How Free-standing Emergency Rooms Increase Healthcare Costs

12-November-2018 Rajeev Rajagopal Emergency Room Transcription

Every hospital has an emergency room that provides health care services to patients without any prior appointment. It is one of the most important and busiest medical departments that provide immediate care to patients at the time of emergency. The notes taken by medical professionals in the emergency room are very critical in providing efficient patient care. These notes are later transcribed into accurate notes with the help of medical transcription services. Transcripts prepared either this way or using speech recognition technology have a significant role as regards patient care as well as physician reimbursement. A major concern the U.S. healthcare sector faces is the increasing costs associated with emergency rooms. Let us examine how this happens.

Free-standing Emergency Room and Emergency Room

Emergency rooms often face the problem of overcrowding and long wait times. This has led to the emergence of the Free-standing Emergency Room.

Free-standing Emergency Department (FSED), also known as Stand Alone Emergency Department, is a new addition to the healthcare system that is developing in both urban and rural areas. FSEDs are not attached to a hospital but have all the benefits of a hospital-based emergency room. Both FSED and emergency room treat all kinds of emergency conditions and operate 24*7. However, FSED and emergency room are different. Emergency rooms are situated only in specific areas of a city whereas FSEDs are situated in more accessible areas. FSEDs are not the same as Urgent Care Centers and due to greater acuity of care provided at an FSED, patient charges may be higher than at an Urgent Care Centre.

Free Standing Emergency Rooms have seen a major growth in states like Texas, Colorado and Arizona. Some of the major hospitals that operate FSED are in network with the major insurance companies. But FSEDs may be out of network with these same insurance companies. Patients sometimes assume that all of their facilities are in network and go for procedures and treatments that may not be covered. This creates higher healthcare costs and complexities that the average consumer does not understand. Proponents of FSED say that they provide care to patients who do not have access to emergency room services. However, it is important that healthcare costs are efficiently contained.

A Solution

It is important to educate patients about when to go to an emergency room and an urgent care centre i.e. if it is a life-threatening injury, then you must visit an emergency room whereas if it is a minor fever, cold or flu then you must visit an urgent care centre. Help them understand the price difference between these two facilities and educate them about free-standing emergency room too. All individuals should be aware of the nearby urgent care and emergency room facility.

In Colorado, a new law was passed last April to make the cost of free-standing emergency rooms clearer. This law has disclosure requirements to help patients understand which kind of facility they need and the network status of that facility. This law will bring transparency about free-standing emergency departments. But it is still important to keep the patients aware of when they should go to the emergency room and when they should not. Similarly, the cost involved in both facilities should also be clarified.

Whether an emergency room or free-standing emergency room, note-taking and transcribing are necessary requirements. This in turn makes medical transcription companies an important consideration for emergency departments.

How to Avoid Costly Emergency Room Bills

08-November-2018 MTS TEAM Emergency Room Transcription

As a company outsourcing medical transcription services for ER departments, we know that ER bills can be huge. Many people visiting emergency rooms are later told by their insurance company that it was not a true emergency. This makes the patient responsible for the bill. Many health insurers try to discourage costly ER care by charging higher co-pay for ER visits, compared to walk-in retail clinics or urgent care centers. Patients visiting emergency rooms will have to answer questions related to their medical history and their health insurance. In addition, they may have to make crucial decisions regarding tests and procedures. Patients have to be prepared to avoid huge medical bills.

New York Times recently posted an article highlighting how Jim Burton, a 37-year-old resident of Lexington, Ky, got a surprise medical bill. Though he had come to the ER fearing a slipped disk, it was found on examination that he only had a back sprain with no signs of other injury and was sent home. His health insurer, Anthem, refused to pay the medical bills of $1,722 saying that his care in the emergency room had not been needed “right away to avoid a serious risk to health.” Insurers like Anthem use this tactic to reduce costs-patients who visit the ER for ailments considered minor are not reimbursed for their treatment. According to the American College of Emergency Physicians, last year Anthem denied thousands of claims under avoidable ER program. ER physicians said that the company did not routinely request for denied patients and so they cannot review the symptoms that brought them to ER. The policy goal of the company is to reduce ER cases as it is one of the most expensive places to get medical care and recommends patients with sprains and respiratory issues to consult primary care physicians. The doctors say that this policy forces the patients to diagnose their own illness and also discourages people with severe illness from seeking good medical care. Members of Congress have written to Anthem expressing displeasure and state lawmakers have drafted bills to stop this practice.

After all the modification, Anthem is now denying only fewer claims. They say that ER is a time-consuming place to receive care and it is 10 times costlier than urgent care. At the beginning of this year, Anthem said that they would make more exceptions for patients who live far from an urgent care facility, those who are under 15 etc. Visits of these people will be covered even if they have avoidable diagnosis. This policy is expanded to four more states – Indiana, Ohio, Connecticut, and New Hampshire. In Missouri, a bill was passed recently to shield patients from dysfunction of the emergency department. The bill will also force physicians to sign insurance contracts and thereby protect the consumers, and to prevent them from getting into a fight with the insurance company.

