicine, up to $210 billion is spent on unnecessary medical testing and medical care annually in the United States (www.hcinnovationgroup.com). In addition to the physical and psychological risks it poses for patients, unnecessary care increases medical costs. Further, downstream services such as unnecessary tests may lead to more unnecessary testing and treatment, causing medical errors and other negative consequences. Studies have identified the areas where overuse is commonly reported as:

Medications
Screening tests
Diagnostic testing
Therapeutic procedures (surgery and other invasive procedures)
Site of care delivery (stay in a hospital when a less aggressive site would be sufficient), and
End-of-life care

Examples of low-value wasteful medical care are: annual physical exams, nuclear stress tests for low-risk chest pain, cardiac imaging in people with low-risk symptoms, aggressive over-treatment for breast cancer, unnecessary thrombophilia testing due to concern about passing on the abnormal gene to children, specialty referrals, behavioral health (BH) therapy, and use of durable medical equipment (DME).

Reasons for Medical Care Overuse

There are many causes of medical overuse. The authors of a 2014 study published in JAMA Internal Medicine pointed out that each factor reinforces and amplifies the others, resulting in a “perfect storm of ‘more.'” According to them, the factors contributing to unnecessary overuse are:

Physician training and culture: As a recent report from the Memorial Sloan Kettering Cancer Center explains, physicians are trained not to miss anything. In cancer, especially, missing something can have grave consequences. Providers often end up doing too much or ordering too many tests. In a survey by researchers from Johns Hopkins and Harvard, respondents cited the reasons for overtreatment as: fear of malpractice (85%), patient pressure or request (59%), and difficulty accessing medical records (38%).
Fee-for-service payment structure: This payment model, which is now recognized as flawed, has led physicians to increasingly perform more procedures and more complex interventions that have little benefit or no benefit at all. The Affordable Care Act, signed into law March 2010, has several provisions that promote focus on increasing value of care. However, a 2017 Forbes report noted that about 86% to 95% of U.S. healthcare providers are still reimbursed based on the number of services they provide. This is driving up unnecessary care and healthcare costs.
Intensive marketing by developers of tests, drugs, and procedures: Pharmaceutical companies aggressively market their products, leading to overprescription of drugs way beyond their clinical usefulness for patients. Direct marketing to consumers via advertising on television, the Internet, the radio and in print is another factor driving inappropriate prescribing.
Defensive medicine: Medical Economics defines defensive medicine as “physicians ordering tests and procedures, making referrals or taking other treatment steps to help protect themselves from liability rather than to benefit their patients’ care”. Research suggests that physicians’ malpractice concerns are a key driver of habits of defensive medicine. Physicians who had a high concern about allegations of malpractice are more likely to order aggressive testing when diagnosing patients with new complaints of chest pain, headache, or lower back pain.
Cultural preference for technological solutions: Patients often prefer treatments that require visible effort and are drawn to expensive, ostentatious technology. While there are many, low-tech technologies in health care that do less harm, high-tech is winning. While technological advances in medicine have actually improved quality of life and increased life span, they can have very harmful effects. For instance, life-saving radiation therapy can have grave consequences if errors occur.
Lack of health care cost transparency: Low-value healthcare services, such as unnecessary imaging are expensive and time-consuming, but provide very little real benefit to the patients in terms of time and money spent. A 2016 study from The Dartmouth Institute for Health Policy and Clinical Practice reported that while 92.2 percent of the physicians surveyed said they felt responsible for managing costs, only 37 percent actually had a proper understanding of the costs of tests and procedures. About one-third of physicians actively tried not to think about costs while making treatment decisions. Such lack of awareness on the part of the provider is a major cause of unnecessary, costly tests and procedures.

Addressing Medical Care Overuse

Improper testing, needless procedures and interventions, and other low-value services are increasing costs of medical care as well as exposing patients to potential harm. The problem of medical care overuse can be addressed only by educating all stakeholders – physicians, patients, hospital and insurance administrators, policymakers, and pharmaceutical and medical device manufacturers – on the importance of high-value care. Other measures recommended by the 2017 ACP International Forum on Reducing Overuse and Misuse in Medical Care include:

Value-based reimbursement models in place of fee-for service models.
Strengthening primary care, which will promote cost-effective, comprehensive, and continuous care, helping patients avoid unnecessary hospitalization, emergency visits, procedures, and interventions.
Evidenced based, individualized care, accounting for quality of life and patient choice.
Electronic medical records with proper connectivity and systems that support high-value decision making and reduce duplication.
Eliminating or minimize the influence of for-profit corporations.

