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Wednesday, March 30, 2011

Medical transcription outsourcing: Helps in managing total quality

The concept of quality in healthcare services can be easily defined for each stakeholder who is involved in the healthcare business. Considering the number of stakeholders in the healthcare process the definition of quality for each segment would vary according to their role in the healthcare process.  One common indisputable thread that binds all the stakeholders in the healthcare process is that of documentation of the care process.  Quality documentation of the care process is essential to fulfill all the diverse and often contradictory demands of all stakeholders.

Medical transcription is the process of documenting the care process by converting the dictation of the patient- healthcare professional encounter into text format. As the medical transcription process requires focused resources in the form of the right team, the right process and the right technology, outsourcing medical transcription would be considered the right solution. Outsourcing medical transcription not only ensures accurate, timely, secure and cost-effective creation of patient medical records but also helps meet the quality inputs required by all the stakeholders in the care process.

Who are the stakeholders in the care process and how do outsourced medical transcription services help in managing the total quality inputs required by the various stakeholders?

The main stakeholders in the care process can be defined as:

Patients: The expectations of the patient from the care process can be summed up as:
  1. Quality care
  2. Low costs
  3. Confidentiality
Outsourced medical transcription services aid in all these aspects by creating accurate and timely patient medical records that reflect the entire patient story. This helps healthcare professionals in clinical decision-making. Outsourced medical transcription also brings down the cost of transcription thus helping reduce costs and protects PHI throughout the entire process of medical transcription by securing technology, infrastructure, people and processes.
Healthcare professionals and support staff: The expectations of the healthcare professional can be summed up as:
  1. Option to preserve the narrative portion of the patient encounter
  2. Option to retain familiar modes of dictation
  3. Customized turnaround time options
  4. Reports in preferred formats/ templates
  5. Delivery of transcripts through the specified modes
  6. Adoption of EMR/ EHR without major changes in working style
Outsourced medical transcription services provide support using technology that provides all these benefits while still being easy to use. This helps healthcare professionals and support staff avail all the benefits of technology while still maximizing their focus and productivity. Features like archives, web based delivery, HL7 interface etc help in fulfilling the expectations of healthcare professionals

The management of the healthcare facility: The expectations of the healthcare facility management can be summed up as:
  1. Reducing costs
  2. Protection against litigation
  3. Reduce the cost of overheads
  4. Quickening reimbursements
Outsourced medical transcription services provide services that help healthcare facilities convert the fixed cost of medical transcription to variable costs thus helping them save on overheads. The detailed patient medical records created by the outsourced medical transcription service provider helps in risk management and receivables management.
The other stakeholders in the healthcare process like regulatory authorities, insurance companies and the pharmaceutical sector also benefit from the detailed, accurate, timely, secure and cost effective creation of patient medical records.
It can be seen that a professional and technologically savvy medical transcription service provider can help in managing quality at all levels.
TransDyne, a leader in the outsourced medical transcription industry has used their extensive background in information technology and their experience in serving the needs of the healthcare sector to provide affordable and integrated medical transcription solutions.
TransDyne offers quality medical transcription at reasonable prices, executed by experienced and qualified medical transcriptionists with a very quick turnaround time executed through secure HIPAA and HITECH compliant channels, with very high levels of accuracy and all this with technology that is advanced but easy to use!
To avail complete medical transcription services from TransDyne, click here.

Control your future

"You control your future, your destiny. What you think about comes about. By recording your dreams and goals on paper, you set in motion the process of becoming the person you most want to be. Put your future in good hands - your own." ~ Mark Victor Hansen - How are you putting your future into your own hands today?

The March HIT Standards Committee Meeting

The March HIT Standards Committee meeting focused on the Stage 2 Meaningful Use work ahead, the Direct Project, certificate management, provider directories, devices, and plans to ensure the certification process has the tools and scripts it needs to reduce the burden on vendors and self-certifiers.

Farzad Mostashari, Acting National Coordinator, began the meeting with a discussion of the trajectory we're on.   We're guided by policy outcomes - improved quality, safety, and efficiency.   The work in 2011 will include the regulatory effort to finalize Stage 2 of Meaningful Use and its accompanying standards and certification criteria.   Efforts will be guided by the new Federal HIT Strategic Plan and will require the hard working teams of volunteers that staff the Policy committee, the Standards committee and numerous other working groups such as the Institute of Medicine Learning Healthcare System group, the PCAST workgroup, and the Privacy/Security Tiger Team.   It will be a busy year.