Webmd.com provides some useful tips to get better and more affordable care during a medical emergency.

Patients shouldn’t assume that the ER is the right place for them: Patients can avoid a long wait and save money by going to an urgent care center instead of the ER. Urgent care centers can handle many illnesses and injuries such as broken bones, burns, and cuts that require stitches. For life-threatening conditions such as seizures, severe pain, head injuries, pain signifying heart attack or stroke, visit the emergency room. Many urgent care centers also accept insurance coverage.
Provide all health information that is necessary: Be ready to provide your medical history that includes:
- List of medications, antibiotics or supplements you are taking, have been recently prescribed or recently completed.
- Any allergies, especially to medications
- Info regarding past surgeries
- Info regarding past or chronic illnesses
- Info regarding previous hospital stays
- Vaccines received
- Any specialists you may be seeing

This information can be stored on your cell phone using a good medical records app.
Understand your ER rights: The Affordable Care Act requires insurers to cover the care patients receive in the ER if they have an emergency medical condition. There is no need to get approval ahead of time and it does not matter whether the hospital/facility is in or outside of the patient’s insurance network.
Find out whether there is any risk in putting off tests and scans until you can see your family doctor who might decide you don’t need them. If you need them, they will be less costly at the doctor’s office than when done at the ER.
Check your ER bills and insurance reports carefully: For most of the ER care you receive, you should be charged in-network rates. If someone outside your network – ER doctor, specialist or a technician – provides the treatment, they can bill you directly for the difference between what they charge and what your health insurance plan pays. If you are treated for a true emergency, most health plans will cover all the emergency room fees. Make sure that you submit them personally to your insurance company.

It is important that patients clearly understand their insurance. A medical transcription company assisting physicians knows how important it is for providers to understand what treatments a patient’s health plan covers and explain the same to him/her. Patients should be advised to check their insurer’s “emergency service benefits” coverage to see how it defines an emergency and what the plan will/will not cover. Most insurers offer general guidelines regarding what constitutes an emergency, and don’t usually limit members to specific injuries or illnesses. Patients should also know which area hospitals accept their insurance plan. They should ask the billing department at their chosen hospital whether the ER doctors participate in their particular insurance plan. Patients can always file an appeal if the insurer rejects a claim.

Tips to Make Patient Handoffs Safer and More Effective

05-November-2018 Julie Clements Medical Transcription Outsourcing

The handoff of a patient from one physician to another is a frequent and unavoidable aspect of care. Medical transcription outsourcing helps health care providers produce the electronic component of the handoff. However, clinical handoffs are prone to errors due to breakdown in communication between care providers. In fact, handoffs have been found to be one of the most risky procedures in hospitals. A 2012 Joint Commission report, about 80% of serious medical errors occurred due to poor communication between providers during patient handoffs.

In addition to communication that is misspoken or misunderstood, errors often occur because of the failure to record information or due to information that is misdirected, never received, never retrieved, or ignored. Hospitals need to have proper measures in place to ensure a seamless handoff process by ensuring effective clinician-to-clinician communication to promote continuity of care, eradicate preventable errors, and improve patient safety. Here are some expert tips to effectiveness of clinical handoffs:

Ensure accurate and complete written signouts: Effective communication means communication that is complete, clear, concise and timely. The Agency for Healthcare Research and Quality (AHRQ) points out that the I-PASS signout format put forward by a seminal study is regarded as the gold standard for effective signout communication between physicians and that it can improve the quality of nursing handoffs. “I-PASS” stands for:
- Illness severity: one-word summary of patient acuity such as “stable,” “watcher,” or “unstable”
- Patient summary: summary of the patient’s diagnoses and treatment plan
- Action list: to-do items to be completed by the clinician receiving signout
- Situation awareness and contingency plans: instructions to follow if there are changes in the patient’s status
- Synthesis by receiver: an opportunity for the receiver to ask questions and confirm the plan of care
Convey the unique needs of each patient: In a recent report, the American Medical Association (AMA) advises medical residents to ensure that they communicate the unique needs of the patient during the handoff. The daily progress note should clearly communicate the physician’s findings, thoughts and plans. However, the misuse of copy-paste functionality in the electronic health record (EHR) often compromises the reliability of the patient information, affecting the clinical handoff process. Copy pasting should be confined to verified, static information such as demographic information, drug lists, and previous medical history. When handing off patients, providers should ensure that relevant and important information about each patient is conveyed. Situational awareness should also be conveyed in an “if-then” format. On the other hand, if the physician is permanently signing away the patient, it would be important to convey more details in terms of history and other matters.
Take steps to improve communication during handoffs: This includes:
- Discussions in an environment without distractions: The American College of Obstetricians and Gynecologists (ACOG) says that the circumstances, setting, and content of the handoff communication should be based on clinical acuity of the patient’s condition.
- Maintain confidentiality: Due consideration should be given to confidentiality and Health Insurance Portability and Accountability Act regulations when conveying patient information.
- Use standardized medical terminology: The documentation involved in the clinical handover should be prepared using standardized medical terminology. Medical transcription outsourcing can ease this task. Reliable medical transcription companies have trained and experienced team well versed in medical terminology and jargon. These experts can provide quality documentation of all types of reports including history and physical reports, clinic notes, consultation reports, procedures, ER reports, follow up notes, and health reports.
- Assign responsibility: ACOG recommends that each patient should be assigned to a primary person or team that will also manage the transfer. If the primary contact is unavailable, there should be a backup system.
- Method of communication: Providers can use verbal communication, written communication, or both. Face-to-face exchange of information is the preferred option because it allows for direct interaction and expression of nonverbal information by expression and body language. On the other hand, written communication allows the information to be relayed in an organized, hard copy format, which is important for reference.
- Documentation: Relevant demographic information, history, physical exam results, an active problem list, medications and allergies, pending test results, ongoing or anticipated therapy, key patient values and preferences, and all other critical information should be clearly documented in the patient’s medical record. This is where medical transcription services come in handy.