Medical transcription services help physicians ensure error-free medical record data entry. However, when it comes to avoiding medical care overuse, physicians need to make sure that tests and treatments they order are really beneficial for the patient.

What Patients Want from a Healthcare Provider?

14-February-2019 Rajeev Rajagopal Medical Transcription

A good patient-doctor relationship is vital to ensure quality patient care and medical transcription services minimize the burden of medical documentation on physicians so that they can spend more quality time with the patient and improve their productivity. Tedious medical documentation can stress and burnout physicians and affect doctor patient interactions. This is because patients may be looking up to their physicians as regards health practices and behaviours in addition to receiving their knowledge and expertise. Physicians could set a good example for patients and thereby have a strong public health influence. Understanding patient’s perception of physicians is important to explore their feelings about their care.

A final year medical oncology trainee Ricky Frazer working at Velindre Cancer Centre in Wales says in a bmg.com article that it is important to empower patients to be partners in decision making. As a patient himself, due to Guillain Barré syndrome, he has given new insights about what patients want and what they think about a physician.

Access to various sources of information: Healthcare providers often advise patients about good sources of information and the risks of searching for information on Google about their diagnosis and treatment. Some departments like oncology, neurology etc have nurses working with the team whom the patient can talk to afterwards and there are many support groups online that you can join. Prior medical knowledge and abundant information about a disease and its symptoms, signs etc can be confusing. So, Google should not be recommended to patients. The information provided to the patient should be comprehensive rather than a single summary sheet on medical condition.
Know the routine results: Doctors often request routine tests and add them to the patient’s notes. Knowing the routine blood test results is important for patients. Telling your patients about their routine blood report will take only a few minutes. You can also assign nursing staff to provide this information to the patients. This will help minimize unnecessary anxiety in patients.
Patients would want doctors to realize that for them as inpatients the day doesn’t start with the doctor’s ward round: Doctors should remember that for inpatients days in the hospitals can be very long. Their day starts as early as 7am with nurses’ changeover or maybe even earlier when the water jug is changed. For many patients, the morning routine may seem like a military operation. The reality is that many patients need to go for shower or get ready. So, a couple of hours at the start of the day are essential for patients to perform drug rounds, showers, and have breakfast. Doctors have to be mindful of the challenging tasks that health professionals and patients have apart from waiting patiently to be seen by their doctor and team.
Patients want to know their journey: Patients often see the nurses discuss their case, which usually occurs at a distance from the patients. Patients are often not involved in the discussion and sometimes junior doctors quickly summarize the case. All patients may not know or understand the seriousness of their disease. As a part of empowering patients it is important to be open and honest in front of the patients.
A small help can be a boost: Some patients become very weak and need assistance to go to the bathroom or to get undressed etc. Healthcare assistance can be a boon to the patients and any kindness and compassion shown to patients who are weak and vulnerable can provide a moral boost.

A 2017 study titled “Patient Provider Relationship Study” which included 2100 patients in the age group 21 to 70, found that all patients wanted four key things:

Better connectivity: Unable to reach a physician at the time of urgency is frustrating for patients and according to the study, millennials’ preference for convenience is changing the traditional healthcare system. Today’s patients are tech savvy and they expect a better digital experience from their healthcare providers. An ideal way to improve connectivity is by leveraging mobile apps. There are customized apps that allow patients to communicate with hospital staffs, book appointments easily, pay bills, and change appointment schedules.
Use of technology: Today, almost everyone owns a mobile phone and patients are more likely to go online via their mobile phones. Patients are attracted to technologies that would help them better manage their appointment with the doctor. A growing number of people also prefer receiving appointment reminders and other information through a secure text message. Studies show that around 73 percent of patients want to be able to text their doctor’s office whereas 79 percent would like to receive text messages from their doctor. Physicians can facilitate patient preference with the help of automated text reminders, follow-up reminders, patient confirmation, and last minute schedule.
More quality time with the doctor: One of the most common complaints among patients is that they don’t get time to spend with the doctor. This is due to the physician’s increased paperwork, heavy workloads, medical documentation and the physicians are already over burdened that they are unable to spend time with the patients. However, with the right technology physicians can minimize their stress.

