Tag: medical transcription

Transcription Market Share Analysis

Lower Volumes, But More Stable Outlook

JOHNSON CITY, TN — Of the estimated 2.1 billion patient encounters documented in the United States in 2015, approximately 32%, or over 670 million documents, were generated by dictation and transcription, according to a new market analysis from WebChartMD.

The analysis (click here to access) breaks out the clinical documentation market into the three main documentation methods most often used by healthcare providers: 1) Provider Entry, in which the healthcare provider enters data him/herself into the EHR; 2) dictation and transcription; and 3) Scribe Entry, in which Medical Scribes enter data into the EHR.  Front-end speech recognition usage was not included in the study.

Provider Entry is the leading clinical documentation method, with an estimated 61% market share, followed by dictation and transcription, with an estimated 32%. Scribe Entry trails with an estimated 7% market share.

Dictation and transcription, the second most-used modality, had its heaviest concentration of usage in ambulatory specialty care and hospital-based documentation.  The medical transcription industry had estimated 2015 sales of $2.2 billion, or 20.6 billion annual lines. About 30% of all US-based physicians – or just over 300,000 – continue to use dictation and transcription for some percentage of their clinical documentation, according to a recent WebChartMD estimate.

A notable change in the break-out of market share has been the rise of the Scribe Entry segment, which has grown from a few thousand to over 20,000 Scribes nationwide in just the last few years. Scribes currently process an estimated 143 million patient encounters annually, or about 7% of the entire clinical documentation market.

One take-away from the analysis? “The government has spent billions of dollars since the 2009 HITECH Act to incent physicians to adopt EHR-based clinical documentation tools.  Despite that, there remains a sizable minority of healthcare providers who continue to use dictation and transcription,” said Christensen. “While transcription will never return to its former levels of usage, I believe there are a number of specific reasons why it will persist as a clinical documentation modality.”

About WebChartMD

WebChartMD, a software development company specializing in clinical documentation workflow applications, partners with over 100 MTSOs nationwide, which in turn serve over 8,000 physicians via the WebChartMD platform. 

Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Billing and RCM, Medical Transcription, Pre-Certs with AzaleaHealth EHR.   We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes. Call 866-777-7264 today, or visit our website for more information.  We have education programs in Medical Scribe Specialists. #medicaltranscription #azaleahealthEHR #revenuecyclemanagement #MDSofKansas #medicalbillingservice

Doctors Complain EHRs Destroy the Patient Encounter

Transcription provides the clear, cost-effective solution to the on-going crisis in healthcare documentation.

JOHNSON CITY, TN – EHRs continue to adversely affect the doctor-patient relationship, according to a new article published in Medscape.  The article (requires free membership with Medscape, click here), titled “Doctors are Talking: EHRs Destroy the Patient Encounter”, describes in detail the toll EHRs are taking on both physicians and patients.

The article cites three main physician gripes:

1. EHRs have made the patient encounter “far more annoying and complex than it ever was before.”

2. EHRs “make (physicians) feel like data entry clerks, with a computer telling them how to practice medicine.”

3. EHRs “erode the doctor-patient relationship by creating a barrier between the two.”

Scribes – A  Good, But Not Best, Solution

The article continues with a discussion of the pros and cons of using an in-office Scribe.  While some physicians favored the use of Scribes, others vehemently opposed it.  As one physician commented, “We have to hire a person to deal with the already expensive EHR.  At the end of the day, we are still worse off than before we had the EHR forced on us.”

Another physician added, “So adding another $25,000/year employee on top of the $80,000 for the EHR is the ‘happy’ solution?” a doctor asked. “I am not the government with unlimited money.”

MTSOs Are Offsite Scribes

In contrast to the more expensive approach of onsite scribes is the model of the offsite transcription vendor, which is a superior option for three key reasons:

1. Deep history and familiarity with the doctors’ and their clinical documentation preferences and style.

2. Strong expertise in medical language terminology and usage.

3. Significantly lower expense than onsite scribes, with no lost time for holidays or sick days.

EHR Vendors: Barrier or Facilitator? 