Providers should keep in mind that malpractice dangers lurk in patient handoffs. Medscape reported that though hospital care has significantly improved over the years, a study of malpractice claims by The Doctors Company found several incidents of preventable harm to patients, often due to a failed handoff. ACOG notes that barriers to effective communication include factors such as lack of time, hierarchies, defensiveness, varying communication styles, distraction, fatigue, conflict, and workload. Having an environment free of interruptions and distractions is critical to effective handoffs. Medical transcription outsourcing is an effective strategy to ease documentation workload and help clinicians find more time to engage in discussions and manage patient care and handoffs effectively.

Study: Combining Dictation and Natural Language Processing can aid Clinical Documentation Improvement

01-November-2018 Rajeev Rajagopal Medical Transcription

Physicians need to document information about patient health events, clinical status, and office visits in EHRs. Clinical data has to be captured accurately for quality reporting, claims reimbursement, public health information, and disease tracking. Medical transcription outsourcing plays an important role in reducing the burden to data entry on providers. Clinical documentation improvement (CDI) is the key to ensuring the EHR correctly reflects the services that were furnished. EHR Intelligence reported that a 2016 study found that dictation and natural language processing (NLP) can support CDI efforts.

Clinical documentation that is legible, timely, complete, specific and clear is necessary to:

Improve health outcomes and hospital/practice management
Boost clinical efficiency
Communicate with other providers about the care of the patient
Minimize physician queries
Increase coding accuracy
Decrease claim denials and enhance reimbursement
Validate the care that was provided
Demonstrate compliance with quality and safety guidelines
Maintain a legal health record

According to a 2016 Black Book Market Research report, nearly 90 percent of hospitals with more than 150 beds that used CDI tools experienced an increase in healthcare revenue and claims reimbursement amounting to at least $1.5 million. Up to 87 percent of the hospitals reported that case mix index improvement was the largest driver of CDI adoption due to its potential “to increase healthcare revenue and optimize high-value specialist utilization”.

However, reports say that many providers are already facing burnout due to the demands of EHR documentation and are reluctant to take on the additional burden of implementing CDI projects. In fact, physicians find entering data into EHRs a cumbersome and difficult task, and this has led to lower quality medical records with redundant, inaccurate information.

According to the 2016 study led by David R. Kaufman, PhD, using natural language processing (NLP) in clinical documentation improved outcomes compared to using the conventional keyboard-and-mouse entry approach alone. NLP leverages artificial intelligence (AI) to process key information from unstructured spoken or written input and according to a KLAS report, and is the second-most frequently utilized CDI functionality, after query templates. However, Kaufman’s team noted that using only NLP can affect accuracy. The researchers suggested that a combination of dictation and NLP can improve clinical documentation, increase usability, and save time.

“A pure protocol of NLP Entry as well as hybrid protocols (involving both NLP Entry and Standard Entry) showed promise for EHR documentation, relative to Standard Entry alone (Standard-Standard Entry),” wrote the researchers.

“EHR documentation methods using a combination of dictation and NLP show potential for reducing documentation time and increasing usability while maintaining documentation quality, relative to EHR documentation via standard keyboard-and-mouse entry,” according to the study.

The researchers said that though the hybrid approach would work best, further study would be required to understand the optimal method of documentation for each part of the clinical note.

The findings of this study suggest that medical transcription services continue to be a relevant option when it comes to improving clinical documentation. Medical transcription outsourcing now ensures EHR-integrated documentation solutions for all specialties.

