Outsourcing Medical Transcription Services

Medical Transcription is the process of converting voice transcription into a permanent written record utilizing word processing equipment and software. Medical transcription is necessary process in medical industry as all medical institutions require computerization of medical notes for clean and compact record-keeping, insurance claims processing, quick reference, conferencing and various other reasons.

Today medical transcription service has almost become a popular term among the health professionals and services are available for all medical specialties. A medical transcriptionist's job primarily involves converting significant and confidential data into written text. This text is printed and included in the patients' records, archived and retained as an electronic medical record.

Before some time staff of skilled medical transcriptionists was working in the medical records department of the hospital has accomplished the work of transcribing medical records. But now a days for any hospital; it is very difficult to afford staff of medical transcriptionists so for that outsourcing is the best option available to save their valuable amount of time and money. By outsourcing their medical transcription related requirements to outsourcing firm they can reduce their burden.

While you are choosing your offshore partner to outsource your needs, you have to be very careful as it requires an attention to detail and an ability to recognize and understand technical terminology.

Medical transcription: Importance of multiple reviews for assuring quality

Medical transcription is the process of creating patient medical records, converting the audio of the patient- healthcare professional encounter into text format. Quality or accuracy of the information in the patient transcript is one of the most important factors, as the information in patient medical records is vital for providing quality care, to start the process of reimbursement and as a component of risk management. To this end while outsourcing medical transcription it is important to assess whether the medical transcription service provider has methods for quality assessment.

As medical transcription has an important supporting role to play in the process of healthcare, a best practices guide titled “Healthcare Documentation Quality Assessment and Management Best Practices” has been jointly created by AHDI, MTIA and AHIMA. One of the highlights of this manual is alignment with the Plan-Do-Check-Act cycle.

Each stage of the process is vital to ensure that the process of healthcare is documented keeping in mind that maintaining the highest standards of quality is a continuous process. The goal of this quality assessment program is to ensure that healthcare documentation is clear, consistent, accurate, complete and timely.

Do: Assessment policies and procedure

This part is very important as it shows that there is a formal policy, which lays out the procedure for quality assessment. Assessment and improvement procedures should be throughout the documentation process, instead of an exercise used for filling blanks, flagging errors or tabulating error rates.

The purpose of this exercise should be to help provide feedback, play a significant role in ensuring patient safety and maintain integrity of the document.

The assessment policy should include:

Concurrent review: This means that the transcripts that have gone through the first stage of transcription by the medical transcriptionists, are subject to complete and comprehensive review. This is absolutely essential when the expertise of the medical transcriptionist has not been established or when the medical transcriptionist transcribes for a new specialty or when transcribing for a new healthcare professional.

Retrospective review: Though concurrent reviews are ideal for the quality process, it may not be possible to review 100% given the tight turnaround time requirements. However reviews are an essential learning tool especially for medical transcriptionists, it is important to have retrospective reviews

Review of flagged documents: This type of review occurs when the initial or first stage of medical transcription has flagged blanks/ error etc. It is important to review these transcripts and resolve the flagged errors before transmitting for final authentication to the healthcare professional/ healthcare facility.

Using the findings from these reviews as feedback: The purpose of these reviews is to help improve the quality and reduce errors. Therefore the findings from these reviews are used as a learning tool to improve the work of medical transcriptionists. Another important aspect of these findings is also to provide feedback to healthcare professionals. The findings can be used to educate healthcare professionals in best practices for dictation.

The purpose of reviews is to improve quality, provide feedback, enabling medical transcriptionists to improve quality medical transcription.

Medical transcription outsourcing: Points to be considered during outsourcing

Outsourcing medical transcription is a prudent business decision and helps the healthcare facility focus totally on their core business while providing the right support. However the outsourcing decision is not one to be taken lightly and needs a thorough analysis of what the healthcare facility hopes to gain from the outsourcing decision. To make sure that everybody in the healthcare facility is comfortable with the outsourcing decision it is important for the healthcare facility to ask itself some questions:

a)     Is medical transcription part of the core business of the healthcare facility?

Medical transcription is not part of the core business of a healthcare facility though it does play an important role in the operational and commercial aspects of a healthcare facility. Medical transcription is a specialized skill requiring a combination of the right team, the right technology and process to be able to meet the criteria of being accurate, timely, secure and cost effective.

b)    How much is medical transcription costing currently?