According to a Mayo Foundation study, a strong patient physician relationship is fostered by ensuring the following things:

Eye contact: Which creates a sense of connecting, listening and caring
Partnership: A two way proposition where both patient and the physician are comfortable
Communication: Honest and open communication between patients and physicians is essential especially in serious cases, so that patients can openly address their fears and concerns to the physician and develop a sense of trust and confidence in the treatment and achieve the positive results. Good communication also ensures better patient engagement.
Time: Time is what physicians do not have and what patients want from healthcare providers. Patients want to spend quality time with their physicians to share their concerns, clarify doubts and build a good rapport.

Healthcare providers should approach the patient with a pleasant smile and this makes patients much more comfortable. With the introduction of EHR, doctors and nurses are forced to spend most of their time in health record documentation and other administrative work and spend less time with patients. Handing over the medical documentation process to an established medical transcription company could enable physicians and nurses to spend more quality time with the patients and establish a strong patient-doctor relationship.

Declining Trust in Healthcare Providers – Reasons and Consequences

11-February-2019 MTS TEAM Medical Transcription Outsourcing

Trust is a fundamental aspect of any type of relationship, personal or business-related. For instance, a company outsourcing medical transcription service to physicians has to build trust and reliability as a dedicated business partner. This is very important, given the sensitive and confidential nature of the information they handle. Similarly, trust is at the center of a physician – patient relationship, and this is what we examine in this blog. Studies and surveys show that patients’ trust in their doctors and overall healthcare is on the decline. A study published in the New England Journal of Medicine shows that in 1966, 73% of Americans said they had great confidence in the leaders of the medical profession, whereas in 2012 only 34% felt the same way. A 2017 SERMO survey showed that 87% of U.S. physicians believe that patients trust their doctors less than they did ten years ago. This lack of trust can have grave consequences such as reduced patient compliance, worse outcomes, poor physician – patient interactions and physician burnout.

What is the reason behind this lack of trust? Social scientists point out that this is largely due to higher levels of education, the spread of the internet, and the failure on the part of physicians and healthcare institutions. When an insurance company declines to pay for a procedure or increases the co-pay for an office visit, it is the physician who has to communicate the bad news to the patient, which causes a dent in their relationship. With the internet acting as a large resource of information and with the increased access people have to this medium, patients do their own research and arrive at their own conclusions regarding diagnoses and treatments. Now, patients tend to question their doctors and if their information conflicts with their doctor’s opinion, they may be less likely to trust their doctors.

The editorial published in the September issue of Lancet Oncology, highlights this issue saying that the clash between greater patient autonomy, falling trust, and the rise in social media has led to an increase in self-diagnosis and the user of alternative therapies by cancer patients. As a result, patients may refuse conventional, proven therapies and increase their risk for death compared to patients who follow recommended treatment protocols.

According to Martin Ledwick, head information nurse at Cancer Research UK, there is nothing new about dealing with fake news and it has been around for a long time. As a charity, their position is “to challenge where there isn’t a decent evidence base for a treatment that is being promoted.” He further said that the Cancer Research Centre set up an online platform 10 years ago, where people could post suggestions about alternative therapies and other treatment options. An experienced team of nurse staff would respond to the inquiries. Ledwick believes that the growth of the Internet in recent years has created a platform for people to share ideas and opinions, and when complementary treatments are offered, people take them. But the problem is, sometimes people think alternative therapies are better than conventional methods.

Social media, widespread misinformation, specious journalism and political marginalization have led to self diagnosis and patients’ demand for specific treatments. According to a study published in 2017, cancer patients who use complementary medicine are more likely refuse surgery, and chemotherapy among other proven treatments. Wrong information and false news are propagated widely via social media and other online platforms. Limiting the spread of misinformation is important to regain patients’ trust in physicians. Efforts should be taken to stop spreading wrong information and make people aware of the harm wrong information and unproven alternative therapies can cause to cancer patients as well as people suffering from other serious health conditions.

Spending quality time with patients is important for physicians to educate them about their health condition and recommend what is good and bad for them. This will empower patients to be more cautious and not fall for wrong information. To gain more time with patients and obtain relief from documentation requirements, physicians can associate with a good medical transcription company that offers real-time transcription. Physicians must work to build trust via good communication skills, and trust and communication with a patient-centered approach can ensure improved patient outcomes. Patient satisfaction will also increase when they perceive that their provider cares about their wellbeing. When patients trust their physicians, they are also likely to better adhere to the treatment prescribed. Physicians and healthcare institutions can conduct regular patient satisfaction surveys and research to evaluate their services. This will help with excellent planning to provide improved services.