Despite the clear advantages of offsite transcription,  it cannot be implemented without the cooperation of EHR vendors, which are the gatekeepers for the implementation of the all-important interface for importing transcribed notes — or sections of notes — into the EHR’s patient record.  In many cases, interfaces remain expensive, non-standardized, and difficult to implement — all of which act as a deterrent to implementation.

“The high barriers to entry for getting an interface in place limits the options many physicians have regarding the clinical documentation workflow,” said Mark Christensen, CEO of WebChartMD.  “We’re asking EHR companies to join us in making it possible for physicians to choose the documentation modality best suited to them and their practice of patient care.  If physicians prefer some modality other than dictation, that’s their choice.  But if their preference is dictation and transcription, we’re asking EHR companies to remove the financial and technological barriers that restrict a physician’s ability to make that choice.”

For more information, or to dialogue further on this topic, contact Mark Christensen directly at mark@webchartmd.com or 1-423-343-5702.  

Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Transcription, Revenue Cycle Management, AzaleaHealth EHR, and REAL-TIME solutions with Medical Scribes.   We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes. Call 866-777-7264 today, or visit our website for more information.  We have education programs in Medical Scribe Specialists and Healthcare Documentation Specialists.

MDS Education Website

Salary Information
Salary Information

Did you know we have a site specifically for our education programs?  It is a little more personal, and completely geared to answer all your questions about Medical Scribe Specialists and Medical Transcription, or Healthcare Documentation, education and careers.   We are answering questions about wages, job demands and anything you can think of!  Check it out today by visiting our newly designed website.

Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Transcription, Revenue Cycle Management, AzaleaHealth EHR, and REAL-TIME solutions.   We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes. Call 866-777-7264 today, or visit our website for more information.

ICD-10 is About Specificity and Documentation

MDS understands that document specificity is critical for ICD-10.  You do not want to see an interruption with your payors.

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AAPC released recent study results showing clinical documentation of more than 20,000 physicians with only 63% of current documentation adequate to support the ICD-10 requirements.  Predictions show one of the largest problems following the October 1, 2014 implementation date for ICD-10 will be documentation insufficient to support the specificity requirements.

 

Posted on: 02-6-2014 by: Tiffany Lantz

By: Diane Taylor, RN-BC, EHR Intelligence

If you think ICD-10 is all about new codes, you are dead wrong. ICD-10 is really about “documentation” ─ we clinicians have learned from day one that, “If it’s not documented, it wasn’t done.” This situation is even truer in the ICD-10 world, where the coder must build the ICD-10 code based on the presenting story of that patient’s visit from admissions to discharge. With all the new code options, you never know what code will be built.

Case in point: The ED physician sees and diagnoses the patient with head and chest contusions and a fractured femur caused by a motor vehicle accident (MVA). The hospital admits the patient. The nurse, who documents the patient history assessment, discovers the patient hit the vehicle in front of her on a busy residential street. The therapist teaching the patient how to crutch walk discovers new information that the patient was driving home after a fight with her in-laws and was texting when the accident occurred. The entire story is now documented fully and ready for coding to add to the claim’s reimbursement.

A “MVA”, “on a residential street,” “texting while driving” and “fighting with in-laws” are all now capable of being coded. Even though 50 percent of the new ICD-10 codes are based on laterality, there are so many new codes that can be used. Documentation matters. Specificity matters.

Real-time documentation is especially important. Care managers will need to know the documentation is present and when the patient status changes from “Observation” to “Inpatient”. They can no longer wait for the end of the shift for clinicians to document. Medical necessity must be present; if not, queries sent to physicians will likely increase. Clinical documentation improvement (CDI) specialists will have to forward clarifications to physicians if information in the clinician’s note does not correspond with what the physician documented. The volume of queries overall is expected to increase substantially. If documentation is not entered in real time, the longer that information remains on the coder’s desk, the longer the time to attain revenue and reimbursement.

Users of electronic medical record systems also need to be able to document laterality as well as perform in-depth documentation for specificity. For example, a coder will need to receive a thorough description of the wound to understand where the insertion of the IV on the body occurred, the reason for the IV order and the medication administered. To be able to describe the location of injury (i.e., is it located left or right side or upper or lower part of the body?), distal or proximal, medial or lateral, and much more will be even more critical for ICD-10 coding.

