Medical Transcription Helps EMR/EHR Adoption

11-September-2013 MTS TEAM EHR Transcription

Medical Transcription Helps EMR/EHR Adoption The U.S. Health Information Technology for Economic and Clinical Health Act (HITECH) and Obamacare insists on the adoption and meaningful use of Electronic Medical Records (EMR) by physicians and hospitals in 2015. Those that fail to meet this deadline will face penalties and reduction in incentives. The EMR system, offers several benefits such as easy accessibility to medical records, better patient engagement with healthcare providers (especially nurse practitioners and physical assistants), and improved patient data evaluation capability for quicker improvements compared to paper charts. Following this, many healthcare providers switched from transcription systems to direct entry of data into the medical record.

However, transition to EMR/EHR is fraught with issues such as high costs of adoption and implementation, maintenance costs, disruption of workflows and loss of productivity leading in turn to loss of revenue. Patient privacy violation can also result when so much of information is exchanged electronically. These factors are acting as a disincentive for hospitals and physicians when it comes to EMR implementation.

Medical transcription can help EMR/EHR adoption. Transcription allows healthcare providers to use secure platforms for the transfer of electronic records. These electronic document exchange solutions can be used by healthcare facilities to resolve many workplace challenges with EHR/EMR implementation. Leading medical transcription companies offer documentation solutions that integrate smoothly with EMR systems.

Reputable medical transcription service providers ensure error-free documentation which in turn, assures safe patient outcomes and deserved reimbursement. With transcription, all patient encounters are captured accurately ensuring quality, compliance, greater productivity and higher revenues for the healthcare provider. That’s why physicians need to continue to use dictation and transcription. Medical transcriptionists have the knowledge and experience to support workflow practices in busy healthcare facilities, helping physicians move smoothly from paper-based systems to the efficient electronic systems to manage patient records.

Adopting EHRs Found Beneficial for Mass Community Doctors

27-August-2013 Julie Clements EHR Transcription

Adopting EHRs Found Beneficial for Mass Community Doctors The adoption of electronic health records (EHRs) is expected to help the U.S. curb rising healthcare costs by eliminating medical errors, increasing the speed of access to data, improving the quality of decision making and avoiding duplication of services. In the initial stage of the implementation, many healthcare providers feared that the adoption of this new health information technology would increase their costs and affect revenue, despite the fact that the government is spending billions of dollars in the form of incentives to encourage EHR adoption.

A recent study published in the Annals of Internal Medicine reports that the EHR adoption by doctors can help in driving down health costs in community-based establishments such as private practices and community hospitals. Researchers analyzed and compared information about insurance claims for patient care at three Massachusetts healthcare communities that implemented EHRs with six communities that did not adopt them. They found outpatient costs in the three Massachusetts communities did not increase as fast as that in the six communities that did not adopt EHRs. The difference in the cost rise between the two groups was around 3 percent.

The researchers found significant cost reductions in outpatient radiology testing after analyzing insurance claims dating from January 2005 to June 2009. However, they did not find any significant savings with regard to lab or outpatient pharmacy care, inpatient care and the total cost of care. The Annals of Internal Medicine study put forward three suggestions that can enhance the cost-effectiveness of EHRs:

Providing technical assistance for EHR implementation
Providing monetary support for the purchase and setting up of EHRs
Creating an efficient data exchange infrastructure

Regardless of the benefits that EHR implementation will offer, the physician’s transcript from his dictation is often the best way to tell the patient’s story with all the vital details. Many experts also point out that entering information into the EHR can take up the physician’s valuable time that could go into patient care. The solution lies in blending EHR with dictation-transcription. Professional medical transcription companies can provide documentation solutions with feeds for EHR.

For producing more revenue out of your practice, you need to allot more of your time on patient care services but they are spent on EHR documentation. With the professional assistance from a medical transcription firm, you can feed patients’ medical data into the EHR with the help of HL7 interface provided by the transcription firm. By partnering with a reliable transcription firm, you can save 30 – 40% on operational costs.

