APGVB OFFICERS RECRUITMENT

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A.P. HIGH COURT RECRUITMENT

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TTD RECRUITMENT AMENDMENT

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Medical transcription outsourcing: Helping healthcare facilities operate successfully

Medical transcription services have been around almost as long as healthcare services, documenting the patient- healthcare professional encounter. Though medical transcription has been around for a long time, these services have evolved from mere typing or data entry services to sophisticated services that contribute to the smooth running of healthcare facilities using the right technology, the right people and the right processes. One of the main factors that have been instrumental in this change has been due to the evolution of outsourced medical transcription service providers specializing in this service.

How do outsourced medical transcription services aid in the successful running of healthcare facilities?

To be successful and profitable, healthcare facilities have to basically concentrate on a few main areas, namely:Document delivery modes that facilitate delivery of transcripts to multiple providers involved in the care process

The ability to communicate health related information to the stakeholders in the healthcare chain: With the emergence of a move towards nationwide healthcare systems, one of the top priorities of healthcare facilities is to develop the ability to be able to exchange health related information in a secure and quick manner. To this end there has been a move to adopt EMR/EHR systems. Outsourced medical transcription service providers contribute to this process, by providing services that include:

1. Document delivery modes that facilitate delivery of transcripts to multiple providers involved in the care process
2. HL7 interface for adoption of EMR/ EHR while still retaining the preferred method of dictation to transcription

Risk management aspects: Another factor that affects the successful running of healthcare facilities is that of risk management. In an increasingly litigious environment, it is important for healthcare facilities to have robust measures in place to minimize risks. Moreover in an increasingly virtual world the information from patient medical records is vulnerable to misuse. Outsourced medical transcription service providers help in this aspect by ensuring the following:

1. Helping preserve the narrative aspect of patient medical records helps in preserving the patient story and this plays an important role in judging the sequence of events and justifying the appropriateness of the treatment process
2. Outsourced medical transcription service providers have measures in place with regard to technology, processes and infrastructure with regard to security of confidential patient information, which helps in risk management

Optimum pricing and revenue management: A healthy bottom line is a vital ingredient contributing to the successful functioning of a healthcare facility. To this end it is important to curb costs and accelerate revenue. Outsourced medical transcription service providers provide support in achieving this goal by enabling:

1. Lowering cost of transcription by almost 40%.
2. Eliminating all indirect cost of transcription
3. As faster creation of patient medical records can help accelerate the reimbursement process, outsourced medical transcription services contribute in this aspect by maintaining a shorter turnaround time

Develop competencies in healthcare related to quality, cost and value of services: Though medical transcription has no direct connection with the healthcare process, it provides important support. Outsourced medical transcription service providers help in this aspect of the healthcare facility operations by enabling the following:

1. Maintaining the integrity of the patient medical record by maintaining high levels of accuracy. This helps in providing continued care and keeping progress of the patient's progress among various other aspects
2. Enables the healthcare professionals and support staff to have easy access to the patient medical records by providing archiving facilities. It becomes easier for healthcare professionals to access older transcripts using various search criteria.
3. Helps shift the focus of the healthcare professional onto the patient rather than the process of documentation by allowing them to document the patient encounter via preferred and familiar methods.

It can be concluded that having a professional and technically proficient medical transcription service provider for medical transcription needs can help in the successful operations of the healthcare facility.

 

TransDyne, a leader in the outsourced medical transcription industry has utilized their extensive background in information technology and their experience in providing medical transcription services to come up with medical transcription solutions that help healthcare facilities save on time, money and effort. 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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More on Hospital Executives' Disproportionate Pay

Local US news media brought some more striking examples of disproportionate pay given to health care organizational leaders. 

Carolinas HealthCare System: Corporate-Style Compensation for a Public Hospital CEO

Carolinas HealthCare System declares it is "the largest health care system in the Carolinas and the third largest public system in the nation" in its membership blurb for the National Association of Public Hospitals and Health Systems.  That association describes its members thus,

Since the establishment of the first public hospital in the United States in the early 1700s, safety net hospitals and health systems have been an essential part of our nation�s health care delivery system.

In the 21st century, safety net hospitals continue their long tradition of quality and service to the community. By delivering care to America�s growing number of working uninsured families, providing world-class trauma and emergency care, preparing for and responding to the threat of terrorism, epidemics, and natural disasters, and training the next generation of doctors, nurses, and dentists�safety net health systems ensure our nation�s communities are health and strong.

The Charlotte Observer just noted how much this "safety net hospital," which declared solidarity with "working uninsured families," pays its CEO:

Carolinas HealthCare System paid its CEO $3.7 million in 2010, $287,000 more than the year before as the system lifted a pay freeze and paid bonuses for reaching annual and long-term goals.