Doug Fridsma  reviewed  the Timeline and Milestones for NPRM Stage 2, noting the NPRM draft needs to be completed in Q3 2011, the NPRM will be published Q4 2011, and the final rule will be published Q1 2012.   This means that the work on the standards needs to be completed this Summer.   Timing for Stage 2 is going to be tight because certification tests must be developed, ?vetted, and implemented by certification bodies so that  EHRs have lead-time for software development, certification, upgrade/installation, and training by October 1, 2012.   The work ahead is in 4 areas:

1. Vocabulary - we need to reduce the optionality and alternatives for vocabularies and code sets.   Multiple vocabularies create significant complexity for vendors and users.  We need a library of constrained codesets that comprise 95% of transactional volume and value i.e. 300 LOINC codes are sufficient for 98% of all ordered lab tests.

2. Upgrade from paper to electronic data transmission - we need to increase the specificity of data transmission standards (i.e. Direct, Connect, Exchange should support most point to point and query/response use cases).   A major focus of standards work should be the content, vocabulary and transmission standards needed for care transitions.

3. President's Council of Advisors on Science and Technology (PCAST) - we should implement pilots and experiments which will provide the foundation for the kinds of query/response transactions suggested by the PCAST report.

4.  The Nationwide Health Information Network specifications should be upgraded to include content and transport standards needed for meaningful use.

Next, Arien Malec reviewed the real world experience deploying Direct.  Feedback has been generally positive and lessons learned include issues of certificate management and challenges of integration into complex corporate email systems.  The Standards Committee was very pleased with the progress and looks forward to upcoming Best Practices and Compliance guides.

Jim Walker accepted the position of Chair of the Clinical Quality Workgroup.   The Workgroup scope includes reducing barriers to implementation of quality measures, focusing on the cost/benefit of gathering the necessary data elements from the EHR including exclusionary criteria.

Dixie Baker presented the Privacy & Security Standards Workgroup Recommendations for Certificate Management   The committee accepted all 3 recommendations made by the Workgroup including:
*Requirements and evaluation criteria for digital certificates
*Need for investigation of alternatives for cross-certifying digital certificate issuers with the Federal Bridge (important for interoperability between non-Federal and Federal organizations)
*Policy Questions for the HIT Policy Committee related to creating a trust fabric for health information exchange

Next, Walter Suarez presented the specifications for entity level provider directories based on input from the HIT Policy Committee.   Standards will be needed for
*Directory Structure and Content
*Submission of directory entries to a National Registry via a publication/posting protocol
*A directory query language

On April 13, the Policy Committee will finish its requirements for Individual Level Provider Directories (ILPDs).  By May, the Privacy and Security Workgroup will present its standards recommendations for both entity level and individual level provider directories.   Although there is much work needed to harmonize standards for the entire directory ecosystem. In the short term, the most important work is the ability of an EHR to query a provider directory.   That is likely to be a stage 2 certification item.

Jamie Ferguson presented a summary of the March 28 Device Hearings.   Major themes were
*Consumers and patients need device interoperability to be inexpensive and easy
*The last mile of connectivity into home devices is currently a barrier
*EHRs need a place to collect device and patient submitted data
*Incentives need to be aligned so that clinicians are willing to accept and review device data
*Patient identity needs to be specified in the transactions between the device and the EHR/PHR
*Standards need to support end to end communication from the device to the EHR and not just to/from intermediaries/hubs/service providers.
*Device interoperability should be included in Stage 3, not Stage 2

Finally, Judy Murphy and Liz Johnson presented their plan for ensuring future NIST scripts and supporting tools reduce the burden of certification including such items as
*the need to pilot scripts
*the need to ensure medications and labs in the scripts are clinically reasonable
*the need to ensure certification criteria such as security requirements are easily testable
*clarifying how modules can be assembled, inheriting the certification characteristics of each
*ensuring the availability of tools needed to test every standards-based transaction

A great meeting.   We're all committed to creating standards and certification criteria for Stage 2 that will address the needs of all our stakeholders.

Health Bloggers Can Earn a Little Extra Something

WEGO Health is a different kind of social media company whose mission is to empower the top 10% of online health social media contributors to connect with each other and with healthcare companies. They call these people Health Activists. Food Allergy Assistant is one of them.

WEGO Health is setting up an Insight Panel (online focus group) for parents who blog about family health, nutrition, parenting and more. I’ve already signed up, but I wanted to make sure that all of you knew about the opportunity as well. The Insight Panel will last about an hour and all participants will receive a $25 gift card for their participation. They’re still scheduling the actual Panel, but WEGO wanted to start sharing this with people now.

If you’re interested in participating in this Panel (or one like it) and want to see if you’re a good fit, take their brief survey here: Parents Who Blog about Health Insight Panel!