Having medical transcription services in-house could be costing the healthcare facility more than what they originally would have estimated. While calculating cost of in-house medical transcription factors like these should be taken into consideration:

o                             Overheads

o                             Allocation of management & administration staff for managing medical transcription in house

o                             Wastage of resources during slack times

o                             Overtime pay during excess inflow of work

o                             Extra pay for weekend and holiday transcription

c)     What are the other resources being used for in house medical transcription?

In-house medical transcription could also involve usage of resources like secretaries, Information Technology staff, capital equipment etc. for medical transcription.

d)     What are the accuracy levels and turnaround time of transcripts?

In-house medical transcription could result in varied levels of accuracy due to the varying volumes of transcription. The accuracy levels could be high when volumes are low and low when volumes are high.  The turnaround time could also similarly vary depending on the volume of transcription. The turnaround time being shorter during slack periods and vice versa during periods with high volumes

e)     Is it important to retain medical transcription in-house?

There are certain factors like concerns for security of the data that could be a hurdle to the outsourcing decision. Choosing a service provider with measures in place to secure people, processes and technology can eliminate security concerns and remove any hurdles to the outsourcing process.

f)       What are the alternate options available?

Healthcare facilities have the option of outsourcing their overflow transcription needs to a combination of independent contractors or medical transcription service providers. This could however result in the healthcare facility having to put in more efforts to coordinate medical transcription from various resources. The easy fix to ensure that transcripts are created in a timely, accurate, secure and cost effective manner is to outsource medical transcription on a turnkey basis to a professional medical transcription service provider

g)     What is the cost of outsourcing medical transcription?

Outsourcing medical transcription services ensures that the cost of transcription is restricted to the cost per line of transcription. Initially the healthcare facility may have to have a minimum outlay towards finalizing the service provider and adapting to the technology used by the service provider.

h)    What are pitfalls of outsourcing medical transcription?

The common pitfalls while outsourcing a function as vital as medical transcription is the fear of poor quality and security concerns. Another major concern is that the price quoted by the service provider may have hidden costs. Both these concerns can be overcome by choosing a service provider who has the right team in place to meet quality concerns,  has adequate measures in place to ensure total security and uses a billing method that is measurable, verifiable, definable, consistent and fair& honest.

i)       What is the value addition in outsourcing medical transcription?

Outsourcing medical transcription provides the healthcare facility with many value added services like technology that offers multiple benefits like different modes of document delivery, archives making it easy to trace transcripts in different stages, specialty medical transcription etc.

j)       What about the transition to outsourced medical transcription services?

Transition from in-house transcription to outsourced services can be eased when the medical transcription service provider has open channels for customer service. This would enable the service provider to solve minor issues as and when they crop up.

k)     What about existing investments in EMR?

Existing investments is EMR/EHR can be protected if the medical transcription service provider has the capability for HL7 interface enabling data to be transmitted to the EMR/EHR system.

l)       What are the options available to capture dictation?

This is a main concern for time starved healthcare professionals, this concern can be overcome by choosing a service provider who allows the healthcare professionals to retain their familiar modes for capturing dictation.

The process of outsourcing medical transcription can become easier by choosing a medical transcription service provider who alleviates these fears/doubts that may rise during the outsourcing process.

Medical transcription outsourcing: Empowering healthcare to perform better

There have been a lot of discussions in the recent past about the importance of medical transcription services, some defending the need for these services while some dismissing the need for medical transcription in the healthcare documentation scenario. At this juncture when healthcare and healthcare documentation are poised at a critical point, it is important to acknowledge the role played by medical transcription services in the healthcare process and the important part it will continue to play in the future of healthcare documentation.

While admittedly medical transcription is part of the expenses and does not have a direct role to play in the actual process of providing care or for that matter generating revenues, it plays a vital role in empowering healthcare professionals, other support staff and the management of healthcare facilities in achieving these goals.  As the creation of patient medical records – medical transcription is a specialized process requiring concentration of capital, technology, personnel and other inputs, outsourcing medical transcription to a professional service provider provides an easy and economic solution to healthcare facilities and healthcare professionals.

How do outsourced medical transcription services empower the healthcare process?

Outsourcing medical transcription empowers healthcare facilities and healthcare professionals in the following areas:

Access to the right team: Medical transcription is a people-intensive process requiring skilled and well-trained teams of medical transcriptionists. Outsourcing ensures that the responsibility of sourcing, recruiting, hiring and training the right team rests on the outsourced medical transcription service provider. By outsourcing medical transcription work healthcare professionals and healthcare facilities automatically have access to skilled and specialty trained medical transcriptionists. Outsourcing medical transcription also provides healthcare facilities and healthcare professionals access to other personnel like the administrative and managerial staff of the medical transcription service provider.

