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Combat the transcription-staff shortage with these alternatives

HIM Connection, May 30, 2006

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Combat the transcription-staff shortage with these alternatives

While transcription timeliness and quality encourage physicians to dictate more and allows them to communicate efficiently with other treating physicians, transcription finds itself plagued by the same condition as coding-a shortage of qualified personnel. Even though transcription can be performed remotely, the shortage continues because the demand for dictated documents is increasing.

The good news is that you have other options. Read on for four approaches to transcription alternatives:

1. Speech-recognition technology. Manufacturers offering this technology readily admit it is not for everyone. It has been most successful in clinical settings with confined or specialized vocabularies, such as radiology and pathology. In these settings, physicians often edit their own reports, which is known as foreground, or front-end, speech recognition.

   Although editing their diction trains the software to recognize the nuances of each dictator's speech, some physicians resist doing so. They may not have time to do so or claim it slows them down so they cannot treat as many patients. Also, physicians are expensive editors. However, teaching the technology to do what it should allows physicians to control costs in their office settings and expedite the creation of legible documents.

2. PDA and templating. Whether entering text into a personal digital assistant that is downloaded to create a portion or all of a document or using a paper or electronic template, legible data contribute to timely documentation in the record. As with speech recognition, this approach reduces the demand for transcriptionists, but requires physicians or scribes to "create" the document. Some believe using templates reduces physicians' efforts and improves document completion. Others assert that templates may actually prompt physicians to document items that they normally would not. If a template prompts a physician to consider another system or symptom, that prompting may improve the accuracy of the diagnosis.

3. Electronic records. These have built-in templates to help structure documentation, while others allow free-text. Unfortunately, the free-text approach may encourage the use of abbreviations or less verbiage, resulting in scant or undecipherable documents. Today's technology lends access to dictation across the room and across the world. The pressure to turn reports around within hours, 24 hours a day, forces firms to look to staffing sources that operate when the United States is sleeping.

4. Offshore transcription. This approach has had some successes as well as well-publicized privacy failures. Some states are considering legislation to prohibit the use of offshore transcription. As with many jobs in the United States, the availability of international skilled staff is greater and less expensive. Literature today cites 25%-60% labor-cost savings for outsourced work in some countries. Implement quality monitoring and protected health information controls if you use this approach.

Editor's Note: This article was excerpted from HCPro, Inc.'s book More with Less: Best Practices for HIM Directors, written by Rose T. Dunn, RHIA, CPA, FACHE, FHFMA. For more information or to order go to www.hcpromarketplace.com or call toll-free 877/727-1728.

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