6 Tips to Improve Hospital Employee Engagement

Memorial Health System in Springfield, Ill., embarked on a journey several years ago to improve its employee engagement. In a 2004 survey of employees at Memorial Medical Center (the health system’s flagship hospital), employee engagement scored in the 30th percentile nationally. As a result, making Memorial Health System "a great to place work" was established as one of the health system’s three strategies. Over the next five years, the system steadily improved in this area, and in 2010, the hospital scored in the 94th percentile for employee satisfaction. The system has been named an "Employer of Choice" for three years, and its affiliate, Memorial Physician Services, earned the award twice before the system applied as a whole. Brad Warren, senior vice president and chief people officer, and Brian Tieman, system director, employee relations, say making engagement an organizational imperative was a key driver in the system's success. Here they share six tactics for other hospitals looking to improve their employee engagement.

1. Make engagement part of your hospital's core strategy. Employee engagement directly impacts a hospital's success, and as such, it should be part of a hospital's overall strategy — not just a task assigned to the human resources department. “Engagement is critical in any service-oriented business,” says Mr. Warren. "We believe great patient care and service is best delivered by employees who are engaged and passionate about our mission," he says.

2. Gain support from senior leadership. Senior leaders must show their commitment to improving engagement in order for improvements to take hold. "No one will believe engagement is a priority unless [the senior leadership team], takes engagement very seriously and displays that level of engagement by modeling the way," says Mr. Warren.

Buy-in from leadership throughout the health system should come naturally. "The only way for Memorial Health System to fulfill its mission to improve the health of the people and communities we serve is to have the unfailing support of employees and their understanding of how their work supports our mission, vision and strategic goals,” he adds. “That level of support will require the highest levels of employee engagement."

3. Hold managers accountable. Senior leaders can best demonstrate their commitment to engagement by holding the leaders who are their direct reports accountable for improving engagement scores and encouraging those leaders to do the same for those who report to them. "Senior leaders need to be actively involved in ensuring a sense of accountability to the teams under their direction," says Mr. Warren. "Without this, we could become complacent."

At Memorial Health System, every department supervisor, manager or director across all affiliates meets with his or her leader to go over employee survey results and develop an action plan to address any deficiencies in the department. "We have made changes in staffing if results did not improve," says Mr. Warren.

4. Provide training. If hospitals plan to hold supervisors accountable for improving engagement, they should offer training to enhance supervisors' skills in this area.

Memorial Health System holds training sessions it cleverly calls "Great Place to Workshops," which are open to any supervisor within the organization. These sessions, offer supervisors training on leadership and provide management tools and techniques. The health system also holds a special workshop each year solely focused on helping mangers interpret employee survey results and develop action plans around them, says Mr. Warren.

The system also demonstrated its commitment to training by adding an organization development division within its human resources department. These specialists work one-on-one with managers of lower-scoring departments to develop action plans to improve engagement. They also staff open "survey labs" where managers can drop by for help interpreting survey results, developing action plans and tracking improvement progress.

5. Share best practices. Hospital leaders should also facilitate the sharing of best practices to improve employee engagement. Memorial Health System holds workshops that give managers the opportunity to share best practices for survey participation and engagement and has created best practice tip sheets featuring some of the most popular ideas. The system also invites managers of departments that have experienced significant improvements to speak and answer questions about their successes at the Great Place to Workshops.

"Having our own managers share their best practices is very well received," says Mr. Tieman. "Employees enjoy hearing success stories from their colleagues, not just, for example, by a best-selling author."

Examples of the best practices include rewarding departments that meet survey participation goals with a free luncheon or other activity, holding regular department themed events to encourage camaraderie and sending employees birthday cards in the mail thanking them for their hard work throughout the year.

However, the most successful best practice the health system uncovered seems to be one of the simplest — involving all employees, not just managers, in engagement efforts. Some departments have "green teams" — teams of employees that work throughout the year to encourage survey participation and move survey scores from the red levels that require improvement to performance that reflects attributes of an engaged workforce.

"Ultimately what has made a difference in our engagement journey is that it has been a collective effort between employees and leaders, not leaders doing it alone," says Mr. Tieman. "Yes, the manager is the leader, but every employee is part of the solution."

6. Focus on employee relationships with front-line supervisors. Memorial Health has placed extra emphasis on improving employees' relationships with their front-line supervisors in response to research suggesting this is one of the most crucial links to engagement.