Chief Executive Officer Michael Tarwater, 57, who has led the $6.3 billion public hospital system for nine years, received a base salary of $986,172, two bonuses totaling $2 million, and other compensation, including retirement and health benefits, of $630,346.

In 2009 his compensation package totaled $3.4 million.

So the leader of an organization that serves the poor and uninsured gets enough compensation to make him  quite rich.    

Mary Washington Healthcare: Net Income Increases, but 20% Goes to Bonuses of Top 20 Executives

According to the Fredricksburg (Virginia) Free Lance-Star, from 2008 to 2009, Mary Washington Healthcare saw its total revenues increase, but its net surplus decrease,

The company's net income was $25 million in 2008, up from $20 million in 2007.

Then

The company opened its second hospital that year [2009] and recorded revenues of more than $666 million, up from $551 million in 2008. However, net income dropped to $8 million, in part because of the opening of Stafford Hospital.

So what happened to its executive compensation?

The top employees at Mary Washington Healthcare earned more than $1.1 million in bonuses in 2009, their reward for a successful 2008.

More than two dozen key executives and employee physicians earned annual bonuses ranging from $2,000 to $246,278. The median bonus for the company was more than $28,000.

Fred Rankin, president and chief executive officer, received the largest bonus among managers: $151,430. Rankin continues to be the firm's highest-paid employee, with a 2009 salary package of $955,282.

The hospital's net income increased $5 million (25%) from 2007 to 2008.  It then dropped $17 million (66%) from 2008 to 2009.  Reflecting 2008 results, its top 20 executives received 2009 bonuses of over $1 million, an amount that exceeded 20% of the hospital's 2008 net revenue increase on which the bonuses were based.  The total compensation of these 20 people in 2009 was approximately $6.5 million (see here), which exceeded the hospital's entire increase in net revenue from 2007 to 2008.  The hospital CEO's compensation in 2009 would have consumed one-eighth of the net revenue that year.  This all suggests that the top executives of this hospital consume an inordinate part of the organization's total revenue stream.    

Hutcheson Medical Center: CEO Compensation and Deficits Rise

Here is how the Rome News-Tribune described the financial status of Hutcheson Medical Center, located in Fort Oglethorpe, Georgia:

HMC reported a profit of $766,766 in 2007 and a $7.3 million loss in 2009.

In addition,

In 2008 more than 80 Hutcheson employees lost their jobs when the hospital eliminated its emergency medical services.

And after the profitable year of 2007, the Hutcheson administration approved major renovations for the hospital�s front lobby and entered into a $35.5 million dollar bond issue to fund further renovations and pay off debt.

That bond issue is currently in default, which prohibits the next $10 million payment from being released to HMC.

Things look worse in the future:

At a meeting Thursday, Jan. 28, of the Hospital Authority Board, HMC chief financial officer Gerald Faircloth revealed that the hospital had losses of $3.3 million in the first quarter of budget year 2011 and projected total 2011 losses at around $9 million.

Faircloth, whose compensation went down by $15,000 from 2008 to 2009, also reported that HMC has an estimated 15 days of operating cash on hand.

'So the wolf is at the door,' said Bill Cohen, a trustee who represents Catoosa County on the Hospital Authority Board.

Faircloth agreed.

Wolves notwithstanding, however, the Hutcheson CEO has done very well:

In the face of Hutcheson Medical Center�s financial losses over the past several years, financial documents reveal that president and CEO Charles Stewart�s compensation package has increased more than 26 percent from 2007 to 2009.

According to Internal Revenue Service documents for the 2007 and 2009 budget years, Stewart received $337,081 and $425,745, respectively, in total compensation. The Fort Oglethorpe hospital�s budget year runs from October through September.

Stewart�s 2009 income includes a �bonus and incentive compensation� of $69,750.

So despite a major financial loss, lay-offs and service discontinuations, and a bond default, the CEO got "bonus and incentive compensation" in 2009.   At least that drew some attention:

'I�m really surprised that the board (Stewart) works for would give him such an increase,' said Walker County commissioner Bebe Heiskell, referring to the HMC board of directors that oversees the day-to-day operations of the hospital. 'For a failing hospital that�s exorbitant.'

So while the hospital's financial performance continued to decline, the total compensation provided its CEO continued to increase.

Summary

Here were three instances in which the compensation of top non-profit hospital leaders seemed out of all proportion to the hospitals' financial results, let alone their accomplishment of their missions. In the first case, the CEO of a public hospital system meant to serve poor and uninsured patients was paid enough in one year to make him an instant multi-millionaire. In the second, the bonuses alone handed out to a handful of top executives ostensibly based on a net revenue increase would have consumed one-fifth of that increase, and when net revenue declined the next year, those executives' compensation would have almost consumed that entire year's net revenue. In the third, a CEO got increasing compensation while his hospital suffered increasing losses.