AHIMA recommends that providers utilize all their operational and personnel resources at every stage to implement efficient CDI strategies, according to the EHR Intelligence report. Furthermore, the organization recommends that practices should collaborate with their EHR vendor to “remediate documentation vulnerabilities, tweak templates, and update documentation alerts and prompts.”

However, the report notes that it will be challenging for providers to focus more attention on EHR documentation when existing administrative requirements are already such a strain. In these circumstances, medical transcription outsourcing to an experienced company could be the answer to optimizing both accuracy and efficiency.

How Can Doctors Add Value to Their Time With Patients?

29-October-2018 MTS TEAM Medical Transcription

Consultation time and waiting time are key factors that affect patient satisfaction. Several reports bring up the fact that medical appointments are getting shorter by the year, resulting in doctors having very little time to spend with their patients. According to the latest report from Statista, as of 2018, 5% of U.S. physicians say that they spend less than nine minutes with each of their patients, while over 60% say that they spend between 13 and 24 minutes with each patient. More than half of the physicians said that they spend around 30-45 hours per week seeing patients. Good communication is central to the doctor-patient relationship, which can be difficult to accomplish within this strict time limit. Physicians getting busy with electronic health records (EHR) is also a factor contributing to these brief clinical interactions, which can be improved with assistance from medical transcription companies providing EHR-integrated services.

The most important way to improve patient care through the doctor-patient relationship is to increase the amount and quality of time for the doctor to spend with his/her patient in the clinic or office. Examining the patient thoroughly and then spending adequate time discussing everything would improve patient care as well as satisfaction.

A recent blog published in MedPage Today provides tips for physicians to make the most of their rushed time slots and how to make the patient feel well cared for. Rising demand for treatments, falling reimbursements, and more complex diagnoses and treatments can make the condition worse. Here’s what physicians can do to make the most out of the time they have and provide a better healthcare experience for patients.

Verbal Communication Techniques Work Better

The MedPage Today blog suggests that it is better to use verbal communication techniques than non-verbal, even if you’re in a hurry to end the session. Some of these communication techniques that don’t require more time or a huge amount of effort include:

Allowing a certain amount of uninterrupted talk time for the patient (while actively listening)
Sitting down at the same level
Using open-ended questions so that patients can discuss all their concerns
Finding time for a summary at the end of the consultation

How to Improve Patient-Physician Communication

For instance, the American College of Obstetricians and Gynecologists provides certain tips to improve patient-physician communication, which involves –

Using patient-centered interviewing and conversing in a caring way in daily practice and engaging in shared decision making with patients
You can encourage patients to write down questions in preparation for appointment. Providing an organized list of questions can facilitate conversation on important topics.
Arranging a communications consultant to conduct a workshop on cultural and gender sensitivity for physicians and office staff based on the needs of individual practices.
Hiring non-physician health care providers – advanced practice nurses or physician assistants, with patient-centered interviewing skills to assist with established patients.

Certain effective communication skills that are crucial for a physician to understand the patient’s point of view and incorporate it into the treatment include comfort, acceptance, responsiveness, and empathy. While comfort and acceptance refers to the physician’s ability to discuss difficult topics without displaying uneasiness and the ability to accept the patient’s attitudes without showing irritation, responsiveness and empathy refer to the ability to react positively to indirect messages expressed by a patient.

While doctors can rely on medical transcription services to save time for patient care and reduce their documentation tasks, they should also be concerned about patient’s long wait times. Read our blog on tips to reduce patient wait times in any practice.

Some Challenges That Impact Patient Access to Healthcare

22-October-2018 Rajeev Rajagopal Medical Transcription

The Electronic Health Record (EHR) has completely changed the landscape of healthcare industry and the way physicians treat their patients. The new systems provide improved patient access to healthcare and allow patients and their families to take charge of their own health. With EHR-integrated medical transcription services, physicians can quickly generate medical documentation that can be viewed by patients also. It improves patient engagement and satisfaction. However, many patients across the country do not have easy access to healthcare.

What are some of the challenges involved?

