Medical transcription is an integral part of the daily process and procedure for any medical practice or hospital. Without it, the entire flow of work and services at an office or facility can come to a standstill. When evaluating your transcription needs, there are certain considerations that you must explore.
No one size fits all solution is right for every practice. Your workflow schedule, the needs of physician and staff and your specialty all influence which service or product will be most effective. For some practices, outsourcing transcription services might be an immense benefit, while for others in-house voice-recognition software would suffice and there are choices in between. Be sure to look at transcription from all angles before deciding which direction to pursue.
There is nothing more important than accuracy and timeliness of your transcription.
Transcription accurately transcribed from your dictation should be the number one priority for all facilities. Quality transcription means a high-level expectation of near complete accuracy, with estimates up to 99.9% accuracy being available in the marketplace.
Your expectation can’t be overstated, and you should demand this from any Medical Transcription Service you might be considering hiring. Not only does the patient expect their medical documentation to accurately convey the events of their medical encounter, but the physician, the medical practice, other professionals and of course the insurance companies absolutely must have accurate records in order for their businesses to function. Statistics have documented significantly less malpractice lawsuits for medical practices and hospitals where transcription is done by highly educated and experienced human transcriptionists.
That expectation for quality control is the domain of the properly educated medical transcriptionist. When a Medical Transcription Service is utilized these companies depend on the accuracy of their product for their reputations. They typically hire highly experienced medical transcriptionists and put them through rigorous testing prior to hire with intermittent re-testing and regular reviewing of their individual work.
Medical Transcription Services should have multiple staff members providing levels of proofreading and quality control on the transcribed documents to catch any mistakes in spelling, grammar and other parameters of the report. This level of scrutiny can give the physician peace of mind that their transcription service will have their back.
A good Medical Transcription Service will offer two to three layers of quality assurance, meaning at least two or three people, including the transcriptionist, will review your transcribed record, at least one utilizing the original recording, before it is released to the client. This procedure assures that errors will be caught and rectified by the service before the transcribed document is returned to the physician or facility. However, many Medical Transcription Services only have one layer of human oversight. If you're going to be outsourcing, you'll want to know exactly how many pairs of eyes look over your documents before they are sent back to you. More oversight means fewer mistakes. As you are evaluating a potential Medical Transcription Service make sure they have a Quality Assurance Program!
The dictation you need transcribed might be a very different specialty from those of other physicians, so it's always important to ensure the company you contract with has experience serving your specialty. Checking references and asking to see examples of their past work for your field are good ways to confirm this.
You can also use the terms of a contract to hold the company accountable for its performance. There will of course be an occasional typo. Minor errors are OK, but you want to strive for 98% of reports without major errors. Quality parameters are usually built into the contract. Clauses for these issues and a procedure for corrections should be clearly understood.
There are several ways to perform dictation based on the physician's choice and comfort level, facility needs and technology compatibility. The most common mode today is calling in over the phone to a Digital Dictation System hosted by a Medical Transcription Service.
The transcriptionist or transcription service accesses the MP3 recording and transcribes the dictation using their specialized equipment. For smaller applications such as physician offices and groups, a digital handheld recorder can be utilized for convenience. The physician can dictate from anywhere and then return to their office to place the recorder in the base, at which point the recorder will automatically upload the dictation to the transcription service.
With the increasing use of voice recognition, physicians are using software to dictate their reports. It is unfortunately standard on these platforms for the physicians to spend dozens of hours proofing the reports and 'training' the software to be familiar with their personal vocabulary and diction. You will find that most Medical Transcription Services have their own list of how they will accept dictations.
Physician practices and hospitals have three main options for having their dictation transcribed: perform transcription in-house, outsource it to a Medical Transcription Service, or use voice-recognition software to digitally translate verbal dictation into the written word. Let's take a closer look at these options.
Performing transcription of your dictation in-house has been the standard process since recording of dictation was invented in 1897. The immediacy of receiving your transcription this way is definitely a bonus. However, on closer inspection we must address the massive expense of having an additional employee with salary and benefits, cost of supervision, equipment and space in your very expensive office. Most offices have given up this old school set up in favor of one of the two options below.
Medical Transcription Services have long been utilized by medical practices and hospitals to support them in their dictation/transcription needs. These companies can save physicians immense amounts of time in practice and in the hospital which they would otherwise spend writing out notes or as is happening now with EMRs, physicians are required to spend more time than ever inputting patient information themselves into the EMR, performing data entry when they could be seeing patients. The ease of use experienced with picking up a phone and dictating the report, then hanging up knowing its handled can provide physicians and hospitals with an almost automatic daily process solution for providing their dictation and receiving their transcription with little to no interaction.
The bottom line to hiring a Medical Transcription Service is that they allow doctors to have more focused hands-on experiences with patients, rather than be distracted by filling out charts during the appointment, and more personal time from not needing to proofread or monitor their transcription. Medical Transcription Services allow the physician to dictate the relevant patient information at their leisure, which can then be sent to a service to be transcribed in a timely manner. Studies have indicated patients prefer the doctor to face them and speak with them rather than see their doctor working on a laptop while in the room with the patient.
Transcription services performed outside the United States have been around for many decades. The largest worldwide transcription services are almost exclusively offshore, though most will offer that they also have U.S. based transcriptionists, something that can not effectively be proven. Along with that issue is the problem of private medical records being transcribed in a foreign country where the United States privacy laws do not apply. Their rates are typically half of a United States based transcription service, but with that comes a definite a sacrifice of accuracy. Most medical personnel including Risk Management specialists would recommend keeping medical records within the United States.
Consider also your dictation being transcribed by persons whose native language may be other than English and the possibility for inaccuracy based on cultural differences. If your dictation is required to be clinically accurate then you'll want the transcription to be done domestically.