As we have said before, far too often the leaders of not-for-profit health care institutions seem more interested in padding their own bottom lines than upholding the institutions' missions. They often seem entirely unaware of their duty to put those missions ahead of their own self-interest. Like the financial services sector in the era of "greed is good," health care too often seems run by "insiders hijacking established institutions for their personal benefit." True health care reform would encourage leadership of health care who understand health care and care about its mission, rather than those who see a quick way to make a small fortune.

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"Keep true to the dreams of thy youth." ~ Johann Friedrich von Schiller

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Food Allergy Friendly Massachusetts

Beginning tomorrow, February 1, Massachusetts restaurants will be required to have a certified food protection manager on staff. This staff member must must have completed allergen-awareness training through a state program and certification must be renewed every five years.

In addition, restaurant managers in MA must make sure their staff is trained and educated in the area of food allergy and the manager must deliver the meal to the table of the food allergic diner.

Yeah Massachusetts!

I've been saying for years, if Disney can make food allergic diners feel comfortable, so can other restaurants. MA is the first state to enact this type of policy. Here's hoping others soon follow.

I see a family vacation to MA in our near future. My kids would love the Freedom Trail and I've always wanted to visit Martha's Vineyard. How much easier our trip planning will be knowing we can speak to restaurant staff about food allergies and they will get it.

Really get it.

I'll be anxious to hear from Massachusetts readers and travelers as this law takes effect. Food allergy awareness will save lives and will allow those with food allergy to participate in activities others take for granted.

Like stopping at a restaurant for a quick lunch; or eating out with friends; or attending a family party at a restaurant...

Everyone has the right to eat safely.

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PQRI XML Submissions Required for Certification

One of the challenging aspects of Complete EHR Certification is the PQRI XML needed for submission of quality measures to CMS.

There are 15 required hospital quality measures but the 2 Emergency Department measures are stratified for reporting and must be presented in 3 different ways, so a total of 19 PQRI XML files need to be generated for Complete EHR Certification of hospital systems.

Each of the files uses identical XML.  The only parameters that change are

pqri-measure-number which is set to the NQF measure being submitted such as NQF 0435 (see the graphic above for the list of NQF hospital measure names)

eligible-instances which is the number of patients who meet eligibility requirements to be measured for the time period being submitted

meets-performance-instances which is the numerator of the measure i.e. those patients who had the appropriate treatment or outcome

performance-exclusion-instances which is the number of patients removed from eligible-instances for specific clinical reasons.  The denominator of the measures is always (eligible-instances minus performance-exclusion-instances)

performance-not-met-instances which is the number of eligible patients who did not have the appropriate treatment or outcome.  It can be calculated as (eligible-instances minus meets-performance-instances minus performance-exclusion-instances)

reporting-rate which is a multiplier i.e. for a percentage the reporting rate is 100

performance-rate which is the calculated performance level and is equal to meets-performance-instances/(eligible-instances minus performance-exclusion-instances)*reporting-rate

Let's do a real example so this becomes clear.   If we want to create PQRI XML for NQF Measure 0435, which is "Ischemic stroke patients prescribed antithrombotic therapy at hospital discharge", we need to go the HITSP TN906 document and gather the definition from pages 48-52

In this case,

eligible-instances is defined as "Patients admitted to and discharged from the hospital for inpatient acute care with a diagnosis of ischemic stroke (ICD9 433.00-438.99)"

meets-performance-instances is defined as "eligible-instances patients prescribed anti-thrombotic therapy(page 355-358 of HITSP specification) at hospital discharge"

performance-exclusion-instances is defined as
"Patients with age < 18
Patients with length of stay >120 days
Patients with comfort measures only documented
Patients enrolled in clinical trial
Patients admitted for elective carotid intervention
Patients discharged/transferred to another hospital for inpatient care
Patients who left against medical advice or discontinued care
Patients who expired
Patients discharged/transferred to a federal healthcare facility
Patients discharged/transferred to hospice
Patients with a documented reason for not prescribing anti-thrombotic therapy at discharge"

Suppose that 110 patients are eligible, 80 received anti-thrombotic therapy, and 10 were excluded.

performance-not-met-instances would be (eligible-instances minus meets-performance-instances minus performance-exclusion-instances) or  110-80-10=20

performance-rate would be meets-performance-instances/(eligible-instances minus performance-exclusion-instances)*reporting-rate or 80/(110-10)*100 = 80%