Limited availability of appointments: Majority of healthcare units have fixed working or consultation hours and this may not be useful for everyone. Patients need convenient hours to visit doctors outside of their work. So, healthcare organizations are now trying to expand their office hours. Some organizations are using health IT and connected health that allows patients to get medical advice without coming to the office. Telehealth or Telemedicine is one such innovation that allows patients to seek medical assistance without coming into the clinic or hospital. This system is highly useful for emergency cases to connect with the doctor. Organizations can adjust their office hours to provide patients more easy access to the clinicians at any time.
Clinician shortage in rural areas: Shortage of clinicians in rural areas is a major concern in many countries. According to the American Hospital Association, there are about 57 million Americans who live in rural areas. They also say that remote geographic location, small size, physician shortage and often constrained financial resources pose a unique challenge for rural hospitals. Healthcare organizations have started tapping telemedicine to close care gaps caused by geographic barriers. Direct-to-consumer telemedicine allows patients to make use of their own devices like smartphones or computers to video call a provider. Many smaller facilities in rural areas use telemedicine to connect with experts in more urban areas. This helps patients avoid travelling to faraway places to receive treatment or specialized care. Patients in rural areas also struggle with shortage of physicians and the situation is much severe than urban area shortage issues. According to National Rural Health Association statistics, the patient to primary care physicians ratio in rural areas is 39.8 physicians for 100,000 people compared to 53.3 physicians per 100,000 patients in urban areas. As per a report by University of Nebraska Medical Centre, clinicians’ shortage issues are plaguing rural areas across the country. Although primary care clinicians’ access is up 11 percent from 2008 doctors are still bracing to get hit hard by the growing national clinicians shortage issues. Healthcare professionals are now looking for policy changes that would help channel more providers to rural areas. Some visa waivers could encourage foreign-born but American-educated providers to serve in rural areas.
Transportation barriers: Patients can easily fix an appointment with their doctors whenever they want but transportation barriers can keep them from visiting their physicians, especially for people with disabilities or those who cannot obtain transportation to the clinician’s office. According to AHA statistics, around 3.5 million patients do not have access to proper care as they don’t have transportation to the physician’s place. Transportation is a critical social determinant of health that has recently gained nationwide attention. In 2018’s HIMSS conference rideshare giants Uber and Lyft announced plans to close care gaps emerging from medical transportation woes. Uber introduced its own healthcare offshoot and Lyft partnered with an EHR vendor to help healthcare providers and patients to connect with rides to medical appointments.
Limited education regarding care site: It is important for organizations to remove all obstacles that prevent patients from getting to the clinic. This will ensure that the patients reach the right place. This is very important to integrate alternative treatment sites into their repertories. Patients can access care at an urgent care centre, a retail clinic, a micro hospital, a freestanding emergency department and numerous other emerging treatment facilities. It is important for medical practices to deliver proper patient education which enables patients to identify providers ideal for certain healthcare needs. According to a February 2017 survey from CityMD, many patients do not know where they should receive care for various symptoms. 46 percent of respondents correctly selected urgent care as the appropriate choice for a scenario in which a child is suffering from 104 degree fever.

Medical professionals should educate their patients on the specific uses of different care sites. Clinicians and offices and hospitals should display information in their own facilities and circulate patient education materials. Providing proper patient care and accurate medical records is highly important for quality patient care. According to the Association for Healthcare Documentation Integrity, accurate and high integrity documentation requires collaboration between physicians and the organization’s documentation scheme or with medical transcription services.
It is important to ensure that the medical records are accurate and reliable. Medical errors can occur anywhere – it may be in medication, surgery, after care, lab reports etc and it can even lead to death. Below are some tips to follow to ensure more accurate medical documentation.

Ask your patients if they have any questions. Ensure that the patients are sharing all necessary personal health information.
Physicians and surgeons treat patients and create records according to the strict policies of EHR. But the duty of the physician is to focus on their patients and not on documenting records. EHR documentation could be outsourced to a scribe or a good medical transcription company. Only the task of approving the entries should be given to the doctors.
In the EHR system, bring a balance between structured and unstructured data.
Standardization of general layout is important. It helps physicians to spend less time searching for the right button and it also minimizes the chances of errors.

Providing the right care at the right time is very important. Today, many healthcare organizations hire reliable medical transcription services to ensure streamlined documentation. They offer customized services at affordable rates and also help physicians and other healthcare professionals to focus more on providing quality patient care and services.

Five Strategies to Boost Patient Satisfaction Scores in Surgery Centers

18-October-2018 MTS TEAM Medical Transcription

Good documentation is an essential element of effective care and medical transcription outsourcing plays an important role in helping surgeons maintain EHR progress notes and operative reports. However, surgical care is different from medical care and it is therefore important to examine the relationship between patient satisfaction and quality for surgical patients, according to research published in the Annals of Surgery in 2015. In fact, the inclusion of Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores in the Centers for Medicare and Medicaid Services (CMS) Value-Based Purchasing Program (VBP) underlines the importance of the patient experience as a key quality metric. Poor patient satisfaction scores can affect a surgical center’s reputation as well as reimbursement.