Comparison of U.S based and Off-Shore Medical Transcription

20-August-2013 MTS TEAM Medical Transcription

off-shore-medical-transcription Outsourcing medical transcription tasks is common practice for the many advantages that it offers the healthcare professional. However, there is the question of choosing between U.S. based and off-shore medical transcription in countries such as India, the Philippines, and so on. Before you make your choice, compare these options. Here are some pertinent considerations:

Productivity – The transcription team in an offshore company is working US day time while it is night time there. This might affect production. This does not happen with a US based transcription service provider who works U.S. day time and is available when you need their services. Productivity can also be affected by internet speeds. Internet speeds are varied offshore depending on where you are in the world. A high speed internet connection, DSL or cable modem is crucial for quick downloading of dictations and transcribed files.

Turnaround Time (TAT) – The time zone difference can also work to your advantage. Outsourcing transcription tasks to a country which has different time zone can help you get your transcripts in customized turnaround time. For example, India is around eleven hours ahead of U.S. However, there may be issues with customer support if the off-shore company does not have an office at U.S. Reliable offshore medical transcription companies that are U.S. based offer customized TAT anywhere from 24 hours or less, and also assure 24/7/365 technical support.

Work Force Quality – Offshore transcription teams are better educated. The transcriptionists have good English language skills and are trained to understand American accents. They are also trained in medical jargon and terminology and can provide timely transcripts that are up to 99% error-free. In other words, offshore transcriptionists are professionally trained to provide services for physicians in the U.S. Most of the physicians in their own country are still writing.

Cost Effectiveness – The direct labor costs, HR and administrative costs, training costs, annual maintenance costs are much lower for an offshore outsourcing transcription service provider. Physicians can expect cost savings of 30 to 50% cost savings due to the pricing benefits offered by an offshore company.

HIPAA Compliance – When you outsource transcription tasks, it is very important to ensure that the company you partner with (U.S. based or off-shore) is HIPAA compliant. This would ensure that it has all the regulations in place to ensure safety of patient information such as teams trained on HIPAA compliance, password-protected computers, encrypted servers (for data uploads and downloads), shredding facilities, and a protected work environment.

The ideal choice of transcription service provider is one that has off-shore transcription service provider as well as a reliable U.S. office. Such companies can ensure remote, real time transcription coverage and assure accurate and prompt documentation that meets U.S standards at affordable cost.

Technology and TAT in Medical Transcription

08-August-2013 Rajeev Rajagopal Medical Transcription

Technology and TAT in Medical Transcription
The American Health Information Management Association (AHIMA) defines TAT for transcribed reports as “the elapsed time from completion of dictation to the delivery of the transcribed document either in printed medium or electronically to a repository”. Healthcare providers have to get their transcribed reports as quickly as possible. However accurate, of what use would a history or physical report be if the healthcare provider gets it after the surgical or medical procedure is performed?

Technology plays a significant role in ensuring the delivery of processed documents within the specified TAT. Professional medical transcription companies are equipped with the latest technology applications that increase the overall efficiency of transcription process and deliver the transcribed files in time to meet the needs of the healthcare provider.

A study titled ‘Transcription Turnaround Time on Common Document Types’ published by the Joint Task Force on Standards Development of the American Health Information Management Association (AHIMA) and Medical Transcription Industry Association points out that the successful implementation of certain technologies can reduce the dictation-to-delivery time. These include:

Use of digital recorders, microcassettes, personal digital assistants (PDA) and other portable dictation devices
Document distribution technologies which include distributed printing, auto fax, uploading/integration to an EHR, document scanner, document repository or any other information system.
Web-based or electronic based solutions that provide easy access to voice and text which include the capability to access voice files prior to documentation process.
Systems such as picture archival and communication system (PACS), barcode readers and handhelds with online patient lists don’t require a user to manually enter data instead they perform automatic collection of patient data.