The PQRI XML generated would be

<submission xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xmlns:noNamespaceSchemaLocation="Registry_Payment.xsd" type="PQRI-REGISTRY" option="TEST" version="1.0">
  <file-audit-data>
    <create-date>31-01-2011</create-date>
    <create-time>04:22</create-time>
    <create-by>Your Organization Name Goes Here</create-by>
    <version>1.0</version>
    <file-number>1</file-number>
    <number-of-files>1</number-of-files>
  </file-audit-data>
  <registry>
    <registry-name>Your Application Name Goes Here</registry-name>
    <registry-id>123456</registry-id>
    <submission-method>C</submission-method>
  </registry>
  <measure-group ID="X">
    <provider>
      <npi>1111111112</npi>
      <tin>123456</tin>
      <waiver-signed>Y</waiver-signed>
      <encounter-from-date>2010-01-01T00:00:00</encounter-from-date>
      <encounter-to-date>2010-12-31T00:00:00</encounter-to-date>
      <pqri-measure>
        <pqri-measure-number>NQF 0435</pqri-measure-number>
        <eligible-instances>110</eligible-instances>
        <meets-performance-instances>80</meets-performance-instances>
        <performance-exclusion-instances>10</performance-exclusion-instances>
        <performance-not-met-instances>20</performance-not-met-instances>
        <reporting-rate>100.00</reporting-rate>
        <performance-rate>80</performance-rate>
      </pqri-measure>
    </provider>
  </measure-group>
</submission>

For the ED measures, which capture time measurement rather than patient counts, you need to create 3 files for each measure, stratified by

1. All patients that were admitted via the ED, excluding the ICD-9 range for PSYCH (ICD9 290-319) and Observation Patients.

2. All observation patients that were admitted via the ED, excluding the ICD-9 range for PSYCH (ICD9 290-319)

3. All psychiatric patients that were admitted via the ED, including only the ICD-9 range for PSYCH (ICD9 290-319)

eligible-instances is recorded in the same way as other measures.

meets-performance-instances is used to record the median time data.

performance-exclusion-instances, performance-not-met-instances, reporting-rate, and performance-rate are set to zero.

Hopefully this explanation makes it easier for hospitals and vendors to create the necessary PQRI XML for certification.

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Basic Health Tips Can Keep Out Trouble In School

Hand washing is the basic step towards maintaining a healthy body. The teachers should teach the students the importance of the hand wash.

According to a study, it has been found that lack of hand washing and improper food can cause gastrointestinal trouble. In a confined classroom, area where the students study the virus of gastrointestinal sickness can spread very quickly. This study was published in 2010 issue of the Journal of School Health, which dealt with the food processing in various schools and universities.

A gastrointestinal illness is short-lived. The symptoms are cramps, fever, diarrhoea and vomiting. It does not need medical treatment. However, the victim should be provided with water because sometimes dehydration takes place. The victim should have adequate fluid intake. In some cases, the children are admitted in hospitals for the speedy recovery. In case of E. Coli contamination, the victim can die of food poisoning.

The co-author narrates that there has been 121 outbreaks of gastrointestinal sickness. Around 51 percent of these involved bacterial infections and mostly the viruses were being transmitted by the food. Around 12 percent of these were transferred by drinking unsafe water.

Food-borne illnesses are “grossly underreported” to public health authorities, said Lee.

The author says that hand washing before having meal is the best solution to prevent the viruses from the entering the body.

Source http://topnews.us/content/233572-basic-health-tips-can-keep-out-trouble-school

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Medical transcription: Establishing a policy for continuous quality assurance

The importance of documenting the patient encounter is manifold as it helps in many aspects that contribute to the smooth running of healthcare facilities, besides being a statutory necessity. As healthcare services are critical it is important that the process of documenting the patient- healthcare professional encounter be subject to certain norms. The patient – healthcare professional encounter can be documented by various means, one of the most preferred being medical transcription; a process which converts dictation to text.

As medical transcription has an important supporting role to play in the process of healthcare, a best practices guide titled “Healthcare Documentation Quality Assessment and Management Best Practices” has been jointly created by AHDI, MTIA and AHIMA. One of the highlights of this manual is alignment with the Plan-Do-Check-Act cycle.

Each stage of the process is vital to ensure that the process of healthcare is documented keeping in mind that maintaining the highest standards of quality is a continuous process. The goal of this quality assessment program is to ensure that healthcare documentation is clear, consistent, accurate, complete and timely.

 

Act: Making a policy for quality assurance

As quality in medical transcription is not only vital, but also a continuous process, it is important for medical transcription service providers to have a quality assurance policy based on the following guidelines:

• Apply the principles of quality while tailoring the quality assurance process specific to the organization
• Assess the specific factors that affect outcome of the documentation process including the workflow, turnaround time and technology while establishing a quality assurance policy
• Establish a budget specifically for implementing quality measures in the medical transcription process
• It is important to not only specify the quality process but also make it available to every person involved in the medical transcription process including the medical transcriptionists, proofreaders, editors, quality assurance team etc
• It is important to tweak the quality policy according to account specifications and update it constantly as per changing requirements
• Make quality an automatic step in the workflow following audio to text without adversely affecting accuracy or turnaround time. This can be based on the account and experience of the medical transcriptionists. Concurrent reviews are needed for inexperienced medical transcriptionists to improve quality and retrospective reviews provide valuable inputs for learning
• It is important to provide feedback on the results of the reviews to help improve performance of medical transcriptionists
• Train the assessment staff
• Establish and follow guidelines for the frequency of quality assessment
• Provide all inputs and resources to medical transcriptionists and other staff to ensure quality output

