Transcription in the EHR Age

Recently a colleague of mine forwarded me an article by Ken Congdon of Healthcare Technology Online, "Transcription in the EHR Age." He stresses the pitfalls practices experience while implementing an EHR primarily because of how drastically it changes a physician's behavior and recognizes challenges with respect to quality and data accuracy. Ken suggests that transcription in conjunction with the EHR can address many of the challenges associated with implementation. Using the technology transcription companies have available now, dictated information can be converted to text by a Medical Transcriptionist and inserted directly into an EMR. R+B Sten-Tel offeres such a solution today with EntriPoint. In other words, Medical Transcription can be a catalyst for EMR adoption.

Medical Transcription - The Future

As I meet with prospective clients I am coming across a question which is growing in it's frequency: "Isn't medical transcription going away?" Folks marketing voice recognition and EMR technology have done a good job professing that their solutions are the nail in the coffin for outsourced transcription services.

I tell my prospective clients that it depends on the practice and physicians. Voice Recognition technology has become a tool which helps improve productivity, but it doesn't replace human intelligence. There is still a certain percentage of each document which needs to be edited. A study by the AC Group finds that traditional EHR data-entry is 9 times longer than narrative dictation/transcription. Users come to a crossroad where they need to weigh the balance between the cost of transcription and the loss of productivity.

Even with EMR and Voice Recognition technology there is still a need for human intelligence. Specifically, a practice that needs to remain productive and not lose patient visits due to productivity shortfalls will continue with dictation/transcription. Furthermore, although in it's infancy, Discrete Reportable Transcription - DRT is the answer many are looking for by combining the efficiencies and quality gains of medical transcription with the value of discrete data.

EMRs Cutting Doctor-Patient Time

A recent article in American Medical News "Don't let EMRs cut into your doctor-patient time" describes a situation where the interaction between a physician and his patient is diminished and less intimate because he was stuck behind a computer screen trying to document the encounter.

That's what DRT - Discrete Reportable Transcription is all about. Why force a doctor to type his or her own note or search for the right diagnosis on a computer screen. Physicians should be focused on their patients, not their keyboards. DRT allows physicians to dictate their patient visits, leaving more time to improve their patient's health. The transcribed information is delivered directly into the system as discrete data.

The Value of Discrete Data

With Discrete Reportable Transcription (DRT) a dictated note can be inserted into a patient's medical record within a practice wide EMR. The difference between DRT and a standard import feature many EMR provders offer is that a DRT solution inserts discrete data. With the data being discrete, even a dictated and transcribed portion of a patient encounter allows for the same benefits one would receive through other means of documenting such an encounter within the EMR itself. Therefore, it allows for searching or reporting on data within an EMR which has been dictated. For example, discrete data makes it easy if a Practice Manager wants to find out how many patients have a history of smoking or an Orthopaedic practice needs to find out who has been referred to a certain Physical Therapist. DRT isn't just transcription, because the data provided becomes much more valuable than words. Make sure your EMR is DRT enabled.

Can Transcription Help EMR Implementation?

The AC Group recently noted a 73% failure rate of EMRs due to usability frustrations. Part of that is the fact that many EMRs do not offer a comprehensive dictation/transcription solution as part of their documentation process. Instead they rely on the physicians to enter the data in themselves. The medical transcription industry has developed technology called Discrete Reportable Transcription (DRT) which enables physicians to document their patient encounters just the way they always have. It provides a choice for documentation. Make sure the EMR you choose is DRT enabled and ensure a successful implementation.

Pennsylvania eHealth Initiative

Peter Minio of R+B Sten-Tel is representing PA-AHDI as a Charter Member in the Pennsylvania eHealth Initiative (PAeHI). PAeHI was organized several years ago to promote and support the use of Electronic Medical Records (EMR), specifically as a part of a broader statewide Health Information Exchange (HIE). The group has brought together leaders from government, trade organizations, healthcare delivery (hospitals and ambulatory practices) and the vendors who offer products and services which support the health information infrastructure which ultimately make an HIE.

As part of Peter's participation in this group, he has joined the Communication & Education Committee. His contributions will assist the committee in reaching it's goals of supporting and promoting these efforts with an educational focus through various communication channels. Come back to receive updates on the activities of PAeHI.

"Meaningful Use"

Read a feature article George Catuogno wrote in Healthcare Ledger back in June 2009 titled "HITECH Act Promises EMR Funding to Clinicians with Meaningful Use". George eloquently lays the framework as to why Discrete Reportable Transcription (DRT) can play an important role enabling the successful adoption of Electronic Medical Record (EMR) technology.

The article touches on the pitfalls to EMR implementation but also describes how along with human intelligence, discrete data paired with Natural Language Processing (NLP) can address many of the common setbacks. By way of referencing numerous studies and examples, George demonstrates how a DRT enabled EMR accelerates adoption, eases implementation and adds value by enhancing capabilities.

Benefits of DRT

Discrete Reportable Transcription (DRT) is a solution which addresses EMR usability issues. It reduces time spent documenting patient encounters, consults and assessments by supporting narrative dictation with results delivered directly into an EMR/EHR. This affords clinicians more time and intimacy for quality patient care, leaving the clerical work for a trained EMR transcription staff.

DRT allows physicians to use their preferred method of clinical documentation and reduces time spent documenting encounters. It ensures better patient care by allowing a clinician to practice using their natural method of working and increases accuracy with a proven dictation-transcription process by allowing Medical Transcriptionists to be a “second set of eyes.”

R+B Sten-Tel achieves these benefits for clients through their EMR portal, EntriPoint™.

AHDI & MTIA Advocacy Summit

In February 2009 the Obama Administration passed the American Reinvestment and Recovery Act (ARRA), which was inclusive of the Health Information Technology for Economic and Clinical Health Act (HITECH Act). Through this legislation, physicians will receive incentives if they prove “meaningful use” of EHR technology. The Department for Health and Human Services (HHS) and the Office of the National Coordinator of Health Information Technology (ONCHIT) have yet to determine the criteria for “meaningful use.”

Members of both the Association for Healthcare Documentation Integrity and Medical Transcription Association organized on Capitol Hill this past June advocating how medical transcription can and should play a role in the qualifications for “meaningful use.” Studies show narrative dictation/transcription method is a proven productivity tool and increases accuracy of clinical documentation.

To learn more read Medical Transcription : A Proven Accelerator of EHR Adoption, a white paper explaining how Medical Transcription can help meet some of the usability challenges physicians face with EMR implementation.