As a transcription software provider we frequently receive requests for information on integrating transcription with EMR.  Specifically, administrators want to know if we can do it, what it will cost and most importantly, why they should even consider integrating the two in the first place.

As EMR's become even more the rage you will have to learn about integration with them to remain competitive so let's have a look at how to answer these questions.
The third question is really the most important question of all so let's discuss that first.  Why bother integrating at all?  Automation is only good when it does what it is supposed to do and that is to eliminate or reduce non-productive, repetitive tasks and free up valuable human resources for more productive work.  If done correctly integrating the EMR with transcription will do just that.  Many medial facilities suffer from having to manually manage two different systems; one for electronic records and another for transcription.  That consumes tremendous resources that could be used for more productive tasks.  That's not only an expensive and wasteful use of valuable labor but an expensive addition to document turn around times and accounts payable.

So integration is great for the clinic but what about the transcription company?  The main advantage for a transcription company in having a system that integrates with EMR's is that it keeps you from losing contracts that require integration and it will allow you to win future contracts with organizations requiring integration.  Those small details aside, integration can actually save you money in several ways.  First, you'll improve productivity because MT's get automatic ADT feeds that will populate your transcriptions with accurate patient demographics the first time.  Secondly, sophisticated formatting of the transcription is typically unnecessary as the integration engine itself will create the required EMR format.  On top of that you don't have to worry about document delivery because the digital document is automatically posted into the EMR.   For the typical transcription company a transcription platform that communicates seamlessly with an EMR platform hugely simplifies the entire process for everyone and gives you and your staff more time to do other things besides manage cumbersome paperwork.

Lower costs, faster payments, less to manage, better records and more available resources.  What's not to like about that equation?

On to the next question:  Can you do it?  There are two keys to answering that question.  The first is whether or not you're using a transcription platform that is capable of moving data to and from the EMR in question (without disrupting your workflow).  Creating that type of interface requires a high level of technical expertise that can be expensive.    To be blunt, some ASP's are better than others.  Some have the technical expertise to make integrations smooth and easy, while others simply don't.  A well managed transcription ASP will be able to integrate with virtually any EMR at a reasonable price.  Unfortunately, there are many ASP's that don't fit into that category.

The second key is whether or not the EMR program itself can "talk" with other programs.  Some programs simply don't allow communication with other programs or they charge obscene fees to access their software, while others are fairly straight forward and inexpensive.
 At any rate, the success of your integration requires coordination and cooperation from both platform developers.  The bottom line here is this:  you need core access to both your transcription platform and the EMR software by experienced, competent programmers who understand the intricacies of both.  

So how much will all this cost?  The answer is, “It depends.”  The cost depends on the level of sophistication of the integration and the capabilities of your ASP and the EMR program.  If the EMR program adheres to at least some standards like HL7 then the integration can be pretty straight forward and costs can be reasonable.   But then again the EMR provider might require significant fees to access the program or its design may be so complex that communication with other programs becomes extremely involved.  If you're using an ASP that doesn't play well with others you might see some pretty hefty programming charges.
 In our experience most ASP's charge around $12,000 to create an interface with some of the more common EMR programs.  We typically charge $6,500 for our interfaces because we've done so many of them and our platform is easy to work with (see below for more information).
 Let's try to wrap all this up into something you can actually use. If you have a client or prospect that requests information about integration with transcription you need to ask some questions.

Questions you need to ask your prospect or client:
Is integration with your EMR required to get the contract for transcription, or is it an option you're considering for the future?
•What is the EMR program you are using, or plan to be using?
•Do you have the technical staff to implement this on your side?
•How much are you willing to pay for the interface? Some facilities expect the transcription company to pay for the transcription interface while others are willing pay an interface fee. You may not have to eat all the upfront costs, but then again absorbing those costs might create some leverage for getting the contract.
•What is your target date for having an operable interface?

Questions you need to ask your ASP:
•What do you charge for a seamless interface with XYZEMR program?  You need to be very specific.  Most likely they'll come back with additional questions before they can answer.
•How do you determine the cost of creating an interface? Scope of project, hourly rate, or do they have standard rates for different programs? Standard rates is the best answer because that means they have experience and probably know what they're doing.
•How many interfaces have you done with this EMR program, or similar programs?
•How long will it take to do the job?

A Little Bit about IntraScript
We've done countless interfaces with most major providers of EMR software, including :
Standard and non-standard HL7 v2.3 and newer port to port network exchange

•Softmed Systems, Inc., ChartScript v8.2 unstructured templates MS Word
•Meditech HL7 to transcription vendor v2.3 or newer
•HMS, GE's Logician, EPIC and Kaiser Medical
•XML and Web Services (WDSL)
•Custom ASCII file parsing for patient demographic data (ADT)

Our standards based “data hub” design gives us the ability to adapt to specific operational environments with minimal or no costs.  Since we use SQL and XML we are not tied to any legacy or proprietary protocols, giving us tremendous flexibility and advantage over our competitors.  IntraScript can capture voice files from virtually any past, current and future dictation server and seamlessly import them into our platform for fast, automatic file capture and delivery.

We're usually about half the cost of our competitors and some are so outrageously priced its absurd.  We can build interfaces to most any specification so we usually quote integration with EMR's based on scope of work to be fair to our clients and to ourselves.  However, we are very good at containing costs and we are usually much less expensive than our competitors because the software is designed to be flexible and open.