1. Transcribe Medical Transcription Service Medical Language Specialists “MT Knowledge Workers” A Vital Part of Today’s Healthcare System Presentation By Laura Holbert, CMT, Owner

2. Our Mission Statement To promote the integrity of healthcare documentation through development of an educated, prepared workforce in clinical documentation

3. The Following Presentation Will Include: The different methods of preparing a patient record and the different types of approaches to accomplish this. The cost of creating patient records depending upon the chosen method, i.e., physician creation, in-office transcription, subcontracting transcription, and outsourcing to US. vs. off-shore service. The advantages of using a transcription service and comparison covering office costs, physician’s time, quality, etc. What TranScribe Medical Transcription Service offers including pricing, turnaround, quality, confidentiality, and specialty services. Methods Costs Advantages/ Comparison Services

5. Is it really the most cost-effective method for your business?

6. Is there another solution to cost savings?

8. Handwriting a Patient Record According to Medical Documentation Guidelines, if a chart note was not documented, the service was not done. That's also true if the chart is illegible and a CMS (Centers for Medicare and Medicaid Services) auditor can't read it. Since a physician's notations in the medical record are an important part of treatment, illegible notes create a serious problem for all healthcare providers who need the information for follow-up care.

9. Dictating A Patient Record The physician dictates the medical information into a recording device. The medical transcriptionist listens to the dictation and transcribes it onto a computerized file which is then sent to the healthcare provider. Dictation remains the most intuitive and least time-consuming means of data entry. Physicians can dictate anytime, anywhere using a PDA, digital dictation machine or telephone at their convenience. Provides expressive power to describe patient's condition and other health-related events. Dictating patient records provides for more efficient use of doctor's time.

10. Structured Data Entry -- EMR Electronic Medical Records (EMR) is a software in which all of the patient’s medical records can be stored. The most important part of every EMR is the process of entering the data. EMR is basically a collection of complete patient data which is made available to the physician which helps in providing a complete, correct, and timely view of patient’s information. EMR has transformed the industry of healthcare recently. Most of the healthcare professionals were of the opinion that the technology of EMR would take the place of Medical Transcription completely. Nonetheless, the healthcare industry almost immediately understood the fact that medical transcription has more advantages than EMR and majority of the healthcare professionals prefer dictating notes instead of documenting the data through Electronic Medical Records. Some EMRs are strictly point-and-click, template-driven systems that make no allowance for dictation and transcription, while other EMRs are DRT enabled, allowing physicians to use traditional dictation as a means of populating the EMR. There are several disadvantages of using the EMR method of patient’s recordkeeping. EMR requires additional time and certainly more attention for a medical doctor to search from huge amounts of data and generate progress notes using specific templates. Templates must be customized as per the physician's requirement. Customization can be inflexible and costly, well accepted by only tech-savvy doctors. The approach of direct data entry by the physician has generally failed because busy providers reject it altogether. Output from these templates is too identical and it loses individuality for each patient. It is difficult for a provider to capture complete patient encounters on a computer in front of a patient. All these above-stated reasons show that EMR is a remarkable technology; however it cannot replace the traditional method of medical transcription. It takes more time, and definitely more concentration, for a physician to navigate through large data set and create progress notes using point-and-click templates. Although an average transcribed report costs $2 to $4, it can reduce the doctor's time spent on data entry. And, considering the value of doctor's time, transcription is not a costly proposition. By not having a medical transcriptionist it is costing, on average, nine times the amount when a physician types his/her own reports.

11. Front-End/Back-end speech Recognition There are two types of Speech Recognition Technology (SRT) systems. Front-end speech recognition (FESR) is where the speaker dictates into the PC and the voice is converted to text concurrently and the speaker himself corrects the errors made by the software; doctors have been reluctant to adapt to this system due to time constraints in their busy schedule. With back-end speech recognition (BESR), or delayed SRT, commonly in use now with large hospitals and clinics, the speaker has dictated, then an editor (such as an MT) listens to the voice file, edit for errors and proofreads the draft. When comparing FESR with BESR it was found that enterprise healthcare organizations experienced significant success with BESR by routing work translated through a speech recognition engine to an MT for later correction. This method supported clinicians’ ability to narratively dictate without changing their habits and therefore has been widely accepted as an effective documentation method. Typically 80% of clinicians were adaptable to BESR with no change in dictation habits, and higher for certain specialties like radiology. The trouble with FESR that many clinicians find objectionable is the need to interact with the process to make real-time corrections, thereby causing a change in dictation habits and slowing the clinician down. Although there is an upside (real-time documentation means immediate completion for the chart) in most situations that value is diminished by the extra time it takes the clinician to complete the record, the associated costs of that clinician’s time, and the fact that turnaround time (TAT) via a back-end process is usually adequate. A lot of homework is needed to train the equipment before it can be used. Even well-trained equipment needs human intervention like editing, proofreading and formatting. SRT cannot correct improper grammar, incorrect punctuation, incomplete dictation etc. Then there are many homonyms involved where the human brain processes and uses the appropriate words, while voice recognition softwares need to prove their credibility in this regard. Background noise too reduces the recognition accuracy. Even though many EMR and SRT technology providers have taken aim at medical transcriptionists (MTs) as being a costly and obsolescent part of healthcare documentation, the limits of EMR and speech recognition technology (SRT) are being significantly complemented by the work of MTs in cases where solution providers and savvy healthcare organizations have recognized the value of the relationship between technology and MT “knowledge workers.”