Here are some effective ways in which surgery centers can enhance the patient experience:

Optimize the pre-surgery experience: There are many players involved in the pre-surgery process such as the surgical center staff in pre-admission or pre-anesthesia testing, the surgeon and his/her staff, hospitalist, OR director, anesthesiologist, CRNAs, nurses, and staff members in patient financial services and admissions. A Beckers Hospital Review report points out that proper orchestration and streamlining of all the areas of pre-surgery can make the experience less stressful for the patient, improve clinical outcomes, and boost patient satisfaction.All the areas that need patient information and discussion prior to surgery should be linked to the scheduling process. Pre-admission testing and clearances must be completed and evaluated prior to surgery. In addition to reducing delays and cancellations, preparing the patient well can also reduce complications that can lead to hospital readmissions and increased length of stay. Insurance verification services are critical to determine patient eligibility, remind the patient of the co-pay and deductible requirements, and set expectations for billing and payment. The surgery center/hospital staff can also contact and inform the patient of the procedure day and time, the required preparation, medication related instructions. They should ensure the patient has proper transportation and answer any questions the patient may have.
Ease day of surgery experience: The day of the operation is when patient anxiety is highest. The Beckers Hospital Review report notes that key players in the perioperative process can help alleviate stress through patient contact and staged interaction. Improving patient satisfaction at this stage includes providing clear wayward signage and instructions – from the parking lot or entrance to the check-in desk. Some organizations have a medical assistant meet surgical patients and escort them to registration or their patient room. Consistent communication at every stage is critical to improving patient satisfaction scores. If times are delayed, the caregiver should immediately explain the situation to the patient and family members and reschedule timings for the revised surgical day and alert the patient about this. In the operating room, the staff should carry out their interviews and pre-surgical evaluation and checklists in a sequenced manner, which will reduce patient anxiety and make the process go smoothly.An Outpatient Surgery Magazine report describes how Northwestern Memorial Hospital in Chicago uses music to calm surgical patients’ nerves. Each pre-op bay in the hospital is equipped with a computer monitor that’s hooked to an Internet music radio service. When patients at the hospital settle into their pre-op beds, they receive disposable ear buds and can relax listening to music before their surgery.
Engage the patient’s family: In addition to communicating effectively with the patient, effective communication with the patient’s family is a critical factor in patient satisfaction. The patient’s family is an essential element in the care of the patient. When the patient is in the operating room (OR), family members waiting outside can be really nervous and it is up to the surgeon and OR team to communicate with them. In the Outpatient Surgery Magazine report, Mauricio Garrido, MD, clinical director of the Heart and Vascular Institute at Abington Hospital – Jefferson Health in suburban Philadelphia explains how set up a videoconference linking a feed in the OR to an iPad and uses it to update the family in the waiting room. While nothing in the operative field shows on screen, the team lets the family know they have overcome the major hurdles of the operation. Garrido says that video conferencing with families in the waiting room is beneficial not only for the family but also motivates his staff when they see the family members “being grateful and relaxing”.
Ensure a smooth post-surgical experience: Once the patient is awake and stable, surgeons can explain to both the patient and their care givers what exactly was performed, what the patient can expect, as well as inform them about the follow-up visit or call. Both the nurses and the anesthesia providers should observe the patient’s symptoms and pain level, and contact the surgeon if any intervention is required. Surgery centers must also take steps to inform the patient about the billing process and integrate patient financial services within the process to provide patients with answers to their billing questions.
Smooth and timely discharge: Patients usually want to leave quickly and surgery centers need to get them out without compromising patient safety. Having a standardized discharge process handled by a discharge nurse with clinical experience and communication skills can promote smooth the timely discharge. The nurse navigator can help patients ensure compliance with their post-surgery care instructions. Making the discharge experience pleasurable can also boost patient satisfaction. The Outpatient Surgery Magazine reported on the unique patient pleasing strategy used by Children’s Mercy Hospital in Kansas City, Mo. The hospital sends its younger patients home with a drawstring backpack shaped like the face of a bear and with the hospital’s logo printed on it! In addition to being convenient way to transport paperwork and belongings, this strategy also makes the hospital’s name visible in the community.

As surgery centers implement streamlined processes and innovation to improve patient satisfaction scores, medical transcription companies can take care of their documentation needs.

Reports Say Hospitals Are Investing More on Medical Transcription Tools

15-October-2018 Julie Clements Healthcare News

Technological advancements in the healthcare industry have resulted in innovative solutions including the Electronic Health Record or EHR. Good quality medical records are essential to proper ongoing care of patients and are paramount for effective communication between healthcare professionals. Professional medical transcription services ensure efficient electronic filing and accurate medical documentation for medical practices, clinics and hospitals to prevent any kind of medical error and ensure delivery of quality patient care.

With every year, the medical industry is changing and there have been changes in medical transcription also. As more and more medical professionals subscribe to medical transcription there is increased demand for medical tools and transcription professionals. Medical transcription is one of the few industries to fully embrace new technologies and infrastructure. According to a recent research report, hospitals will make use of more medical transcription solutions from companies like Acusis, MModal, iMedx, Scribe Healthcare, Superior Global Solutions, TransTech Medical Solutions and so on.