Improving that relationship involves training supervisors to be more open and supportive with employees. Memorial Health System has had significant success in this area. In 2010, 83 percent of staff at Memorial said they agreed with the statement "My manager or immediate supervisor is receptive to staff suggestions," up from 41 percent in 2006.

Another key responsibility of front line supervisors is helping employees understand how their role supports the organization's mission, vision and goals. "The more information we can provide on how the work of all employees in all professions and walks in life impacts our success, the more success we'll have," says Mr. Warren.

Supervisors should not only model passion for their job but also help employees develop passion for their work through giving it meaning. "Part of the role of the supervisor is to connect our vision and mission to the work employees under their direction do every day," he says. "This is something that really can only be done through a personal relationship."

Mr. Warren adds, "’Value of employees’ is one of our seven organizational values. That tells you how critical we view employee engagement to be to our success. Buildings are important, standards are critical…but the best strategy for creating great patient experiences and delivering high-quality, patient-centered care is through the hands and hearts of engaged people."

Tuesday, March 29, 2011

Medical transcription outsourcing: An in-depth analysis

In today's world, most businesses are viewing outsourcing some part of their operations as an effective solution to decrease costs and increase focus on their core business. The healthcare sector is no different. The healthcare process is complex and depends on many quality inputs to deliver services that meet high standards. Many parts of the core healthcare process cannot be outsourced; however certain portions that provide support to the healthcare process like medical transcription can be outsourced.

Medical transcription has an important role to play in the healthcare process by chronicling the patient – healthcare professional encounter in a manner that reflects accurate information. Outsourcing medical transcription adds to the efficiency of operations by ensuring turnaround time as per the healthcare professionals' requirements, security as per HIPAA & HITECH and lowering costs substantially.  However outsourcing a vital service like medical transcription can lead to doubts and misgivings.

Given below is an analysis of outsourced medical transcription services, that helps healthcare professionals and healthcare facilities recognize the possible pitfalls of outsourcing and the means of overcoming them:

Quality: One of the main fears that healthcare professionals and healthcare facilities have regarding outsourcing medical transcription is that of substandard quality. Quality in medical transcription is the accuracy of the information captured in the patient medical record viz a viz the dictation. Substandard quality can have far reaching consequences that affect many areas of the healthcare facility operations including patient care and risk management. It becomes important for healthcare facilities to source a medical transcription service provider who can provide services consistently without compromising on quality. The training methods and the quality assurance process used by the medical transcription service provider process needs to be assessed to determine the capability of the service provider to deliver quality services as promised.

Security: Breach of security during the medical transcription process can result in HIPAA and HITECH violation, which has far-reaching and adverse implications on the healthcare facility. To ensure that the medical transcription service provider is capable of ensuring HIPAA and HITECH compliance, the service provider needs to be assessed on the measures taken by the medical transcription service provider to secure technology, infrastructure, people and processes.

Turnaround time: Apart from the accuracy of the information the other most important aspect that affects the healthcare facility operations is the turnaround time. While outsourcing medical transcription it is important to source a service provider who can meet the varying turnaround time needs of healthcare professionals without adversely affecting accuracy. To assess the capability of the medical transcription service provider in meeting turnaround time committed it is important to assess them on the availability of skilled medical transcriptionists, the transcription process and the technology used by the service provider.

Technology redundancy: The process of medical transcription has become dependent on technology to provide the necessary support for factors like convenience, turnaround time, security, flexibility and meeting statutory requirements like adoption of EMR/EHR etc. It is important to source a medical transcription service provider who can provide the necessary technological support without requiring huge capital outlay from the healthcare facilities. To assess a medical transcription service provider in this regard it is important to source a medical transcription service provider that uses advanced technology with features that are easy to use.

Hidden costs: One of the main advantages of outsourcing medical transcription is that of enormous savings on costs. However the caution to be exercised in this regard is to ensure that there are no hidden costs. To assess a medical transcription service provider in this regard it is important to assess the billing methodology. The billing method used by the medical transcription service provider needs to be measurable, definable, verifiable, consistent, fair and honest.

It can be seen that though outsourcing medical transcription can lead to certain costs if done improperly, these impediments can be overcome by following a process of assessing the medical transcription service provider on each of these critical aspects.

TransDyne, a leader in the outsourced medical transcription industry has used their extensive background in information technology and their experience in serving the needs of the healthcare sector to provide affordable and integrated medical transcription solutions.

TransDyne offers quality medical transcription at reasonable prices, executed by experienced and qualified medical transcriptionists with a very quick turnaround time executed through secure HIPAA and HITECH compliant channels, with very high levels of accuracy and all this with technology that is advanced but easy to use!

To avail complete medical transcription services from TransDyne, click here.


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