Though the task force recognizes that introduction of speech recognition technologies such as Front End Speech Recognition (FESR) and Back End Speech Recognition (BESR) can improve TAT, it points out that transcription services will not be fully replaced anytime soon. The reason is that manual medical transcription services and comprehensive free-thought narratives are crucial to produce a report that ensures continuity of care. In fact, a study conducted in September 2012 found that while VR (Voice Recognition) offered benefits such as improved TAT and the ability to complete reports without manual intervention, the prohibitive costs of implementing VR leads to its rejection as a substitute for digital transcription services.

TAT in the Medical Transcription Industry

25-July-2013 Julie Clements Medical Transcription

It is very important for medical transcription services to meet the TAT requirements of clients. However accurate the transcribed file may be, it is of little use for the physician or healthcare practice if it arrives later than scheduled. The quality of vital life saving care to patients and the efficiency of hospitals and physicians therefore depend largely on the efficiency of medical transcription services.

TAT and Its Varied Interpretations

Given the current lack of standards or benchmarks regarding TAT for dictation and transcription, it is not surprising to find a wide range of definitions. Commonly, transcription TAT is considered to be the elapsed time between when a dictated record is made available for transcription and when the transcribed report is returned for authentication. However, some organizations include the time to authenticate and finalize the record (as with radiology practices) and the time to distribute the record within the scope of turnaround, and others may include varying degrees of availability, such as when a report is pending quality assurance (QA) review but has not yet been distributed.

The varying definitions and kinds of understanding regarding turnaround times constitute a major issue when it comes to the efficiency of medical transcription. TAT is variously understood as:

The period from the time the file was dictated to the time it is handed back as a transcribed document to the client.

The period from the time the dictated file was made available to the transcriber to it being handed back for authentication or checking for quality assurance (not to the client).

Some transcription firms include the checking or authentication process within the turnaround time period and some others also include the time for distributing the transcribed file to the client within the turnaround period.

Others, though, include neither. Only the time period from the beginning of transcription to the handing over for quality assurance checks is understood as the turnaround time.

In other words, there seems to be an inconsistency in the understanding of TAT across the industry, which could cause serious issues. The chief reason for this seems to be a lack of a benchmark or yardstick for the medical transcription industry with regard to TAT.

Understanding TAT the Right Way

The correct understanding of TAT in the transcription sector is the time period from the completion of dictation of the file by the client to the handing over of the transcribed file back to the client, whatever be the medium of distribution – electronic or print.

The arrival of new EHR measures must coincide with a better understanding of TAT and the implementation of a common measure by which to judge the TAT compliance of the medical transcription service provider. Failure to do this, while harming the wellbeing of patients, the reimbursement process and overall risk management in the healthcare sector, can also have adverse effects on the transcription industry as clients will look for alternative means of transcribing important files.

Survey on Contracted TAT

According to a survey conducted among health insurance survey managers, the average contracted TAT for various kinds of documents is as follows:

Paper documents of history and various kinds of reports and notes – 21 hours
Paper discharge summaries – 40 hours
Paper radiology reports – 12 hours
Electronic documents of history and other notes and reports – 18 hours
Electronic discharge summaries – 35 hours
Electronic radiology reports – 10 hours

An efficient medical transcription company will never default on the turnaround time and, apart from fulfilling or exceeding the industry standard, would also cater to the customized TAT needs of clients.

Prepare Yourself for ICD – 10 based Medical Documentation

22-July-2013 MTS TEAM Medical Transcription

ICD-10 October 1, 2014 is the date set for ICD-10 compliance. The number of diagnostic codes will increase from about 14,000 to around 69,000 while the number of procedure codes will increase from around 3,000 to about 87,000.

The specificity required for medical documentation will increase when ICD-10 medical codes come into effect. Physicians’ practices will have to ensure that their dictation is accurately transcribed to ensure the quality documentation required for reimbursement.

The ICD-10 code sets have basic structural and conceptual changes that set them apart from ICD-9. Compared with ICD-9, ICD-10 calls for much greater detail on the location of ailments, cause and type, and complications or manifestations. For instance, asthma is listed as “mild,” “mild intermittent,” “mild persistent,” “moderate persistent “or” severe” in ICD-10. So physicians will have to start thinking about how they can provide sufficient documentation to medical coders.