A Technavio report published last month says that hospitals globally will spend more than 72 billion on medical transcription tools by 2020, which is a 6 percent compound annual growth rate. The Technavio report also points out that voice recognition software is the biggest driver of hospital plans. Increased adoption of automatic transcribing technologies is expected to replace all analog devices in the coming future. Other factors that contribute to the growth of this healthcare industry market are rise in value of skilled professionals and rise in outsourcing medical transcription. Majority of the transcription devices have built-in speech recognition and memory storage systems.

Advanced communication methodologies ensure better and faster transfer of updates between medical transcription providers and healthcare professionals. This will help meet quick turnaround time requirements. Physicians no longer need to dictate and medical transcriptionists need not turn the recordings into text. As technological advancements increase, the medical transcription sector is also utilizing the latest voice recognition software technology. It helps transcriptionists minimize turnaround times because their role is more as editors while the technology provides the transcription.

No matter how quickly technology is advancing, the demand for medical transcriptionists will continue to be there because artificial intelligence and machine learning cannot ensure the accuracy the human eye and intellect can ensure. Medical transcription companies offer scalable and customized options for practices of any specialty or size and to hospitals among other healthcare providers. They have a set standard for transforming unstructured notes into well-crafted medical reports which allow physicians to clearly understand the patient’s health condition and decide on the right treatment approach.

How EHRs can Help Combat the Opioid Crisis

11-October-2018 Rajeev Rajagopal EHR Transcription

The widespread adoption of electronic health records (EHRs) has helped improve clinical productivity and efficiency. Medical transcription outsourcing plays an important role in optimizing EHR use by ensuring accurate, legible and timely documentation. According to recent reports, optimizing EHR functionality can help in the battle against the opioid epidemic.

According to a CNBC report published in June, painkiller overdoses kill 116 people every day. The US President declared the opioid epidemic a public health emergency last year, and announced a proposal to tackle this national health crisis. Passed in March, the U.S. omnibus spending bill includes $4 billion to address the opioid crisis. Key federal agencies under Health and Human Services and other stakeholders across the continuum of care are working to combat the opioid crisis on many fronts, leveraging EHR technology has become an important priority in this battle. Here are the various ways EHRs can help combat the opioid crisis:

Helps modify providers’ prescribing practices: EHR systems can be used to collect and analyze data to address opioid abuse and addiction, and to prevent overdose deaths. A recent healthcare Informatics report cites a Healthcare Informatics article, which told of how Pa.-based Geisinger’s clinical IT leaders developed a strategy to address Pennsylvania’s opioid crisis utilizing data and health IT tools to modify providers’ prescribing practices. These efforts helped the health system slash opioid prescriptions from a monthly average of 60,000 opioid prescriptions to 31,000 prescriptions per month.
Allows viewing of patients’ medication histories at the point of care: By providing a view of patients’ medication histories at the point of care, electronic prescription of controlled substances (EPCS) can notify providers about patients who might have a drug dependency. Information such as prescribing guidelines, quantity limits, and alternative medications can be incorporated in the EPCS. Also, electronic prescriptions also go directly from the provider to the pharmacy, preventing illegitimate practices such as forging/altering prescriptions by the patient.
Prescription Drug Monitoring Program (PDMP) data integration prevents over-prescription: Quick and easily accessible information regarding the patients’ controlled substance prescriptions in their state as well as surrounding states is necessary to ensure that opioids and other controlled substances are not prescribed inappropriately. Integrating EMRs and the state’s PDMP can prevent over-prescription of opioid medication to patients whose prescription history suggests abuse or diversion. With this integration, it will be possible to retrieve the patient-specific report directly within the EHR system in just seconds. Necessary information such as the drugs prescribed, number of prescribers, and different pharmacies a patient has used would be immediately available.Health IT News recently reported on University of North Carolina Health Care at Chapel Hill plans to integrate its EHR (Epic) with the state’s PDMP to allow better tracking of prescribing controlled substances statewide. Such alignment with the PDMP is crucial in the battle the opioid problem.
Interoperability of EMR permits sharing of patient records among providers: The Centers for Medicare and Medicare Services (CMS) recently issued guidance aimed at promoting interoperability of electronic medical records at Medicare-participating hospitals. Interoperability makes it easier for providers to access the patient’s history and the prescribers’ history of prescribing controlled substances more seamlessly in their workflow. Under CMS’ proposed rule, incentives will be given to providers who update their EMR to allow patients to access and share their medical records with other providers and institutions. This can help physicians to better manage complex medical problems that require opioid pain medications.
EHRs can help curb opioid use in ambulatory surgical centers (ASCs): Beckers ASC Review recently listed several ways EHRs can help ASCs restrain opioid use:
- Using EHRs to standardize order sets could help implement an effective multimodal pain management protocol.
- EHRs can prevent overprescribing as they provide real-time summaries of all medications administered during a patient’s visit and allow providers access to chart patients simultaneously.
- Using the EHR medication reconciliation section, providers can easily assess patients’ home medications and possible interactions with planned discharge medications.
- Before the surgery, EHRs can be used to collect information needed to develop the optimal pain management combinations for the patient.
- Surgical centers can use EHRs to design discharge instructions for specific procedures.
- EHRs can be used to understand opioid use related to procedures, ordering providers, and administering personnel so that steps can be taken to prevent overuse.