Physicians working in medical practices or clinics are expected to experience difficulty adjusting to the new ICD-10 code sets. They will be responsible for providing hospitals with information in ICD-10 form to aid their peers. Clinic orders, such as lab and radiology, will need ICD-10 diagnosis so the hospitals can process these orders appropriately. If the coordination of this level of communication doesn’t improve, patient care and treatment can be affected and denials will surely increase.

So are you really ready for ICD-10? Apparently it’s not just a coding project.

Diane Taylor, RN-BC, Delivery Manager, CTG Health Solutions, is a healthcare professional with 30-plus years’ experience with a focus on clinical transformation and change management.

 

Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Transcription, Revenue Cycle Management, AzaleaHealth EHR, and REAL-TIME solutions.   We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes. Call 866-777-7264 today, or visit our website for more information.

2013 Reflections

MDS reflects on the many blessings of 2013.  We have great appreciation for our customers, new and old, our friends, our business alliances and partners, and most of all … our incredible MDS team!  We are confident in what 2014 brings and wish good health, happiness and true peace for all!

AHDI reflects on most read healthcare articles for 2013.  Take a look …

UPMC transcriptionists protest after outsourcing
Pittsburgh Post-Gazette
From Nov. 6: Cindy Cromie was a medical transcriptionist working for UPMC Hamot in Erie, Pa., when she, like the rest of the 130 people who provided medical transcriptions for the hospital system, got a call this spring to come to a meeting in Pittsburgh. They gathered in the Western Psychiatric Institute and Clinic of UPMC, where they were told that their work was being outsourced to Nuance Communications of Burlington, Mass.

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Job changes coming for transcriptionists
Healthcare IT News
From July 17: Nearly 90 percent of medical transcriptionists say that transitioning to documentation roles with electronic health records means that gaps in skills need to be identified and new career paths charted, according to new a study. New speech and language processing technologies have set the stage for a fundamental transformation in the way transcriptionists work, according to the survey – conducted by the American Health Information Management Association and the Association for Healthcare Documentation Integrity — which found that 87 percent of respondents are preparing for new ways of doing things.

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AMA: EHRs create ‘appalling Catch-22’
HealthcareIT News
From May 8: As the healthcare industry moves to EHRs, the medical record has essentially been reduced to a tool for billing, compliance and litigation that also has a sustained negative impact on doctors’ productivity, according to Steven J. Stack, M.D., chair of the American Medical Association’s board of trustees. “Documenting a full clinical encounter in an EHR is pure torment,” Stack said during the CMS Listening Session: Billing and Coding with Electronic Health Records.

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Speech recognition software: Does it help or hinder care workflow?

FierceHealthIT
From Nov. 20: Does front-end speech recognition make for a smooth-running operation, or does it simply complicate documentation and patient care? Doctors and researchers debate this question in the November 2013 issue of health information management magazine For the Record. Gary David, Ph.D., an associate professor of sociology at Bentley University in Waltham, Mass., notes in the article that front-end speech recognition does not always save labor, but it does change workflow.

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Scribes can be beneficial in medical practices
HealthDay News via Doctors Lounge
From Oct. 23: Medical scribes can accurately document physician or independent practitioner dictation and activities, allowing providers to spend more time with patients, according to an article published in Medical Economics. Maxine Lewis, president of Medical Coding & Reimbursement in Cincinnati, discusses the role of scribes in medical practices.

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EHR copy and paste? Better think twice
Healthcare IT News
From Oct. 9: Who would have thought that something so simple as copy and paste could have such serious consequences? Speaking at the MGMA annual conference in San Diego, Diana Warner, director at AHIMA, confirmed the seriousness of inappropriately using copy and paste functions in electronic health records. And the government agrees — it’s no laughing matter.

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Digital health records’ risks emerge as deaths blamed on systems
Bloomberg
From June 26: Electronic health records are supposed to improve medical care by providing physicians quick and easy access to a patient’s history, prescriptions, lab results and other vital data. While the new computerized systems have decreased some kinds of errors, such as those caused by doctors’ illegible prescriptions, the shift away from paper has also created new problems, with sometimes dire consequences.

