Use of Dictation Software on the Rise as EHR’s Adoption Are Reducing Productivity

03-December-2013 Julie Clements Medical Transcription

According to a Healthcare Information and Management Systems Society report, the increasing use of speech recognition software and dictation systems is changing the face of healthcare. An article in InformationWeek based on the HIMSS report says that the growing adoption rates along with speech recognition’s comparatively low market penetration rate suggest that there is great growth potential for these technologies.

With the adoption of Electronic Health Record (EHR) systems, healthcare providers are finding it difficult to meet their practice goals as EHR, contrary to expectations, reduces productivity. Healthcare providers are finding it difficult to deal with their structured templates especially because a lot of clinical data is unstructured.

According to a report based on a recent survey, many physicians say they are unhappy with the EHR products available to them, possibly because EHRs are still in an early stage of development. They describe them as “clunky, confusing and complex”, and they finding it very difficult to incorporate EHRs into their workflow in a smooth manner. In fact, about one-third of all physicians surveyed in an American EHR Partners study said that they were very dissatisfied with their EHR and that they were finding it very difficult to get back to pre-EHR productivity levels.

These factors are encouraging healthcare providers to adopt speech recognition and dictation technology to deal with the complexity of managing EHRs. These natural language processing tools makes unstructured data accessible and make new data sets available to physicians. Dictation devices are easy to use. Medical transcription companies offer speech recognition software and QA of the output transcripts to healthcare providers. The medical transcription company then QA’s the report and transcribes them accurately and in custom turnaround time.

HIMSS data shows that the adoption rate of speech recognition software rose from 21% to 47% during 2009 to 2013. It would rise even further if vendors could convince the physicians about its accuracy and time saving capabilities.

How to Reduce Blank Spaces in Medical Transcription

28-November-2013 Rajeev Rajagopal Medical Transcription

Medical transcriptionists usually leave blank spaces when they encounter inaudible or incomprehensible terms in dictations. Such issues usually arise due to a physician’s unfamiliar accent, background noises, unfamiliar medical terms, and so on. Though it is better to leave blank spaces rather than guessing the terms, transcripts with a lot of white spaces definitely indicate poor quality work. So, how can we minimize such blanks in transcription? Here are some effective methods:

Contextual Thinking – When you find blank spaces after finishing your report, listen to the problematic sentences again and see whether you can fill in the blanks. If you are still left with white spaces, think contextually. If the term is a kind of treatment, verify what kind of symptoms and complaints are mentioned in the transcript. Then find out which diseases are typical of those symptoms and complaints and the treatments available for such diseases. This might help you catch the missing term.

Listen to Pronunciation – Rather than worrying about the spelling, listen to the pronunciation first as this can help you find the right word. Suppose you heard ‘Intravenous Pylogram’ and you are not familiar with that word. Doing a search with ‘Intravenus Pylogram’ would help you find the correct word, which is ‘Intravenous Pyelogram’.

- Use the Internet – It is better to use internet for your search purposes rather than only checking the medical dictionary or the records in your computer. Browsing online would provide a large volume of information and quick results. For example, if you search for ‘Intravenus Pylogram’ using internet search engines, you will get the correct word ‘Intravenous Pyelogram’ even as you type ‘Intravenus Pylogram’ as shown as below:

Intravenous Pyelogram

As search engines automatically correct spelling, you need not worry about spelling mistakes. If you have no idea about the term in the blank space, you can type in or paste the whole phrase or sentence into the search engine and quickly find out anything related to the term.

Refer to Similar Reports – You can refer to reports similar to your transcripts for filling in the blank space as same word or term may have used in other reports. Suppose your transcript is about the MRI of the cervical spine. Regardless of who dictates that MRI report, the anatomy will be the same. So if you find blank spaces in your transcript, you can refer to the MRI of the cervical spine dictated by other doctors to find the difficult word or term.

Try to Recall the Physician’s Voice – You may have forgotten to recognize a physician’s voice. Always remember your physician’s voice and accent. Overtime this will help reduce your blanks in your report as the same physician will tend to use the same words over and over again. You just have to refer to a former transcribed report to get the missing word.

In a professional medical transcription company, trained and experienced transcriptionists know how to complete dictation quickly and accurately – without leaving blank spaces.