TransDyne, a leader in the medical transcription industry has made quality a key word in their work processes. TransDyne has adopted the process of continuous and comprehensive quality improvement to improve quality of medical transcription at every level. TransDyne realizes that quality is continuous process and therefore Quality Guidelines are established and implemented at every level. This attitude of adopting quality as the basis of their services and their aptitude in information technology has helped them come up with easy to use medical transcription solutions that help save on time, money and efforts.

 

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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AP GENCO SUB ENGINEERS EXAM SCHEDULE

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#TSAMastery #af Bling! Shiny and Attractive – But Where Does it Take You? http://ht.ly/1b6tzc

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HITECH and Funding Cuts: The Battle Begins

At "US House of Representatives Proposes to Defund Largest Non-Consented Medical Experiment in U.S. History: HITECH" I predicted this:

... I have no financial conflicts of interest regarding HITECH or health IT to weep about. Others do, and it's not hard to predict their financial interests will push them to oppose repeal "by any means necessary."

The next few months should be an interesting time in the politics of healthcare IT.

A replacement HITECH act that's "HI" on research and caution, but not so "HIGH" on stealth, coercion and euphoria (i.e., as on mind altering substances) would be welcomed.

The battle's already begun. At "Meaningful Use incentives jeopardized by GOP bill", Jan. 28, 2011 by at Dan Bowman at FierceHealthIT.com, views exactly as I expected have begun being proffered by the industry:

... All of that [possibility of HITECH funding termination] has HIMSS Vice President for government relations Dave Roberts just a little on edge, reports Healthcare IT News.

"We're trying to tell people that this process is going on. This is only one body [of Congress]. Don't let this be a concern," he said. But "if this is a new way of thinking, that could be concerning. So I think that while this particular bill may not pass, it's something that has to be watched closely."

Patti Dodgren, CEO of Hielix--which helps to facilitate electronic health information exchanges across the U.S., shares Roberts' view. [Any possible conflicts of interest towards full-speed-ahead-damn-the-torpedoes health IT diffusion in that role, I ask? - ed.]

"Just the suggestion of repealing HITECH stimulus funds for physicians...is short-sighted at best, and threatens the very progress that is already beginning to be realized within the industry to move our healthcare system into the 20^th [yes, 20th] Century," Dodgren told FierceHealthIT. "All this bill serves to do is strengthen the cynics of health IT.

[Translation: "short sighted" and "cynic" = those more interested in taking the time to do health IT "right" and in patient rights and patient well being, than in personal gain - ed.]

We work with thousands of physicians and state government healthcare officials who have worked tirelessly over the past months to achieve the benefits that healthcare IT promises [no, Ms. Dodgren, they haven't, actually; you and they have merely encouraged a rushed, cavalier and reckless rollout (of a technology even HIMSS' former Chairman of the Board, a physician, admitted is not ready), damaging - not helping - health IT's prospects. See below - ed.], and this bill is a disservice to them and to the healthcare industry."

It may be a "disservice" to those who stand to profit from the health IT industry, but it's a great service to the healthcare industry and to the patients it serves.

I didn't really need to look, as experience at HC Renewal has proven time and again about the healthcare pundits, but the credentials of someone making such claims about health IT are not impressive IMO.

From an online bio, Ms. Dodgren holds the illustrious "CPHIMS" certification that I wrote about at my April 2008 post "Is the HIMSS Certified Professional in Healthcare Information and Management Systems stamp substantive, or just alphabet soup?". After 8 years as Director Budgeting & Financial Systems at (now-defunct) Digital Equipment Corp. (DEC) and 4 years as Senior Business Analyst at Dun & Bradstreet, she has been a "change management professional" for twenty years who "co-founded a management consulting practice which specializes in the application of change management principles to health information technology." I note no medical (or medical informatics) training or experience.

My reply to these people is as follows, as posted in a FierceHealthIT comment:

By S Silverstein MD | Posted 7:09pm | January 30, 2011

Patti Dodgren and Dave Roberts seem to favor continuation of a risky and even harmful national medical experiment that does not even have the fundamental decency to seek patient informed consent.

See http://hcrenewal.blogspot.com/2011/01/maude-and-hit-risk-mother-mary-what-in.html for examples of some of the risks.