Further, in the ASC setting, EHRs allow anesthesiologists, prescribers and other members of the patient’s care team to communicate quantifiable values and indicators of pain more efficiently and accurately.

When it comes to opioid therapy, quality pain management transcription service is critical to ensure accurate and precise EHR documentation for medical-legal reasons as well as for evidence-based performance. As experienced medical transcription company can ensure comprehensive documentation of pain management in EHRs to support the battle against opioid overuse.

Study: A Physician’s Reassurance can have a Healing Effect

08-October-2018 MTS TEAM Healthcare News

With increasing patient volume, administrative work related to visits, and other duties, physicians face mounting demands on their time. Medical transcription outsourcing helps with electronic medical record (EMR) documentation, allowing physicians to focus on face-to-face contact with patients and provide better care. According to a new study, just a dose of reassurance during the clinical encounter can reduce symptoms and is enough to make patients feel better. The findings of the study led by Alia Crum, assistant professor of psychology at Stanford University’s School of Humanities and Sciences were published recently in the Journal of General Internal Medicine.

According to graduate student Kari Leibowitz, lead author of the paper, the study provides evidence that the placebo effect works. Just a few encouraging words from the physician can make a patient feel better. The Stanford psychologists found that the physician’s assurance about a patient’s recovery time from an allergic reaction can significantly reduce symptoms.

The researchers tested the effects of a physician’s words on patient symptoms through a simple experiment with 76 study participants. Up to 61.8% were female and 54% were younger than 22 years. The steps involved in the study were as follows:

A harmless, allergic reaction was induced in the participants by administering a histamine skin prick. Used to diagnose allergies, histamine causes reactions like swelling, rashes and itching.
After the skin prick, the participants rated how itchy they were on a scale of zero to 100 at 3, 9, 12, 15 and 18 minutes.
Six minutes later, the physician came in and reassured approximately half of the participants by saying “from this point forward your allergic reaction will start to diminish, and your rash and irritation will go away.”
The physician said nothing to the rest of the participants (the control group) about the reaction they experienced.

Both groups reported similar increase in itchiness in the first 3 minutes after skin prick before receiving any assurance. However, it was found that the feeling of itchiness declined significantly faster in the participants who received just a few words of reassurance from the health care provider, compared to those who got no reassurance about their reaction or recovery.

“For many conditions, the simple act of being reassured by a medical professional can aid in the healing process, and we needn’t always rely on medication and procedures to make us feel better. My hope is that findings like this one inspire additional research on the physiological mechanisms of assurance as well as promote training and compensation for physicians to more effectively leverage psychological forces in their practice,” Crum told Stanford News.

According to the researchers, “These results provide empirical support for the clinical utility of assurance alone and suggest that reassuring patients who consult for minor complaints may not only equip patients with helpful information – it may assist in alleviating patients’ symptoms.”

Studies show that placebos can influence conditions such as depression, pain, sleep disorders, irritable bowel syndrome, and menopause. The placebo effect is generally attributed to a person’s expectations. If a physician gives a patient a pill saying it will make them feel better, the pill often proves effective. The theory is that the body’s chemistry will produce effects similar to those that a medication could have.

WebMD reports on a study in which people were given a placebo and told it was a stimulant. After taking the pill, their pulse rate rose, their blood pressure increased, and their reaction speeds improved. When people were given the same pill and told it was to help induce sleep, they experienced the opposite effects.

Anxiety is a common emotion experienced by patients and reassurance by a medical professional helps. How healthcare professionals manage patients’ or families anxiety and other emotions can also have a big impact on the patient’s wellbeing. In fact, nurses have a major role to play when it comes to reducing patients’ anxiety. Here are some tips from Nurses.com:

Listen to the patients and their families
Ask the patient how he/she is feeling
Keep the patient calm and comfortable by asking them questions about their work and other aspects of their personal life

On their part, physicians should work to build a positive relationship with patients at the clinical encounter by:

Showing courtesy and respect
Showing empathy
Listening and maintaining eye contact
Asking the patient about themselves
Communicating in earnest and explaining the diagnosis clearly
Working with the patient to set the care plan

Patient satisfaction and health outcomes are both impacted by whether patients feel that the people treating and caring them are sensitive to their needs and empathize with them. Establishing good rapport with patients, communicating effectively and reassuring them play an important role in improving patient health. EHR-integrated medical transcription services are a great option for physicians as it allows them to focus on reassuring patients and building a positive relationship with them at the office visit.