Advanced Technology is Key to Meet Increased Demand for Medical Transcription

22-November-2013 MTS TEAM Medical Transcription

The productivity of medical transcription process is very important, especially in the backdrop of overwhelming demand for medical transcription. The U.S. Bureau of Labor Statistics expects the volume of healthcare services to continue to increase, leading to a growing number of medical tests and procedures, which in turn will increase the demand for transcription. Technology is the key to increased productivity and this is relevant in the case of medical transcription too. Companies that provide medical transcription services should therefore ensure that they have the expertise and advanced technology to meet physicians’ clinical documentation requirements.

Turnaround time (TAT) – the time from dictation to delivery of transcribed documents – is crucial in medical documentation. According to a study published by the Joint Task Force on Standards Development of the American Health Information Management Association (AHIMA) and Medical Transcription Industry Association, the successful implementation of some technologies can significantly reduce TAT. The Joint Task Force lists the following categories of technology as positively impacting TAT:

Portable dictation devices such as microcassettes, digital recorders, personal digital Assistants (PDAs) and more
Speech Recognition Technologies
Systems that eliminate the need for manual entering of data and support automatic collection of patient information including barcode readers, picture archival and communication system (PACS)/EHR integration, handhelds with online patient lists and more
Document distribution technologies such as auto fax, distributed printing and uploading/integration to an information system (document scanner, document repository, EHR and more)
Web based or other electronic means solutions having the ability to access voice and text which include accessing voice files before transcribing the documents

Advanced Technology are Key to Meet Increased Demand for Medical Transcription

Using the following, the study shows how the use of advanced technology makes it easier to print or fax the documents transcribed after dictation. It also shows that transcribed documents could reach the physician’s office easily by uploading them into the EHR. As the turnaround time decreases with the use of advanced technology, transcription productivity will increase eventually.

According to the Bureau of Labor Statistics, increasing technological advancements can make individual transcriptionists far more productive. Earlier, medical transcriptionists were required to listen to an entire dictation for transcribing a medical report. Now, specialized software developed using back-end speech recognition technology can automatically prepare an initial draft of a report. The job of transcriptionists then gets reduced to just reviewing that draft for accuracy (as the software has limitation to identify synonyms, names and other words while converting the recording into printed format) and listening to the original recording if required.

Successfully blending technology, processes and the services of a team of skilled transcriptionists, a professional medical transcription company can help physicians get accurate and timely clinical information for improved patient care, reduce costs, save resources, and meet their revenue goals.

Challenges in Transcribing an Emergency Room Reports

08-November-2013 Julie Clements Emergency Room Transcription

Challenges in Transcribing an Emergency Room Reports Accuracy is a crucial factor in medical transcription. However, turnaround time is also critical when it comes to transcribing emergency room (ER) reports or medical reports supporting urgent care. Emergency care centers are busy places where doctors treat patients for life-threatening problems such as chest pain, serious injuries and more, and related reports need to be transcribed quickly and accurately. ER reports include patient progress reports, history and physical reports, chart notes, medical evaluations and other details. However, there are several challenges involved in transcribing ER medical reports in short turnaround time:

Audio Quality – Recordings with background noise are difficult to transcribe quickly and would require several rounds of listening. While a clear recording may take about 10 minutes to transcribe, a complex recording with poor audio quality can take around 15 minutes or more to document. In most cases, audio problems occur for recordings made without using microphones. Background noises and echo can be minimized with a microphone as it captures the speaker’s voice more efficiently.

Emergency Physicians’ Accent and Speed – If the ER physician has a strong or unfamiliar accent, the transcriptionist would need more time to understand what they are saying. This would also be the case if they talk too fast. Such issues are of course minimized if the medical transcription is handled by skilled and experienced professionals.

Various Kinds of Technical Terms – ER doctors specialize in trauma care, advanced cardiac life support, and management of other life-threatening conditions. Terminologies would pertain to multiple specialties such as cardiology, anesthesia, critical care medicine, ENT and orthopedic surgery and so on. This means that their reports would contain a large number of complex technical terms, those related to surgical procedures, life support, trauma resuscitation. The medical transcriptionists preparing ER room documentation should be well-versed in all these terminologies and procedures and be able to provide them with accurate reports so that they can make quick decisions.

Typing Speed – If everything goes well, but the transcriptionist does not have good typing speed, then emergency case reports would be delayed. For instance, a person with a typing speed of 50 words per minute would take 15 minutes to transcribe a medical report, but the same matter can be transcribed within 10 minutes if typing speed were faster.