Many practices are implementing electronic medical record (EMR) not only to avoid meaningful use penalties in 2015 and ensure proper Medicare payments, but also in the belief that it will help with their documentation. However, physicians will find data entry into the EMR (electronic medical record) difficult. Moreover, just entering data into drop down menus would miss out on valuable details. The doctor’s notes on the patient’s story are often crucial to diagnosis and treatment and cannot be captured through the EMR. Only accurate transcription of these notes can provide the entire picture.

icd-10

A professional medical transcription company should ready itself for the transition to ICD-10 by updating its procedures and technology, and preparing its staff to handle the new and increased documentation requirements of healthcare providers.

Ensuring Quality in Medical Transcription

17-July-2013 Rajeev Rajagopal Medical Transcription

Quality is vital when it comes to medical transcription. If the transcribed documents are of poor quality, then they can affect document integrity (specialists or referring docs will find the documents difficult to understand), have negative financial consequences, and even put patients’ lives at risk.

In the context of medical transcription, ‘quality’ can be defined as explicit, unambiguous, consistent and complete health care data documentation from a clinician’s dictation. Of course, high quality audio recordings (clear voice/voices without much noise) are necessary for generating quality transcripts. However, a stringent quality assessment methodology can maintain quality throughout the transcription process so that the final document is at least 99% accurate.

A professional medical transcription company would have three types of quality checks in place:

First Level: In this level, the actual transcription is done by medical transcriptionists. After making the first draft, the transcriptionists will check the work twice – the first time using voice, and next, by reading the report for comprehensibility. The work is transferred to second level after these three steps.

Second Level: The documents prepared by the medical transcriptionist are checked at this level. Proofreaders check each file for integrity (both demographics and text/report) and ensure that there is no drop in quality. The transcriptionists are provided with solid feedback, which allows them to improve their work and avoid penalization.

Third Level: The third level of checking is carried out by medical editors. Mistakes which may go undetected at the other two levels are corrected at this level. A very rigorous quality check is performed and the proofreaders and transcriptionists are given daily feedback to help them avoid errors.

Constant audits are the other integral part of the quality assurance (QA) process. These audits help to ensure all the quality checking process is performed correctly and that client requirements are implemented. Advanced quality transcription software is employed for quality assessment at each level.

The Health Insurance Portability and Accountability Act (HIPAA) strictly restrict the public disclosure of a patient’s health care information. So in addition to quality, medical transcription companies have various measures in place to ensure transcript confidentiality. This includes the creation of the transcripts in a secure environment as well as safe modes of transfer such as FTP and encrypted browser-based file transfer.

Unwarranted Concerns when Outsourcing Medical Transcription

11-June-2013 Julie Clements Medical Transcription Outsourcing

Healthcare providers outsource medical transcription to save costs and to meet staffing challenges. However, they face many concerns when making the decision to outsource. The truth is that many of these concerns are unwarranted.

Outsourcing companies do not care about accuracy – This is untrue. In fact, outsourcing can contribute to higher levels of accuracy in transcription. A business process company offering medical transcription services has qualified and experienced staff on the job. Well-versed in medical lingo and various medical procedures, these experts work with advanced software and hardware to ensure quality transcripts. Periodical training sessions are conducted to keep the staff well-informed. A reliable company would also have stringent quality checks to ensure transcripts with accuracy levels as high as 99%.

Outsourcing companies are not aware of HIPAA rules – Security concerns loom large when healthcare information and patient data are outsourced. HIPAA rules and regulations were instituted in 2003 to ensure the confidentiality of personal health information. HIPAA-compliant medical transcription services are available. A reliable outsourcing company would strictly adhere to the contract to maintain the confidentiality of medical information. Its staff would be fully trained on the latest HIPAA guidelines. The company would also have a secure work environment, including password protected workstations, to ensure that the confidentiality of healthcare data is not compromised. No home-based transcription service is ever used.