The former Board Chair of HIMSS, Barry Chaiken, MD, MPH, FHIMSS said it best in July 2010:

http://histalk2.com/2010/07/19/histalk-interviews-barry-chaiken/

... We�re still learning, in healthcare, about that user interface. We�re still learning about how to put the applications together in a clinical workflow that�s going to be valuable to the patients and to the people who are providing care. Let�s be patient. Let�s give them a chance to figure out the right way to do this. Let�s give the application providers an opportunity to make this better.

Let the industry learn the responsible way, not on patients' and physicians' blood, sweat and tears through way-too-early national initiatives that will only add to the $14 trillion national debt (http://www.usdebtclock.org/), and throw some of the money into industry pockets.

Franky, as a physician with no financial conflict-of-interest axes to grind, I am increasingly disgusted with the cavalier, money-grubbing attitudes of the health IT industry and its pundits. Their attitudes and behaviors represent a poster study of healthcare industry at its worst.

This latter fact is not lost on me as I speak with government representatives seeking to improve medical drug/device watchdog legislation, and to attorneys looking to protect patients from harm or gain recompense for those already injured as a result of faulty IT.

-- SS

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It All Ends Tonight... http://ping.fm/XVwTq

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"Hem your blessings with thankfulness so they don't unravel." ~ Unknown

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The Journal Project - by RevShar | InspirACTION http://ping.fm/fUt3k

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"Give yourself something to work toward - constantly." ~ Mary Kay Ash

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Medical transcription outsourcing: Reduces the burden of the support staff

The process healthcare cannot operate in isolation; being dependent on various sources for inputs and support. Healthcare services are  built on the premise of good quality inputs in the form of skills of healthcare professionals and other associated services like the medical equipment manufacturers, the pharmaceutical industry, laboratory services etc. for the smooth running of the medical and operational aspects. On the commercial and legal aspects, healthcare facilities have to coordinate with insurance providers and other statutory regulatory authorities.

To run a healthcare facility successfully is a huge effort requiring quality personnel to coordinate all the activities. One of the vital inputs that contribute to several aspects of successfully running a healthcare is information in patient medical records. Medical transcription is the process of creating patient medical records, converting the audio of the patient- healthcare professional  into text. As medical transcription is an essential activity that requires specialized inputs to ensure quality services, outsourcing medical transcription is a convenient option.

Outsourcing medical transcription has numerous advantages, which help in reducing the burden of support staff.

How does outsourcing medical transcription reduce the burden of support staff?

Outsourced medical transcription services provide support to support staff in the following:

Eliminate the need for recruiting medical transcription staff: Outsourcing medical transcription essentially eliminates the onerous process of recruiting, hiring and training medical transcriptionists. This also essentially eliminates the need for organizing staff for extra transcription work or organizing medical transcription work during holidays and weekends.

Eliminate the need for a transcription platform: To be able to meet the turnaround time and HIPAA/ HITECH requirements, medical transcription needs an effective and efficient transcription system. This system needs to accept dictation from various modes, automatically check for audio files at prefixed intervals and transmit for transcription, provide various methods of document delivery, HL7 interface for EMR adoption, archives for easy retrieval of older transcripts etc. By outsourcing medical transcription all the software and tools required by the healthcare facility are provided by the outsourced service provider

Help in coordinating records management/ health information management: Medical transcription is an important aspect of health information management. Outsourced medical transcription service providers help in various aspects of HIM, by providing legible, accurate, timely, accessible, consistent, relevant and secure

Provide support in medico-legal aspects: Preserving the patient story in its entirety is an important aspect of recording the nuances of diagnosis, treatment and progress. Medical transcription aids in this by helping preserve the narrative.

Helps in budgeting and accelerating reimbursements: Outsourcing medical transcription is an effective method of cutting not only the direct costs of medical transcription but also the indirect costs of medical transcription. Moreover timely medical transcription helps in quickening reimbursements, as it provides the base information for coding and billing.

Helps meet statutory regulations: It is mandated by law that the patient medical record needs to be maintained for a certain period. Moreover with the recent mandate of adoption of nationwide electronic health systems, outsourced medical transcription services can play an important role in this aspect too.

It can be seen that outsourced medical transcription service providers provide valuable support to the efficient running of healthcare facilities, reducing the burden of support staff.

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 total 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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US House of Representatives Proposes to Defund Largest Non-Consented Medical Experiment in U.S. History: HITECH

In a new bill in the House of Representatives, the ��Spending Reduction Act of 2011�� (link - PDF), it is proposed to cut unobligated funds of, among others, division A of the "American Recovery and Reinvestment Act of 2009":

Spending Reduction Act of 2011

... TITLE III�RESCISSION OF UNOBLIGATED STIMULUS FUNDS AND REPEAL OF CERTAIN STIMULUS PROVISIONS

SEC. 301. RESCISSION OF UNOBLIGATED STIMULUS FUNDS.