An experienced medical transcription company can easily handle these challenges. With a dedicated team of skilled transcriptionists to handle emergency room transcription service, a professional service provider can deliver efficient and affordable documentation solutions within specified turnaround time.

Delaying EHR Adoption is a Bad Idea

01-November-2013 MTS TEAM Medical Transcription

Delaying EHR Adoption is a Bad Idea The goal of Electronic Health Record (EHR) adoption is to help healthcare providers build a sustainable practice and improve the safety and quality of health care. Centers for Medicare and Medicaid Services (CMS) have already made over 144,000 payments amounting to $7.1 billion to professionals and hospitals as financial incentives to help make the transition to EHR. From the year 2011 to 2022, CMS is expected to pay out $22.5 billion to healthcare providers who adopt EHR technology. In 2015, providers who do not make the switch to EHRs will face penalties and lose out on Medicare and Medicaid incentives.

Despite all these incentives, there are still many providers out there who are not ready to implement EHRs and who are still using paper charts and handwritten prescriptions. The main excuses given relate to costs, fears of increased workload lack of technical knowledge and inability to choose from the various EHR software platforms in the market.

Experts point out that most of these fears are unwarranted. Costs of EHR implementation include hardware, software, implementation assistance, training and ongoing network fees and maintenance. Physician practices can avail of assistance from their respective Regional Extension Center (REC) to calculate how much EHR implementation will cost them. Physicians may also be eligible for free or reduced-price support. In any case, delaying adoption is only going to result in penalties that will reduce their reimbursements.

Proper and systematic training including real patient interaction training can help manage increased workload issues, say experts. As far as choosing an appropriate EHR system is concerned, physicians can always rely on professional assistance. Experienced consultants can help them choose a software platform that can best meet their specific needs. Most EHRs are also user-friendly and physicians do not have to be particularly tech-savvy to work on them.

Feeding information into your EHR system can be a time consuming task and for that physicians can rely on a professional medical transcription service provider that has the resources to accomplish the task. A reliable medical transcription company can help healthcare providers achieve compliance, improve patient care, and enhance revenue.

Focus Group Transcription – Ensuring Clarity at the Recording Stage

24-October-2013 Rajeev Rajagopal Medical Transcription

Focus Group Transcription - Ensuring Clarity at the Recording Stage Focus groups form a popular qualitative research methodology in various business fields, including the medical field. The information obtained from discussions such as this, is not only useful for research purposes but also for diagnosis and treatment. For instance, the University of Wisconsin conducted a research on computer interviewing for patients in a family practice clinic, and the outcome of the study was evaluated in a follow-up focus group discussion by physicians. This helped in collecting useful data and obtaining the required information in a more convenient way. The main benefit of focus groups is that it can generate a large amount of information difficult to obtain from written surveys or one-on-one interview in a short period of time.

It is imperative to capture all the nuggets of information generated in a focus group interview or discussion as we don’t know which data will turn out to be most valuable. Here comes the importance of recording focus group interviews or discussions and transcribing them accurately for later use. So, how can we record focus groups efficiently? The answer is ‘digital recording’. Apart from getting high quality sound, digital recordings can be downloaded directly into the computer using built-in USB and transmitted easily through email.

What are the points to bear in mind when recording focus group discussions/interviews?

Ensure that the participants have no objection to recording the focus group discussion.
Give details about the research and the necessary background information before starting the recording. This will save the recording time.
If you want the different speakers in the focus group to be identified in the transcribed documents, ask each of them to introduce themselves at the time of recording. In the case of a large group, ask each of them to mention their name whenever they make a comment.
Set up some rules (for instance don’t talk over each other, don’t make noise) for the participants before you start the recording so that there will be less difficulty for the transcriptionists later.
Use an external microphone on your recorder instead of using internal mikes as they are only suitable for one voice. It is better to use a series of microphones when there are more than four participants.
Choose a quiet place for recording to reduce background noise and thereby increase the sound quality.
Ensure that your recorder has the facility to transfer files to a PC and you are using a file format that is compressed so as to transfer them over the internet to the transcriptionist.
Check if there is any recording problem with your recorder before starting the group.
Do not serve food in between the recording as the audio may be rather unclear amidst the noises of eating.

If you have challenging focus group transcription requirements to meet, go ahead and hire a professional medical transcription company that can offer the service of skilled, experienced medical transcriptionists and three-level quality assurance.

