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Rethinking Transcription Costs
EMR and Transcription
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Rethinking Transcription Cost
How Much Does Your Transcription Really Cost? Don't feel bad if you don't know. Unfortunately 85% of all transcription companies don't know either. Imagine what your day would be like if 80% of your problems just disappeared. More time to do the job you are supposed to be doing? More vacation time? Fewer headaches and a less stressful environment? Sound like a far fetched idea? Not according to our research. Eight out of every ten transcription managers we talk with claim they spend more time managing the administrative speed bumps of the transcription process than they spend actually managing transcription itself. Issues like managing multiple platforms that don't communicate well with one another, delivering stat reports across campus, looking for lost files, working on different systems, re-works due to manual errors, manually entering data from other systems. How much is that really costing you to produce accurate, timely transcription? Most likely it is substantially more than the simple per line cost or document cost so often associated with transcription. Whether you are having your medical documentation transcribed by an in-office employee, remote employee, or by a transcription service, you need to be aware of all that is involved so that you can find ways to improve the entire transcription process and the impact it has throughout the healthcare system. The Trouble with Turn Around Times (TAT) There is no doubt TAT is the king of metrics when it comes to transcription, and rightly so. Slower TAT cause delays in patient care and extends accounts receivables, so they are very important. However, the resources it takes to achieve those TAT are frequently overlooked and in many cases the costs are exorbitant. In our business we frequently see productivity measured only by turn around times without regard to the real underlying costs of the resources it takes to generate and deliver reports. The consequence of measuring productivity only by TAT is that there is no true indicator of the amount of time and resources that are being squandered unproductively. Recognizing and measuring the efforts required to attain acceptable TAT often reveals substantial cost in money, time and in valuable and limited resources. What really impacts TAT? The speed and accuracy of the MT is of primary importance to TAT, but in order to get a grip on real costs one must review and measure all the steps taken to produce and deliver a document. Following is a non-inclusive list of things you might want to evaluate and measure to get a better understanding of your transcription costs, and where costly inefficiencies might be hiding. Things you can measure •Direct MT Cost - The cost per unit (line or document) MT's are paid •Direct Editor (QA) Cost - The cost per unit editors are paid •Direct Administrative Cost - The total administrative cost (wages and benefits) divided by transcription unit •Direct Clerical Cost - The total clerical cost (wages and benefits) divided by transcription unit Once these types of measurements are taken a good picture of the operation will evolve and you will begin to see how much cumulative time (and therefore money) it takes to create a document. You will also be able to identify inefficiencies within the practice and hopefully create a good case for resolving them. These benchmarks are critical to identifying problems and resolving them. Most inefficiencies are rarely a product of MT production, but are usually centered on clerical and administrative practices required to create a finished product and internal reports. These are usually a result of incompatible systems which require too much clerical work to create an end product, or manually doing repetitive tasks that could and should be automated. An example might be manually faxing referring physicians copies of transcriptions or manually entering data generated by one program into another program to generate reports. Leveraging Technology to Create Efficiencies A decision without information is nothing more than a guess. Technology, if used wisely, enables better decisions and creates efficiencies within your organization. Available transcription technology offers many advantages when it comes to collecting useful data. Because everything is digitally managed in a well designed transcription platform there is potential for records of virtually every action involved in the entire process of dictation and transcription. Therefore, a good platform will enable you to gather information and create reports that help you to make good decisions about your operation. A well designed platform will have a variety of ready made reports as well as real time analytics to help you measure productivity and activity (activity and productivity are not the same thing!) Efficiencies through technology are most frequently gained when manual, repetitive tasks are automated. A well rounded platform will give you the flexibility to design and automate your workflow so that you can focus your resources on managing exceptions rather than repetitive activities and become proactive in your administrative style. That means you have more hours in each day to do things important to the organization, like managing relationships or improving overall quality. Finally, most institutions are already using or are considering the use of some form of electronic medical records (EMR) and those systems will become better and more prevalent over the next few years. It won't be long before the integration of transcription with EMR will be a requirement for any viable transcription organization. If you don't already have a system that can easily and readily integrate with EMR you might want to start thinking about it. The cost savings of EMR are simply too significant to ignore, and integration with transcription is a natural progression that will continue to become more and more important. To sum it all up, you can't manage what you can't measure. Collecting data and creating benchmarks for performance are the first steps towards improving your organization's performance and will show you where costly inefficiencies are hiding. A good dictation and transcription platform is frequently the first step towards making significant and positive changes in your organization's performance. An simple example for measuring the real cost of transcription The follow table provides a very simplified numerical picture of the costs of transcription in a typical healthcare institution. In this scenario MT's are contract labor paid by the line, as are editors. It is assumed that one administrator and four clerical workers are necessary to manage and create the documents required by the institution. There is no attempt to identify and allocate overhead, as that is more detail than is really needed for this exercise, but that could certainly play an important role in determining real costs. Most likely there are additional costs and efforts required to coordinate transcription with other activities, but this is a good starting point for most organizations when trying to identify real costs and productivity issues.
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