12. Whichever Method A Physician Chooses . . Medical Transcriptionists Will Continue To Be An Integral Function of Medicine Advantages

13. Eliminating Transcription can hurt bottom line In our experience and, that of many EMR vendors, dictation is the preferred choice by 80% of doctors. Why?

14. What Is The Most Cost Efficient Way To Produce A Patient Record? Dictation is the most efficient way to document patient care

15. Discrete Reportable Transcription(DRT)

17. Dictation remains the most intuitive and least time-consuming means of data entry.

18. A study by the AC Group finds that traditional EHR data entry takes nine 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.

20. So Now You Have Decided To Use A Medical Transcription Service . . .Which Is Best For Your Business?

22. Overtime

23. Expenses Towards Benefits

24. Payroll Taxes

25. Workman's Comp Expense

26. Sick/Vacation Time Coverage Expense

27. Employee Training/Retraining Expense

28. Software

29. Dictation/Transcription Equipment Maintenance Expense

30. Dictation/Transcription Equipment Capital Expense

31. IT/Technical Support

32. Management Expense

33. Office Supplies

34. Extra Office SpaceThe following chart will show the annual cost for an In-Office Medical Transcriptionist

35. A per-line cost to have an In-Office Transcriptionist would equal $0.25 per line. Our rates range between $0.09 -- $0.13 per line. As you can see, it is more costly for in-office transcription. NOTE: (*Hourly wages for CALIFORNIA STATE based on statistics as provided by US Dept of Labor)

36. Outsourcing to u.s. transcription service (subcontractor) Outsourcing transcription outweighs the cost of in-office transcription. When you outsource your medical transcription requirements, you no longer have to own or maintain a dictation system, a typing platform or worry about upgrading your equipment. Your capital expenses on maintenance with the average maintenance agreement can cost upwards of 10% of equipment costs, annually.

37. Outsourcing to an offshore Transcription service

39. Confidentiality is a very important part of our business. All medical transcriptionists are required to sign a HIPPA Confidentiality Agreement with strict adherence.

40. We are a transcription service with a professional attitude and a very dedicated, hard-working team of qualified transcriptionists. We DO NOToutsource any work off-shore -- ALL work is performed in the United States.

41. Work is proofread by a certified QA manager.

43. Quick Turnaround -- We give a quick turnaround. A 24 to 48-hour turnaround from the time dictation is made available unless otherwise specified, then a quicker turnaround is available.

44. Guaranteed Accuracy -- You will receive guaranteed accuracy, corrections at no cost, and a personalized service to your office.

45. Free reprints, if needed.

46. Daily Patient Logs -- A daily patient log is created and delivered with patient records to ensure accountability.

47. Fully HIPAA-Compliant secure web interface providing audio file upload, tracking, and transcribed file download capabilities.

48. Confidentiality -- Providing full confidentiality of all office/patient material.

49. Availability -- We are available for questions via phone, instant message, or e-mail.

50. Encryption/Secure FTP -- Documents are sent in encrypted files from our secure FTP Server or in encrypted e-mail attachments in Microsoft Word, Word Perfect or Adobe PDF format. Transcribed reports are delivered right to your computer (PC) ready for print and/or integration into your current or future EMR.

51. Storage -- All transcribed documents are archived indefinitely.

53. Lines are based on a 65-character count line.

54. Our pricing tools are based on such factors as volume, turnaround time, types of dictation chosen, specialty requirements and document management flow system requirements.

55. Reports can be implemented into an existing EHR system saving cost of printing.

57. For Further Information: http://www.healthstory.com http://www.mtia.com http://www.cchit.org http://www.adhi.com http://www.ahdionline.org