Access to the right process: To ensure efficient and accurate medical transcription, a due process to ensure quality needs to be adopted. Outsourcing ensures that healthcare facilities and healthcare professionals have access to the best practices adopted by the service provider. The various steps involved in medical transcription like allocation of work to the right medical transcriptionist team, quality assurance processes are also essentially outsourced to the service provider.

Access to the right technology: Technology has become an integral part of medical transcription making the process easier, quicker and more secure. Outsourcing medical transcription ensures that healthcare facilities and healthcare professionals have full access to the software and tools used by the service provider. Benefits like the usage of dictation devices of the healthcare professionals’ choice, automatic upload of audio files for dictation, document delivery mode options, archives and adoption EMR/EHR using HL7 interface are some of the advantages of the technology used by the medical transcription service provider. Moreover the medical transcription service provider also provides for the security of the data during the process of transcription.

Access to the experience and expertise of the medical transcription service provider: Medical transcription has evolved over the years to a sophisticated service adapting to the new developments like providing editing and proofreading services for speech recognition software etc. Outsourcing provides healthcare facilities and healthcare professionals access to the experience and expertise of the medical transcription service provider.

Outsourcing medical transcription empowers healthcare facilities and healthcare professionals in various aspects like clinical decision-making, receivables management and risk management.

Medical transcription outsourcing: The key to overall efficiency

Healthcare sector depends on robust back office support to be able to deliver quality care without compromising on any of the financial, operational and statutory obligations. To this end the efforts of healthcare professionals and the administration of healthcare facilities has been to ensure that healthcare professionals have maximum time for the care of patients rather than any other administrative functions.  One of the factors that ensure healthcare professionals can concentrate totally on the care of patients is ensuring that the process of documenting the care process is simple and easy.

Medical transcription, the process of converting the audio of the patient – healthcare professional encounter into text format using the services of a professional medical transcription company ensures overall efficiency. Outsourcing medical transcription ensures overall efficiency by providing services that include:

Minimum or no investment: The remarkable benefit of outsourcing medical transcription is that the investment of the healthcare facility towards this process is minimal. Healthcare facilities have to make minimum or no investment towards medical transcription outsourcing. In fact outsourcing medical transcription allows healthcare facilities to save on resources like space, medical transcription equipment, utilities and other overheads.

Convenient methods of capturing data: One of the significant advantages of outsourcing medical transcription is that it enhances overall efficiency by allowing healthcare professionals to use dictation modes according to their convenience. Medical transcriptionservice providers have also started providing editing and proofreading services for back end speech recognition software to ensure that the transcripts meet  acceptable accuracy levels.

Customized services: The needs of healthcare facilities and healthcare professionals keep changing due to various factors and circumstances. Keeping this in mind transcription companies provide customized services, which include providing specialty trained medical transcriptionists, customized turnaround time options, reports in customized templates/ formats etc.

Choice of various document delivery modes: Using the best of software and tools,medical transcription companies also provide various options for delivery of transcripts to healthcare professionals and healthcare facilities. These include delivery to specific folders, options for remote printing & faxing, delivery to multiple healthcare professionals etc. Medical transcription service providers also offer HL7 interface for adoption of EMR/ EHR system.

Easy access to older records: Healthcare is a continuous process requiring complete information regarding the patient’s medical history and the course of treatment over a period of time. Medical transcription service providers periodically archive the older transcripts and these are provided to the healthcare facilities and healthcare professionals for easy access using various search options.

Cost effective: Outsourcing medical transcription improves overall efficiency by helping reduce both the direct and indirect cost of medical transcription substantially. By taking care of weekend and holiday transcription needs, medical transcription companies further enhance the overall efficiency of healthcare facilities.

Outsourcing medical transcription to the right service provider can definitely help improve the overall efficiency of the healthcare facility

Medical transcription outsourcing: Providing enterprising solutions

Medical transcription has been a part of healthcare from the very beginning.  After all medical transcription is the scribe that faithfully creates patient records from the details provided by the healthcare professionals of their encounter with patients. Though medical transcription has been around almost as long as healthcare services, it has evolved a long way from the original primitive version of hand written notes to the current version of creating patient records on the computer.

It is recognized that medical transcription is a specialized skill requiring the right combination of team, technology and process and it has been acknowledged that the efficient, effective and economic fix to create patient records is to outsource medical transcription. Outsourced medical transcription services have the advantage of providing enterprising solutions to the changing needs of healthcare facilities and healthcare professionals.

