Dictation And The EMR


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This presentation explores the role of dictation and transcription in healthcare and the possible shortcomings of traditional EMR

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  • In fact, it will be more easy and beneficial to the MTs, who will do editing and QA the SRT/VR report, as they will not have to transcribe the dictations, just to edit or QA/QC the files.
    In SRT/VR methods, physicians will need an “extra set of eyes” same as QCs/QAs to edit or review the patient report and make sure it is accurate. MT Helps

    As you all know, MTs are the best having 'extra set of eyes' because of their experience and daily routines.

    The EMR will allow information to all the physicians to look at. If a patient's report has inaccurate information in it, then it is possible the next physician would make a wrong decision for that patient based on the report created by SRT/VR.
    So, you can easily find that it is very important to have MTs/QAs editing and reviewing medical reports for perfect accuracy.

    (source: http://mthelps.blogspot.com/
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Dictation And The EMR

  1. 1. The Medical Records Institute estimated in Fall 2008 that 90% of healthcare documentation in the US was done in the form of dictation and transcription.
  2. 2. Dictation has and continues to be a primary and efficient means of creating documentation by busy physicians in small private practices, as well as large clinics and hospitals.
  3. 3. The American Recovery and Reinvestment Act of 2009’s promises of financial subsidies for physicians that adopt and make “meaningful use” of Electronic Medical Record (EMR) Systems has led to some concern on behalf of healthcare providers who are finding themselves challenged to replace dictation with EMR systems.
  4. 4. Is the replacement of dictation with EMR templates in the best interest of providers and their patients?
  5. 5. Does this “advancement” of technology really help doctors to do more with less, increase productivity while cutting costs, OR in this push toward EMR standards are the positive gains granted by the implementation of EMR systems offset by a decline in overall productivity due to workflow disruption?
  6. 6. Is there an opportunity for healthcare providers to adopt technologies that bring them the best of both technologies, or are providers to be forced to accept rigid solutions and make the best of it?
  7. 7. Computer technologies offer enormous benefits to healthcare organizations. The key, however, is finding the right solution to meet the needs of each unique organization that adopts it!
  8. 8. Technologies that disrupt established workflows or require significant behavioral changes on behalf of its users can lead to enormous short term, as well as long-term productivity losses that can be challenging to overcome. This is the primary concern surrounding the nationwide push for adoption of EMR systems by year 2014. * Note: There is currently no mandate in place forcing healthcare entities to adopt EMR systems by this date despite widespread rumor to the contrary.
  9. 9. Many EMR systems use templates as the entry point for patient history and exam information. Physicians who have transitioned to EMR systems from dictation platforms have reported significant declines in productivity as a result of using the EMR without medical transcription support.
  10. 10. Typical productivity losses associated with EMRs1 • 1 - 2 extra hours per day, per physician spent on documentation • 2 - 4 fewer patients exams per day, per physician Despite claims by EMR vendors that template-based entry points will cut down on physician workloads. 1. Jusinski, L (2009). “Keeping The Pace", Advance, 19(6).
  11. 11. Point-and-click entry transfers administrative responsibility to the physician, and the costs of that loss of productivity is significant
  12. 12. “Dictation is the most efficient way to document patient care. Take the example of a typical outpatient visit to an internist. It takes about one minute to dictate a note for an established patient and about $4.30 in direct and indirect costs. By contrast, many EMRS use structured data entry as the primary method for entering clinical notes, in which physicians point and click their way through drop- down menus. The time required is at best equal to that of a transcribed note, and physicians often report it takes 8 to 10 minutes to complete a note using structured data entry, meaning that the indirect cost to physicians is anywhere from $13.50 to $27.00.” 2 2. Daigh, R (2008). “Friend or Foe? – The EMR Mandate’s Effect on Transcription Companies", For The Record, 20(17).
  13. 13. Problem with the simplicity of EMR templates: Templates are difficult to use when patient diagnoses are more complex and require narrative. The New England Journal of Medicine reported in April 2008 that template-based documentation may distract physicians and limit thoughtful review and analysis of more complex scenarios. “Although completing such templates may help physicians survive a report-card review, it directs them to ask restrictive questions rather than engaging in a narrative-based, open-ended dialog.” 3 3. Hartzband M.D., P and J. Groopman, M.D. (2008). “Off the Record – Avoiding the Pitfalls of Going Electronic", New England Journal of Medicine, 358:1656-1658.
  14. 14. The argument for continuing dictation and transcription for documentation is clear, but how are physicians, under pressure to migrate to a paperless office, to make that leap with software that does not support dictation?
  15. 15. EMR systems are hyped as solutions that save healthcare organizations time and money by eliminating paper charts and reducing manpower needed at the office. With digital-based dictation and transcription, these two needs are met without changing physician work habits and forcing restrictive EMR work environments.
  16. 16. The KEY to a successful software implementation is finding the platform with the greatest amount of FLEXIBILITY that adopts to the physician’s own desired workflow.
  17. 17. Expecting to adopt an EMR package that drastically alters the work habits that physicians are accustomed to will result in nothing more than disorder, which will come at a cost, either financial or in productive hours that could have been better spent serving patients in need.
  18. 18. A far more efficient method is to continue to dictate notes for transcription. CASE IN POINT: OrthoMemphis OrthoMemphis has saved several hundred thousand dollars by implementing a hybrid system from SRSsoft. That hybrid system paid for itself in less than three years due to a decline in support staff and elimination of storage space for paper records. The hybrid approach that relies heavily on dictated records and scanned documents far more pragmatic than the conventional alternatives. 4 4. Anderson, H.J. (2009, April 1). “An EHR Is Not always a Perfect Fit", Health Data Management Magazine, http://www.healthdatamanagement.com/issues/2009_64/ -27962-1.html.
  19. 19. The goal for physicians should be to find the BEST in dictation and couple it with the BEST in EMR
  20. 20. Dictation systems have come a long way!
  21. 21. Today’s sophisticated digital dictation workflow management systems can immediately route dictation captured from ANYWHERE, ANYTIME via a number of leading technical devices (i.e. BlackBerry, Nokia, and Windows Mobile devices, digital handheld devices, speech microphones, traditional telephony, etc.).
  22. 22. Work is routed immediately for transcription to dedicated typists or typist groups. Work can be routed by author, job type or whatever unique workflow the organization desires for maximum efficiency. These systems are flexible and work the way that the organization desires to work.
  23. 23. WinScribe Dictation manufactured by WinScribe, Inc. is such a system! WinScribe Dictation is a non-proprietary solution that includes a free software development kit enabling organizations to easily integrate dictation with other solutions quickly and easily.
  24. 24. A KEY component when looking to gain the best possible productivity out of software solutions is integrating the software into other 3rd party products to automate the manual tasks staff normally need to undertake. Integration not only speeds up the process, it also ensures that input information is consistent between systems.
  25. 25.  It is platforms like the solution that will enable healthcare providers to leverage the productivity they are accustomed to while still positioning them to attain their goals of a paperless office and the added efficiencies that come with this adoption.
  26. 26. For more information about WinScribe or to request a demonstration of our digital dictation workflow management software, Contact us at: sales@winscribe.com or call us at 1.866.494.6727