Effective on the date of the enactment of this Act, there are rescinded all unobligated balances of the discretionary appropriations made available by division A of the American Recovery and Reinvestment Act of 2009 (Public Law 111�5).

SEC. 302. REPEAL OF CERTAIN STIMULUS PROVISIONS.

Effective on the date of the enactment of this Act, subtitles B and C of title II and titles III through VII of division B of the American Recovery and Reinvestment Act of 2009 (Public Law 111�5) are repealed, and the provisions of law amended or repealed by such provisions of division B are restored or revived as if such provisions of division B had not been enacted.

Division A of the ARRA Act of 2009 (link to PDF) includes this:

SECTION 1. SHORT TITLE.
This Act may be cited as the ��American Recovery and Reinvestment Act of 2009��.

SEC. 2. TABLE OF CONTENTS.

... The table of contents for this Act is as follows:

DIVISION A�APPROPRIATIONS PROVISIONS

... TITLE XIII�HEALTH INFORMATION TECHNOLOGY

Title XIII of the ARRA along with title IV of division B is better known as HITECH:

SEC. 13001. SHORT TITLE; TABLE OF CONTENTS OF TITLE.

(a) SHORT TITLE.�This title (and title IV of division B) may be cited as the ��Health Information Technology for Economic and Clinical Health Act�� or the ��HITECH Act��.

It looks like HITECH is one of a number of spending extravaganzas now on the proposed chopping block.

I can't be too sorry about this for these reasons:

• This country cannot afford HITECH at this time. We are broke, with some calling the economic crisis of 2008 worse than the crisis of 1929, and the national deficit ballooning far out of control. The money would be far better spent at this time on care of those who cannot afford it.
  

• HITECH appeared as if out of nowhere, with little to no input time from stakeholders. This suggests lobbying by those with conflicts of interest to push this bill onto the public, affecting their medical care without informed consent (see my March 2009 post "Draft Patient Rights Statement and Informed Consent on Use of HIT"). The bill includes persuasion along with economic coercion for non-adopting organizations and physicians. ("Adoption" = adherence to government-set standards of "meaningful use" of poorly usable technology.) I disapprove of the stealth process by which HITECH appeared. This is the U.S., not the old USSR.
  

• The technology is not ready. It is dangerous in unqualified hands, which most every medical center and physician office is in 2011 (i.e., an IT backwater). The field of health IT was somehow transformed from an experimental field into the 'savior of medicine' without the proof of value and safety that would ordinarily be required to move an experimental technology from lab to national rollout. Per the Washington Post, this process appears to have been a highly politicized one, favoring the corporate elites. The Washington Post�s 2009 article on the influential HIT vendor lobby �The Machinery Behind Healthcare Reform� is at this link.

While this House Bill is just the initial battle in the repeal of this and other mass expenditures, I would not weep for the HITECH act's passing. It would allow the restoration of health IT back to an unrushed and careful endeavor. It would also give time to work out the significant issues causing health IT difficulty (such as raised in 2009 by our National Research Council) before we embark on national diffusion.

In other words, its passing would reduce risk and help restore an essential level of sanity and due diligence to the healthcare IT sector, now afflicted by irrational exuberance bordering on delirium. We would avoid the largest non-consented medical experiment in US history, which as I have repeatedly written I feel would be disastrous with current levels of understanding of this technology and how to design, deploy and manage it. (My mother's May 2010 HIT-related injuries only strengthened my convictions in this regard.)

Of course, I have no financial conflicts of interest regarding HITECH or health IT to weep about. Others do, and it's not hard to predict their financial interests will push them to oppose repeal "by any means necessary."

The next few months should be an interesting time in the politics of healthcare IT.

A replacement HITECH act that's "HI" on research and caution, but not so "HIGH" on stealth, coercion and euphoria (i.e., as on mind altering substances) would be welcomed.

-- SS

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#TSAMastery #af Share Your DREAM Friday – With Special Guest Dreamer Samantha Kerik! http://ht.ly/1b4JvQ

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"Some people dream of success ... while others wake up and work hard at it." ~ Author unknown

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New Blog Post: Share Your DREAM Friday - With Special Guest Dreamer Samantha Kerik! http://bit.ly/evMccb

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Share Your DREAM Friday - With Special Guest Dreamer Samantha Kerik! http://ping.fm/8HsKw

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PRATIYOGITA DARPAN 2011 FEBRUARY MAGAZINE

FOR PRATIYOGITA DARPAN 2011 FEBRUARY MAGAZINE CLICK HERE

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CRIUM RECRUITMENT

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Cool Technology of the Week

The iPhone and iPad have provided a remarkable platform for mHealth, empowering consumers to manage their wellness, communicate with clinicians, and support treatment workflow via smartphones.

One of the coolest examples is Walgreens new application which supports automated medication management.