Transcripts are not delivered on time: This is not an issue if you outsource your work to a professional medical transcription company. A competent service provider can deliver your transcripts in customized turnaround (TAT) time. The factors that typically affect TAT are volume of work, transcription requirements, and availability of experienced staff. A professional transcription service would have all the resources necessary to meet their clients’ TAT requirements.

Outsourcing medical transcription is expensive – Actually, it’s quite the opposite. If you were to do transcription in-house, you would have to incur huge costs for hiring additional staff, training them, setting up the entire infrastructure, and so on. Outsourcing helps avoid such expenses. In fact, professional outsourcing companies strive to offer services at affordable costs, even saving their clients up to 30-40% on operational. They even offer attractive discounts for volume jobs.

Data Security Upgrades in Healthcare a Main priority in 2013

27-May-2013 MTS TEAM Healthcare News

Data Security Recent studies show that data breaches in US healthcare organizations cost providers more than $6 billion a year, and that hospitals and clinics still lack the ability to protect their patient healthcare records. Among the important challenges that healthcare establishments face in 2013 are implementation of electronic health records, achieving Meaningful Use requirements, and upgrading IT infrastructure.

The average healthcare organization sustained significant data breaches in the past two years. The common reasons for data breaches were unintentional employee action, lost or stolen computers, unsecured file transfer, and third party error. No responsible healthcare organization can afford such data breaches. Here are some important steps that can help eliminate security threats and protect patient data:

No user involvement in data backups: in order to rectify and eliminate data security threats, organizations need to implement automated, centrally deployed data backup processes.

Centralized and granular data access control: health care organizations must implement more granular and centralized data access control to minimize data security threats.

Data encryption protocols: measures like FTP, browser-based 256 bit encryption, Safeboot, PGP and so on should be used for the safe transfer of files through the Internet.

Ability to track data changes: a backup solution that can provide a previous version of files should be employed so that healthcare organizations have greater control over data and can minimize security risks.

Safe and simple data recovery: an endpoint solution which provides safe and easy data recovery should be employed in organizations, which would increase operational benefits and reduce overhead costs.

Protecting data from third party access: measures should be implemented to prevent access of data by a third party. Computers should be password protected; employees should be screened and monitored on security.

HIPAA compliant medical transcription: the healthcare facility should outsource its medical transcription only to a HIPAA-compliant medical transcription company. This will ensure utmost safety for patient data.

Hospitals Help in Boosting US Economy

20-May-2013 MTS TEAM Healthcare News

Hospitals are the primary healthcare establishments that people rely on and they are the major contributors in boosting the US economy. According to data released by the American Health Association (AHA), hospitals spend more than $ 2.3 trillion in economic activity that includes $702 billion spending on goods and services from other business enterprises.

They are also the second largest employer of private jobs and they employ nearly 5.5 million people. As per AHA report, hospital establishments support direct and indirect jobs that amount to a total of 15.4 million. For example, hospitals in Massachusetts employed more than 197,000 people in 2012 and contributed over 51 billion dollars to the Bay State in 2011 according to a report released by the Massachusetts Hospitals Association.

Similarly, based on the report by the Hospital Association of Rhode Island, hospitals continue to be a major economic booster by generating 6.7 billion dollars in 2011. These reports prove that hospitals have a major influence on employment and economic growth in the US.

Even though hospitals are said to be generating revenues, there is somewhat equivalent spending in non-core activities such as medical transcription tasks that require dedicated human resources. To tackle this issue, hospitals can go for the services of a reliable medical transcription company that has a skilled and experienced team of medical transcriptionists that can complete the job assigned to them within the specified time with 99% accuracy. Usually, reputable companies offer affordable medical transcription services that can be customized as per client requirements. Some of the advantages of utilizing their services are customized turnaround times, 30 to 40% cost savings, and no long term yearly contracts. Most of the transcription companies offer free trial to help clients evaluate their services.