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Answer these questions to determine your transcription strategy

HIM Connection, March 7, 2005

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Last week HIM Connection brought you alternatives to consider when transcription becomes too much to handle within your organization. If outsourcing is a solution for your facility, one of the most important decisions the HIM department makes is whether to outsource some or all of its transcription.

This week, we bring you important questions to consider when making the decision:

• Why is outsourcing required or being contemplated? Is it due to:
  • Lack of qualified staff?
  • Increase in volume?
  • Need for new equipment and lack of capital funds?
  • Need for the space currently occupied by transcription?
• Have you eliminated all the nontranscription duties you can from the currently employed transcriptionists?
• Will you be able to retain some staff to perform quality review of the transcribed work returned?
• Do you have technology available in house to establish an interface with the outside firm or must you manually cut and paste their work into your system? Will their work be segregated from organizational report repositories?
• What are your costs?
  • Labor?
  • Benefits?
  • Supplies?
  • Equipment?
  • Equipment maintenance?
  • Space?
  • How much does is cost to transcribe a minute of dictation in house v. outside?
  • Can it be done less expensively without compromising quality?
  • Can it be done less expensively and improve quality/timeliness?

Review the following advice while you assess whether to outsource:

• Speak with some of your physicians to see which transcription firms they use. The firms will likely be local, smaller, medical-transcription companies. Using them could be an advantage because they will be familiar with some of your physicians, having already transcribed office work. The disadvantage: They may not have the technology to connect with your dictation system.
• If the selection is a regional or national firm, do not sign a long-term contract. If you have not finished your assessment of the situation, a long-term contract with a rate agreed to during a time of desperation may be a career-limiting action.
• Send out the most recent work that does not have top priority such as discharge summaries or outpatient visit reports dictated yesterday and today. Have some of your trancriptionists complete the oldest work and the others transcribe today's priority work. By segregating the work this way, you will not fall further behind.
• Do not hesitate to use more than one transcription firm. This benefits you because the two transcription firms know you might be outsourcing work on a long-term basis and are comparing them to other firms.

This excerpt is adapted from the book More with Less: Best Practices for HIM Directors.

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