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Medical scribes boost EHR productivity, streamline workflow
EHR Intelligence
From Sept 25: While EHRs are sold to physicians as a way to increase quality while making documentation more efficient, few providers have seen as much return on that promise as they could like. EHRs can be time consuming to use on a daily basis, and patient interaction can suffer when being forced to peer at a computer screen during consult after consult. The solution, according to one cardiology practice, is to let a professional typist do the typing, and allow the physician to use his skills where they do the most good.

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Updated HIPAA rules posing challenges for healthcare providers
The Wall Street Journal via iHealthBeat
From May 8: Health care providers say they likely will face challenges complying with new rules that expand and update HIPAA provisions. One of the biggest challenges under the new HIPAA rules is a provision allowing patients to request that insurers not be informed of treatments that patients paid for themselves.

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Speech recognition: A work in progress
For The Record
From May 1: While controversy remains within the healthcare community regarding the best approach to using speech recognition technology, there are some points that most industry professionals agree on. Few would dispute that the vendor community has made tremendous strides to advance applications to better meet the needs of the healthcare industry, and innovation continues as developers look for ways to make the technology more intelligent and accurate.

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Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Transcription, Revenue Cycle Management, AzaleaHealth EHR, and REAL-TIME solutions.   We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes. Call 866-777-7264 today, or visit our website for more information.

 

Clinical Documentation Trends – Must READ

I know you will want to read this over carefully.  There are some VERY interesting points made in this study by the Health Business Group on healthcare documentation trends for the next several years.  Please take time and read, as it is well worth it … (my medical transcription and healthcare documentation friends)!

Clinical_Documentation_Trends_2013_2016

“CLINICAL DOCUMENTATION TODAY
• Medical transcription is the most common form of documentation in the acute care market and is also utilized, though to a lesser extent, in the ambulatory space.
• About half of medical transcription is performed by provider organizations using their own staff; half is outsourced to Medical Transcription Service Organizations (MTSOs).
• Acute care providers frequently use both in-house and outsourced resources; ambulatory practices tend to use one or the other but not both.
• Most provider organizations type their transcription directly from audio files.
• A substantial portion of documentation is done using the electronic health record (EHR), especially in the ambulatory market.
• Despite increasing EHR penetration, health care providers express some uncertainty about the ability of EHRs to meet clinical documentation needs and to tell the complete patient story.
• A significant share of clinical documentation is still handwritten.

CLINICAL DOCUMENTATION IN 2016
• The clinical documentation market will undergo substantial change between 2013 and 2016.
• Documentation volume will continue to grow at approximately 2 to 3 percent per year.
• The use of EHRs for documentation will increase, especially in ambulatory settings.
• The use of front-end speech recognition to enter data into EHRs will grow faster than the use of keyboard and mouse.
• Integrated delivery networks (IDNs) will increasingly determine the method of clinical documentation for affiliated practices.
• Documentation on paper will vanish almost completely.
• Transcription will remain an important documentation method, but more of the market will be outsourced.
• There will be increasing use of back-end technology among those who continue to perform transcription in-house.
• New technologies such as Clinical Language Understanding (CLU) will enter the mainstream.
• The introduction of ICD-10 may increase the need for high-quality clinical documentation and Computer-Assisted Coding.”

 

Doctor Speaking with Patient

 

Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Transcription, Revenue Cycle Management, EHR technology, and REAL-TIME solutions.   We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes. Call 866-777-7264 today, or visit our website for more information. 

 

MDS Crosses State Lines to Partner with Azalea Health

hospital workers

 

Wichita, KS (September 19, 2013) – Wichita-based medical document services company, MDS of Kansas (MDS) joins forces  with Azalea Health (Azalea) to provide clients with a billing service and complete cloud-based electronic health records (EHR) solution, Azalea EHR.

For over 22 years MDS has delivered a variety of medical document services, including transcription, editing, EHR integration, and education programs throughout the Midwest. “The merging of advanced technology with continued emphasis on efficient and accurate healthcare documentation has created new demands on physicians. We offer REAL-TIME solutions while helping to improve cash flow, margins and efficiency.” says Donella Aubuchon, CEO of MDS.