Each medication dispensed or sold at Walgreens has a bar code. After registering the application to your nearest/preferred Walgreens pharmacy, you simply scan the label using the iPhone/iPad camera and it automatically uploads to the Walgreens you�ve chosen. There are alerting functions for all parts of the prescription life cycle.   You link your transactions to a credit card on file, drive up to the Walgreens pick up window and they dispense your prescription. The pharmacist asks if you have any questions, just as if  you went into the store.

Walgreens summarizes their application features as:

Pharmacy
�New Express Refills by Scan*: Just scan the barcode on your prescription bottle for instant refills
�Order refills from your account history using your device
�Secure access to your prescription history from the palm of your hand
�Enter a prescription number for refills

Photo
�Upload multiple images simultaneously and pick them up at a local Walgreens in about an hour or have them shipped directly to you

Shopping Features
�New Weekly Ad interface featuring cover flow
�Add items to your shopping cart directly from our local Weekly Ads
�Check product availability and pricing at any store
�Flu Shot and Take Care Clinics locator

Using a smartphone as a bar code reader to support medication management workflow and e-commerce.  That's cool!

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New Study for People With Peanut Allergy

If you live in the West Hartford, Connecticut area, you may be interested in a new study being conducted by the New England Food Allergy Center. It is a desensitization program whereby small amounts of peanut protein are given to a peanut allergic individual over a period of time. The study starts with visits to the Center and are continued at home.

Unfortunately most insurance companies won't cover the costs, which will be in the $3000 range. It may be worth checking with your insurance though. Don't be afraid to escalate this to the medical director of your insurance carrier, who can often over-ride what customer service representatives are told to tell callers.

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Medical transcription: Establishing a process for continuous quality improvement

The importance of documenting the patient encounter is manifold as it helps in many aspects that contribute to the smooth running of healthcare facilities, besides being a statutory necessity. As healthcare services are critical it is important that the process of documenting the patient- healthcare professional encounter be subject to certain norms. The patient – healthcare professional encounter can be documented by various means, one of the most preferred being medical transcription; a process which converts dictation to text.

As medical transcription has an important supporting role to play in the process of healthcare, a best practices guide titled “Healthcare Documentation Quality Assessment and Management Best Practices” has been jointly created by AHDI, MTIA and AHIMA. One of the highlights of this manual is alignment with the Plan-Do-Check-Act cycle.

Each stage of the process is vital to ensure that the process of healthcare is documented keeping in mind that maintaining the highest standards of quality is a continuous process. The goal of this quality assessment program is to ensure that healthcare documentation is clear, consistent, accurate, complete and timely.

Act: Continuous quality improvement

As quality is a key word in the medical transcription process, the process of improving quality should be proactive rather than reactive. That is the quality improvement program should aim at preventing errors from occurring rather than correct errors after they occur. To this end the key steps in a quality improvement program should be:

• Review
• Revise
• Communicate
• Monitor

The quality improvement program for medical transcription should focus on all aspects of medical transcription including:

• Dictation devices: The quality of audio is a major contributor to the quality of medical transcription. It is important to address this issue by studying in detail all types of dictation devices to determine which one produces optimum output. It is also important to have a clear idea of the working of the device so as to avoid audio problems like clipped words, garbled words etc
• Author education: As the healthcare professional is the originator of the transcript by providing a narration of the patient encounter, it is important to educate the author on dictation best practices. These could include:

1. Choosing the right dictation device
2. Knowing the equipment
3. Importance of choosing a noise free environment for dictation
4. Practice of specifying type of report etc at the beginning of dictation
5. Using the right pace of dictation

It is also important to establish a forum for feedback that flows both ways between the healthcare professional and medical transcriptionists

• Medical transcriptionists: The responsibility of transcribing the dictation into transcripts rests for the most part on the medical transcriptionist. It is important to provide medical transcriptionists with the means to produce quality medical transcription. These could include:

1. Provide training
2. Provide resources
3. Provide feedback
4. Use feedback as learning opportunities
5. Distribute samples for difficult authors
6. Provide formats/ templates/ macros/ normal
7. Assign mentors for new medical transcriptionists
8. Provide incentives for quality

• Account specific: This would address the issues specific to particular accounts making it easy for medical transcriptionists to produce quality. These could include:

1. Easy to use account specification sheets
2. Constantly update the information on account specification sheets
3. Maintain up to date lists of healthcare professionals etc specific to the account

It can be seen that making quality improvement a continuous process can improve the quality of medical transcription to a great extent

TransDyne, a leader in the medical transcription industry has made quality a key word in their work processes. They have adopted the process of continuous and comprehensive quality improvement to improve quality of medical transcription at every level. This attitude of adopting quality as the basis of their services and their aptitude in information technology has helped them come up with easy to use medical transcription solutions that help save on time, money and efforts

 

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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