May 12, 2010
“Practical Use” of an EHR Using Transcription
Written by: John
In a post on EMR and EHR about Transcriptionists Partnering with an EMR Vendor, I got an interesting comment by George Catuogno from StenTel about the various technologies that the Medical Transcription (MT) industry are using alongside EMR software. George called the use of transcription with an EHR “practical use” while still showing “meaningful use.” I think it’s a mistake for any EMR company to ignore the transcription industry.
Here’s George’s description of the medical transcription technologies which I think people will find interesting:
Related ArticlesThe Medical Transcription (MT) industry actually has done a lot to advance itself amidst HIT, particularly EHR technologies, while supporting narrative dictation, which for many physicians is still the preferred method of information capture because it’s fast and easy (efficient) and it tends to more comprehensively captures the patient “story”. DRT, BESR and NLP are three examples of this. I’ll save the best for last.
1. Discrete Reportable Transcription (DRT) is the process of converting narrative dictation into text documents with discrete data elements than can be easily imported into the appropriate placeholders inside an EMR.
2. Backend Speech Recognition (BESR) has been in play for years which allows physicans to dictate without engaging the computer for realtime correction. The correction is instead done retrospectively by a medical transcriptionist. Some speech rec technologies (like M*Modal) support data structuring. The gap remains, however, in getting applications written that readily move that strucutred infomration into EHRs like DRT can.
3. Natural Language Processing (NLP) trumps both of these solutions because it takes a narrative report, regardless of how it was created, and codifies it (SNOMED) for a number of extraction, analytics and reporting applications: Patient Summary, DRT feed into an EMR, Core Measures and PQRI, coding automation, interoperability, and support for the majority of Meaningful Use requirements. Secondary use opens up to clinical trials and other applications as well.
Overall, if the transcription industry can market itself and get its messaging out through the right channels regaridng these innovations that augment transcription and keep physicians dictating, then transcription is a terrific EHR adoption facilitator, enables “practical use” along with Meaningful Use, and will remain relevant for the foreseeable future.
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7 responses to "“Practical Use” of an EHR Using Transcription"
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My company is very active in emergency medicine applications and use of ePCR, EHR, EMR applications and we believe every EMR system should have triage and teletriage as a ‘front end’. We have Odyssey, which is extremely succussful in the UK and are introducing it here in the US. It has a database of more than one million words of referenced and updated clinical data and cuts triage times to a fraction of time and documentation is automatically generated minimizing transcriptions requirements as well. It also minimizes medical errors and legal risks as well as isolates emergent and nonemergent patient needs. To see you visit:
Teletriage is the Front Door to Managing EHR, EMR, ePCR Medical Records | R. Lee Heath
http://www.defib.us.com/2010/05/teletriage-is-the-front-door-to-managing-ehr-emr-epcr-medical-records/ (follow the links for detailed info)
Roger Heath
inventor making possible the automatic defibrillator
Backend Voice Recognition is the best way to go; unfortunately some of the Physicians are bent upon playing around with the front end Voice Rec system which does not lend itself very well to increasing the efficiencies within the clinic.
Backend Voice Rec integrated well within a EHR is a efficient process and saves time while increasing the efficiencies within the clinic.
To be on point on the blog responses, I believe that a combination of George Catuogno’s three models can be additive or even complementary to any electronic medical record application. It seems that digital dictation and speech recognition has been pilloried by more than a few “EHR/EMR experts” for its lack of accuracy as a standalone application.
As George comments and you quoted, speech recognition is a potential tool that frees physicians from being umbilicated to a work station; be at risk for repetitive stress injurie and unfaithfully have their intent recorded by a template-based EMR.
I had the pleasure of working in the digital dictation and transcription market before EMR’s and feel that the transcription vendors, big and small, do have relevance in today’s EMR market, more as a protection against the potential of workman’s compensation claims and less as an anachronistic tool.
[...] lots of really interesting transformations happening in the transcription industry (as I’ve written about before). One of those that I haven’t seen many people talking about is the transition [...]
Thanks John, for that great article on meaningful Medical Transcription Services. Physicians usually think they are spending a lot in transcription, but reading your article will make them understand that medical transcription is helping them in lot other ways for them to benefit in the future aspects. It is very informative and an “eye opener” for many users.
Interesting. I don’t remember reading the first 3 comments on this post. I usually read everything since it gets emailed to me. I wonder if these comments somehow got caught in my email spam filter.
I apologize for the lack of response. That’s not like me.
Anyway, Anthony I’ve never seen any benchmarks for front end versus back end voice recognition. Anything you could share on that front? What about the costs to implement each?
John Taylor,
Physicians are spending a lot in transcription. That’s pretty much a fact. The key is that that cost might be worth it and might be necessary for a doctor to get the most out of an EMR.
John,
I’ve run internal benchmarks on front end vs back end speech recognition and the back end isn’t significantly faster, but it is more accurate and able to self-correct.