MDS chose to partner with Azalea Health to offer a full range of healthcare billing services and EHR solutions to its clients.   Aubuchon explains, “The specificity of documentation in the health record significantly impacts the administrative and financial side of a practice.”  Azalea’s cloud-based software suite comes with a quality support team and a fully-integrated billing and claims management module which boasts an increase in billing accuracy and aids practices in earning 15% more in reimbursements. In addition to accuracy, Azalea provides a secure portal for users to both record and transmit sensitive data.

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About MDS of Kansas:
MDS of Kansas, L.L.C. is a small business located at 205 S. Hillside and offers Medical Transcription services, education programs for Medical Transcription and Medical Scribes, as well as Medical Billing & Coding services.  For more information, visit www.MDSofKansas.com or call (866) 777-7264.

About Azalea Health
Azalea Health (Azalea) is a leading provider of cloud-based healthcare solutions and services. Azalea provides Electronic Health Records (EHR), Practice Management Systems (PMS), Electronic Prescribing (eRx), Laboratory Ordering and Resulting, Patient Health Records Portal, Telemedicine and Health Information Exchanges (HIE), as well as Revenue Cycle Management Services (RCM), and Precertification Services. For more information, visit www.AzaleaHealth.com or call (877) 777-7686.

 

Medical Document Services of Kansas, LLC (MDS) is a Wichita, Kansas healthcare document service specializing in Medical Transcription, Revenue Cycle Management, EHR technology, Medical Scribe education and REAL-TIME solutions.   We provide efficient, accurate, affordable quality services for hospitals, clinics, and facilities of all sizes. Call 866-777-7264 today, or visit our website for more information. 

Medical Documentation (transcription) & ICD-10

So much buzz out there with M-Modal’s crappy news.  It is sad to see US jobs lost to off-shore (again).  It is very frustrating, as well as devastating, for those affected.  Now more than ever, it is important for MTs, the ones who really want to stay in this industry, to educate and re-tool, and just be diverse!  Be ready for whatever comes our way.  However, we are believers in dictation because we are listening to our physician friends.  We hear what they are saying and we are listening to insurance auditors for major companies.  Increased documentation is coming;  it will be sink or swim for some and many experts believe the only way physicians will survive is to go back to dictating.  Take some time and read the articles below.  They contain interesting information on why we could see a push-back on dictation.  The Affordable Care Act (Obamacare) and ICD-10 are key reasons.  Then you have the physicians who are tired of the clerical roles they have had to assume with EHR.

“These new changes will increase the need for skilled medical transcription and medical coding”  Read More. 

“Whether you are an advocate or a detractor of Obamacare, we do know that it is going to dramatically increase the required amount of documentation. Secondly, we know that the buzzword for ICD-10 (beyond the other buzzword “PAIN”) is “specificity.”  Read more.

“Assuming those medical transcription companies that are here today are still on the scene on Oct. 1, 2013, not having been acquired or retired, (and there certainly are fewer and fewer of them!)  I believe they will enjoy increased dictation with the changeover from ICD-9 to ICD-10.”  Read more.

The Perfect Storm!  Opportunities!

Re-Tooling … Medical Scribes

Are you thinking about bridging a career?  Are you concerned about where healthcare is going in terms of the electronic medical record?  There are so many questions, concerns and still unknowns in this industry, but one thing is sure:  There ARE job opportunities in healthcare.    

While there are still job opportunities in medical transcription, there are unknowns and plenty of competition.  However, there are implications that ICD-10 will create more demand for transcription because of documentation requirements.   Even if you are just not sure what you are doing and you are riding out the storm with medical transcription, or healthcare documentation specialists, getting your credentials could never be more important.  More education is NEVER a bad idea!  The time is right to RE-TOOL.  Why not add another dimension to your skill-set.

MEDICAL SCRIBES – we have classes starting in September with online delivery!  

 

See what The ACCIM has to say:

“Certified medical scribes are a key facet in solving today’s healthcare challenges, and employment dilemmas, utilizing effective model and solutions through real-time partnership with clinical documentation encounters.”  read more …