How does outsourced medical transcription provide enterprising solutions for the documentation needs of healthcare professionals and healthcare facilities?

Outsourced medical transcription has always strived to provide services that meet the changing needs of healthcare professionals and healthcare facilities by taking initiative, using imagination and undertaking to customize technology to provide safe, accurate, speedy and cost effective medical transcription services.

To understand how outsourced medical transcription provides enterprising services it is important to study how the medical transcription service has evolved to meet the challenges/ needs of the healthcare sector.

Given below are some of the milestones that medical transcription has achieved:

Providing remote medical transcription services: Medical transcription has evolved from a service requiring the physical presence of the medical transcriptionist to a service, which can be availed from remote locations. Medical transcription service providers have used the Internet enterprisingly to help healthcare professionals and healthcare facilities avail the best quality service without having to incur any overheads.

This ensures that the healthcare facilities and healthcare professionals can avail the requisite medical transcription services having to pay only for the quantity used. Factors like overtime pay, wastage during slack times, arrangements for weekend & holiday transcription are all covered by the medical transcription service provider without compromising accuracy, turnaround time and security

Making provisions for flexible modes of dictation: Outsourced medical transcription services have ensured that healthcare professionals can capture the details of the patient-healthcare professional encounter without having to change their style of dictation or having to waste time by allowing them to use familiar and flexible methods of dictation. Medical transcription service provider have enterprisingly used technology to help healthcare professionals in optimizing their limited time resources

Aiding adoption of EMR/EHR: Investment in EMR/EHR systems requires a huge capital outlay. Medical transcription service providers have provided HL7 interface to enable adoption of EMR/EHR systems

Editing services for Speech recognition transcription: Some healthcare professionals have invested in voice recognition/speech recognition software. Though this software has the ability to convert speech to text, the accuracy levels have been found to be unacceptable. Medical transcription service providers have enterprisingly provided editing and quality control services for such transcripts.

Specialty medical transcription: Healthcare is a vast field having many specialties.  The medical transcriptionists working on medical transcription for specialties need to be familiar with the language of the specialty to provide services of the required accuracy and turnaround time. Medical transcription service providers have enterprisingly provided for specialty transcription by training medical transcriptionists to be domain experts in one or two specialties ensuring quality work from the very beginning

Archives: One of the requirements of healthcare facilities, especially those generating substantial quantities of transcription work, is to be able to keep tabs on the audio files, work-in-progress and finished transcripts. They also need a system through which can trace patient files easily. Medical transcription service providers have enterprisingly provided archives to enable all these functions

Choices for document delivery: All patient records are vital to the healthcare process, but some require more priority than others. It is important for the medical transcription service provider to have various means to deliver the document to the healthcare professionals in a secure and quick manner. Outsourced medical transcription service providers have provided for this by enabling multiple modes of document delivery

Medical Transcription Security

Everyone realizes that medical transcription projects are being increasingly outsourced to low wage countries like India and the Philippines. This is mainly because these Asian countries are in a position to deliver the goods with good quality at a much lower rate than is made available within the US. But, what happens to the confidentiality of online personal / patient information? How safe is transmission over the Internet? What if someone with vested interests tries to access it? Without some assurance of the confidentiality of the data it would be futile to take the risk of outsourcing. Well HIPAA is here to take care.

So what is HIPAA? It stands for the Health Insurance Portability and Accountability Act that was enacted by the U.S. Congress in 1996. This act regulates the exchange of all patient information using electronic methods. Patients are protected from unlawful disclosure. Thus we see that companies must be HIPAA compliant. Only then will the doctors be sure that all their valuable patient data and dictations are safe and never get into wrong hands.

What are the different requirements of HIPAA compliance for any medical transcription company? Thes include,

• Maintain traceable trail of all personnel who handle specific data
• Password protection
• Encryption of data
• Compliance officers must be appointed

What is the purpose of encryption? Encryption and password protection is essential to protect patient data and one can be sure that no one will be able to access the sensitive information without an authorization. Data encryption makes sure that even if some one else happens to get access to the file he will no able to understand/ decipher whatever is written. Therefore, all digital voice recordings/dictations that are sent via the Internet for medical transcription service must be encrypted. Thus the different requirements include,

• Secure FTP (file transfer)
• Physical protection /security
• Login codes for employees
• Filters
• Firewall
• Encrypted e-mail
• Monitor each desktop
• Backup of tapes
• Be prepared for natural disasters