Why HL7 Interfacing is Necessary in Medical Transcription

17-October-2013 Julie Clements Medical Transcription

Why HL7 Interfacing is Necessary in Medical Transcription Health Level Seven or HL7 is a standard accredited by the American National Standards (ANSI) for the exchange, integration, sharing and retrieval of electronic health information. The definitions in HL7 focus on the logical arrangement of data and the meaning of various parts of the message. This ensures that important healthcare information is made available to various sources without the meaning getting lost.

Patient registration systems and EMR/EHR systems vary among healthcare facilities and would make communication difficult if it weren’t for HL7. HL7 facilitates the packaging of healthcare data as messages for transmission to physicians’ computer systems or EMRs/EHRs. HL7 interfacing is used in more than twenty countries and contains messages for almost every possible field in healthcare including:

Patient care planning
Registration, queries and finance
Document control
Laboratory automation
Personnel administration
Scheduling, logistics, and more

This explains why HL7 interfacing is necessary for medical transcription companies. HL7 allows easy interfacing of the transcription company with healthcare provider networks and EMR systems. The transcription company should be equipped to receive HL7 based Abstract Data Types (ADT)/ order transmissions via Transmission Control Protocol (TCP), Internet Protocol (IP), HyperText Transfer Protocol Server (HTTPS) and/or Virtual Private Network (VPN). The service provider should also be able to send back the transcribed document as a HL7 message to client’s interface engine using TCP/IP, HTTPS and or VPN. HL7 interfacing is complaint to both the Health Insurance Portability and Accountability Act (HIPAA) and Health Information Technology for Economical and Clinical Health Act (HITECH) protocols.

So in addition to accuracy, turnaround time, data security and pricing, look for HL7 interfacing with your Health Information System when outsourcing your medical transcription.

Transcribing Medical Abbreviations and Acronyms Accurately

08-October-2013 MTS TEAM Medical Transcription

Transcribing Medical Abbreviations and Acronyms Accurately You can imagine how dangerous it could be when the abbreviation ‘MgSO4’ (Magnesium Sulfate) is transcribed as ‘MSO4’ (Morphine Sulphate) or the acronym DOA is transcribed as ‘dead on arrival’ instead of ‘date of admission’. These examples such go to show how careful medical transcriptionists should be and avoid mistakes when transcribing abbreviations and acronyms. Here are some things that need to be handled carefully:

Guessing Meanings – It is a bad practice to guess the meaning of acronyms and abbreviations, as certain terms could have double meanings, as in the case of ‘DOA’. Instead, transcriptionists should use their reference books to look up the exact meaning of a doubtful term, relate it to the context, and memorize the rules for future use.

Common Abbreviations and Acronyms – Certain abbreviations are acceptable as such. For instance, those used prior to or after names (Dr., Jr., Ph.D), those included in the name of an organization (Co., Ltd.), and those used to indicate time (am, pm). Transcripionists should be aware of such expressions so no time is wasted in interpreting them.

Expanding Acronyms – If there are uncommon acronyms in the dictation, it’s better to expand them and put them in parenthesis following the relevant acronym. Expand the term when it is first used in the report and use the acronym later, and not the other way round. For example, it is incorrect to transcribe: ‘The patient had EGD this morning. The EGD (EsophagoGastroDuodenoscopy) was scheduled for yesterday.’ You should transcribe: ‘The patient had EGD (EsophagoGastroDuodenoscopy) this morning. The EGD was scheduled for yesterday.’

Period Placement – Periods are not normally used for abbreviations or acronyms with upper case letters, though there are exceptions such as I.V. and M.I. Periods are also necessary in some abbreviations in lower case like q.i.d., q.a.d., and s.o.s. Abbreviations for metric measurements such as kg, mg, and cc do not include periods. So know the rules about period placement for accurate documentation.

Pluralizing Abbreviations – Some abbreviations can be pluralized by using “s” at the end (for instance, WBCs (White Blood Cells)). But, if there are periods in the abbreviations, put an apostrophe after the last period and then place “s” to pluralize them (for instance, I.V.’s). The abbreviations for metric measurements remain same for singular and plural usage.

In a professional medical transcription company, transcription is handled by qualified and experienced transcriptionists who are trained in all these rules and much more. Multi-level quality control processes by editors, QA analysts and medical experts can generate documentation with accuracy levels as high as 99%.