Over many decades voice-recognition software has been developing to become more and more accurate and specialized. With voice-recognition software physicians and Medical Records Departments can receive their reports rapidly. However, though there is the advantage of voice-recognition software reducing turnaround time, the dictating physician now must act as the proofreader as well. Though this software has come a long way, it still makes many mistakes which are unacceptable in a medical report. Who will proof these 'transcribed' reports? Many physicians find the extra workload unnecessary and irritating, and more errors are likely to get through without the added layers of protection an experienced, qualified transcriptionist working for a Medical Transcription Service can offer.
Industry standards have historically varied widely. The accepted method of per line rate charge is still popular as medical transcriptionists are typically paid on production, not an hourly rate. You may encounter Medical Transcription Services who charge by the character and divide by a number to equal a "line". Some transcription services charge by the visible black character, which indicates they are not counting spaces.
Within the professional medical transcriptionist community this is not an acceptable counting style as the 'space' is created with a keystroke by the transcriptionist just like all the other letters on a page, and the transcriptionists expect to be paid. Therefore, a Medical Transcription Service which charges and pays the staff for transcribed spaces is viewed more professional in the industry than one who does not.
When transcribing into an EMR or other online system, rates can be calculated to charge by the 'minutes of dictation' meaning the amount of time it took the physician to dictate the report. This method is not always accurate for rate charging since a minute of dictation can vary widely between physicians regarding an individual's pauses, dictation difficulties, sounds or accents which all affect the time it takes a qualified medical transcriptionist to complete the dictation.
Many larger Medical Transcription Services now offer voice recognition 'transcription' of their dictation. Prices for this service are drastically lower than rates for actual human produced medical transcription. This typically involves the physician's dictation being processed through 'voice recognition software' and a medical record report being produced. Considering the shortfalls of voice recognition and the absolute importance that medical reports be perfect, most services will then give the original physician's dictation, and the voice recognition produced report to an experienced human medical transcriptionist, who will then compare the two, making edits as needed. The pay scale for a transcriptionist to do this work is roughly 50% of what she would have made if she had typed the report correctly to begin with.
Generally speaking, pricing can vary widely by many factors from 6 to 14 or more cents per line. Be sure you completely understand what you are being charged for.
Most Medical Transcription Services have a standard turnaround time of about 24 hours. However, some documents can be completed even more quickly such as STAT service for quickly needed medical reports. Some transcription services will prioritize reports for an additional fee. But for standard documentation, if a company's turnaround time is longer than 24 hours you will want to look at other transcription service companies.
Needless to say, reputation is what puts a company on the map and research before a purchase can be worth unfortunate news later. However, it is surprising to see how many companies conduct business without checking out references. It is a definite layer of protection for your company. Ask the Medical Transcription Service you are considering for a list of current or past clients, also ask for contact information of at least one person you can call to verify their reputation.
Find out from other physicians in your field who they use for transcription services, what it costs them, and what the quality of their service is. You can also find ample reviews online and look up information on the company with the Better Business Bureau and Dun & Bradstreet. There should be some useful information out there on any reputable vendor.
When going with a third-party Medical Transcription Service it's important to know exactly what you can expect from that company. This means taking the time to sit down and read the contract line by line, discussing with the service any items you may not understand or those you wish to renegotiate.
Make sure that you pay for only what you need. Many vendors offer flashy features and optional components. While some might be useful for you and your staff, consider if you really need all the bells and whistles and what that will end up costing you. If all you need is quick, effective, accurate transcription, then only pay for the basics and don't be swayed.
Questions to ask: What can the extra services cost? Are there one-time set up or purchase costs, or recurring monthly or yearly fees? Will you be required to pay for software updates? If there is a problem with the provided software or equipment what are the details for rectifying the situation quickly so as to limit down time? Do you provide faxing or emailing service for your medical reports?
Some companies will try to lock you into a long-term contract, but this is not necessary. Reputable Medical Transcription Services will usually offer a one year or less contract. Of course, if you're satisfied with their service, you can always extend the contract in the future. Some companies do not require a contract at all.
Keep in mind that Medical Transcription Service contracts should always contain an out clause, in case things don't work out. Do not enter into a contract with a service that would effectively be forcing you to continue using them after you have decided to terminate. Reputable Medical Transcription Service companies will work for your business every day and should a day come where parting is requested it should be done professionally and equitably.
Any software that you might use, either on your own such as a practice management system or in conjunction with a Medical Transcription Service, has to be compatible with software or electronic health record systems in your office or with your local health care facility or hospital.
In today's increasingly digitized healthcare industry, software used for the transcription process needs to be able to properly communicate with all the electronic aspects of your practice. Some practice management systems have transcription built in, but you have to make sure it can interface with your transcription service. Most services can provide your transcription in Word format which is a broadly accepted format across the board and can be the fastest interface between users.
Some Medical Transcription Services will offer free access to their hosted FTP site online, where your completed medical reports will be placed for your secure and HIPAA compliant/password protected retrieval at any time is available.
If you are a small or even midsize practice or medical facility, just about any transcription service will be equipped to handle the volume of reports you generate. Smaller practices and facilities, however, may want to consider the option of using smaller transcription services.
You will surely find with a smaller Medical Transcription Service that you will receive personalized services, provided by actual persons who answer the phone when you call or answer your emails back quickly. Changes and requests can be affected immediately rather than finding your way through a maze of larger corporate companies. Smaller companies can provide the same well trained medical transcriptionist to transcribe all of your dictation, becoming familiar with your style and flow creating a comfortable relationship between physician and medical transcriptionist.
In this world of things getting larger and larger, having a small custom service is a breath of fresh air.