How Medical Transcription Service Makes the Difference

03-October-2013 Rajeev Rajagopal Medical Transcription

How Medical Transcription Service Makes the Difference Outsourcing medical transcription service is a highly feasible option for individual healthcare practitioners and healthcare organizations. For hospitals, maintaining an efficient data documentation and transcription system is a big challenge. It demands massive investment and resources. They need trained transcribers or have to train the hired staff. If hospitals find this a tough and massively time- and resource-consuming task, it would be even more challenging for individual physician practices.

Outsourcing Provides the Answer

Medical transcription outsourcing can resolve all the documentation challenges that healthcare providers face. A professional medical transcription company has a team trained transcribers and experienced editors who can ensure quality transcripts of your medical data. They do it the right way and their services are competitively priced. You don’t have to spend your precious resources on maintaining full time staff, pay salaries and benefits, and provide them the required training and infrastructure. If the team fails in its job, it would cost your practice dearly in terms of failed insurance payments. Moreover, the importance of accuracy in data relating to treatment and diagnosis is crucial to ensure proper patient care. Errors in transcription could really break the meaning of the diagnosis and treatment data which could prove catastrophic for the wellbeing of the patient.

Advantages of a Reliable Transcription Company

An efficient medical transcription company can ensure sustainability for your practice with efficiency in documentation. It offers services that are flexible with the requirements of various kinds of practices. It ensures HIPAA-compliance, confidentiality and security in the transcription process. Advanced security protocols are employed to ensure your critical data stays safe all the time and do not fall into the wrong hands. Here are some of the other advantages of professional medical transcription service:

Round-the-clock customer support
Three levels of quality checks
99% accuracy of the transcription
Transcription for all medical specialties
Dictation options of digital recorder or toll-free number
Quick and customized turnaround times
EPM or EHR feeds
Electronic signatures
256-bit encryption
Availability of volume rates
Transcription management software

With comprehensive features such as these, there is hardly any doubt that medical transcription service can enhance the functioning of your healthcare practice, and ultimately, your bottomline.

Quality Digital Audio Recordings for Error-free Medical Transcription

19-September-2013 MTS TEAM Medical Transcription

It is very important to assure high quality digital recordings to enjoy error-free medical transcription. If the dictation lacks clarity, it can lead the transcriptionist to misinterpret the facts in recordings and result in erroneous documentation. So what makes a quality digital audio recording? It depends on two recording parameters:

Compression Rate – The size of digital recordings in a particular format is reduced to transfer them quickly between recorder and computer or between computers. This is termed compression. There are two types of compression, namely lossless (retains the quality but possess lower compression ratios (WAV)) and lossy (reduces the quality for high compression (MP3, AAC, WMA) compression. Both WAV and MP3 formats are used for digital dictation. However, these are too much for voice-only recordings as human vocal range (about 4,000 to 7,000 kHz frequency) forms a very small portion of entire frequency range. This paved way for the advent of Digital Speech Standard (DSS) format which produces very small files that can be transported easily while preserving fidelity. DSS Pro, the improved version, comes with increased fidelity, in-recorder encryption and additional demographic information. Digital recorders such as the Olympus DS-5000, Olympus DS-5000iD, Philips DPM 9600 and more support this format.

Sampling Rate – Sound files are usually sampled 8, 11, 22 or 44 thousand times a second. Though you can get more exact reproductions with high sampling rate, it is possible to understand the human voice at a lower sampling rate. The commonly used sampling rate for dictation files are 8 kHz (8,000 times per second) and 11 kHz or 16 kHz (DSS Pro). The terms QP (Quality Play), SP (Standard Play), LP (Longer Play) and EP (Extended Play) are used to indicate different sampling rates. The rate applies to each term may differ according to the recorder.

As your dictation requirements may differ based on your purpose, the format and sampling rate will also vary. For example, if you want to transcribe patients’ health information (diagnosis details, laboratory test details and more) from recordings, then you should maintain its confidentiality in accordance with HIPAA law. In such cases, the most suitable format is DSS Pro as it supports in-recorder encryption. Sometimes, you may need longer recording time with slightly less quality (in the doctor and patient encounter). You can choose a lower sampling rate in such cases.

It is always better to consult with experts about the type of format and sampling suitable for your digital dictation so that you can generate quality audio recordings. Some professional medical transcription companies offer a quality digital recorder free of cost for volume transcription orders.