Creating Total Transcription Synergy

How EMDAT Moved Midwest Physician Center
from Paper Transcription to Portable Patient Information Access

by: Laura Johnson
Vice President of Operations
Midwest Physician Centers

It’s common knowledge in the industry that administrative burdens place tremendous pressures on the efficient delivery of patient care. Why has health care lagged so far behind the natural advances in communication? While even teenagers wrestle with complex information technology on a daily basis, highly skilled clinicians are still licking their fingertips organizing files and folders and walls and drawers of paper records.

One piece of this monstrous filing system referenced frequently by care providers is the pages of transcription logging patient medical history, diagnosis, prognosis, and outcome. Anyone who‘s ventured toward the walls of color-tabbed patient files understands its ease of access. Yet, records as important as medical transcription can often be accessed by this means alone.

The Midwest Physician Center, a multi-specialty physician group practice in suburban Chicago, started in 1975 as a division of the Chicago College of Osteopathic Medicine. The network of 11 centers is recognized for its compassionate clinicians in a variety of fields. The Midwest Physician Center (MPC) is committed to excellence in patient care, osteopathic medical education, and research. As a whole, MPC strives to be a leading full-service health care provider in the Chicago south and southwest suburban market.

Identification of Our Goal

When MPC began the research necessary to streamline its transcription system and reduce associated cost a few years ago, transcription processing had ventured from our core values of excellence and innovation. Although a certain degree of administration is necessary, MPC felt they had crossed the line. Transcription processing had become a large bottleneck hampering their commitment to delivering high-quality care. Further, transcription costs were growing each year.

When MPC first entered into practice, clinicians dictated into hand-held micro-cassette recorders. Tapes were routed via internal mail through their Orland Park office, the central hub for transcription processing covering each of the 11 local clinics. A transcription firm then couriered dictation tapes to their office for processing. Within two days, the paper transcript was couriered back to the Orland Park office and was routed via internal mail for editing, final sign-off, filing, and, finally, integration with patient care. This obviously wasn’t the most efficient use of time.

In addition to being time-intensive, there were numerous, unavoidable delivery obstacles imbedded in the MPC system, including the occasionally misplaced dictation tapes. The delivery method and constant fax and copy cycle accompanying each physician referral also opened the door for security leaks.

Midwest Physician Center needed to ensure Total Quality Management. In order to accomplish this goal, the facility began researching all transcription options. MPC’s goal had four major criteria, since they needed:

1. Scalability with resources available to handle their large staff of 150 physicians at 11 different locations.

2. Simplicity.

3. Increased security

4. Cost efficiency.

The Solution

Following research into many medical transcription vendors, Midwest Physician Center selected a software platform with access to over 70 transcription companies. The software solution was provided by EMDAT.

How were the goals of Midwest Physician Center met?

Scalability. Midwest Physician Center now has access to a fully scalable, competitive, online marketplace for side-by-side bidding from various transcription companies. MPC receives the most competitive per-line prices and are able to allocate specialties to companies with focused expertise. They can also change their transcription provider easily without affecting the end user – dictating MPC clinicians and support staff.

Simplicity. Midwest Physician Center immediately reintroduced excellence and innovation into their transcription process. Clinicians still use a dictation device similar to their micro-cassette recorder. However, dictation is sent instantly through a secure, Internet connection. Transcriptions are accessible 24 hours a day, 7 days a week, and real-time progress is tracked and available. Turnaround time has been cut in half. Courier, facsimile, and telephone calls have been almost completely eliminated from the process.

Security. While the previous system left Midwest Physician Center vulnerable to security leaks as reports were handled through courier, internal mail, and facsimile, the new electronic process integrates industry-leading security measures allowing only specified individual access to confidential patient information.

Cost Efficiency. Midwest Physician Center purchased dictation devices for full-time clinicians and easily reconfigures others for part-time or visiting clinicians. MPC avoids wasted dictation time caused by repeating header and footer scripts. These lines are pre-designed as templates. Minimal up-front costs were recovered in the first few months. MPC’s transcription fees were reduced by 33% immediately upon implementation.

Accessibility and Portability. The greatest value-add is in Midwest Physician Center’s new system’s networkability. Because the system is now fully electronic, the clinician instructs referral directives in his or her dictation. When transcription is complete, both the clinician and referral physician receive the finished report simultaneously. Unsigned transcripts are automatically identified with a preliminary watermark so all authorized viewers are aware of its status. An added convenience is the portability of the new system. Authorized clinicians can now securely sign records electronically from home and pull patient records to instantly address emergency calls forwarded from the MPC call center.

The Savings

Delving only into hard dollar savings, actual per line cost and line count, MPC’s average cost per visit dropped $0.53 between 2001 and 2002 1 resulting in an overall savings of 33 percent. Similarly, MPC paid $157,145.00 semi-annually in 2001 and only $112,694.00 during the same period in 2002. Without EMDAT, Midwest Physician Center would have paid $44,450.00 or 39 percent more. (see proceeding chart for detailed information).

* For the purpose of comparison, statistics were recorded for the six-month periods ending July 31, 2001 and 2002.

Midwest Physician Center’s soft dollar savings, including labor force, courier, and facsimile reduction, have further strengthen their bottom line.

The transition from a paper to an electronic workflow has not only cut costs, but has improved productivity, quality, and patient care throughout MPC. With these small but important innovations, Midwest Physician Center has strengthened their commitment to its founding core values of excellence and innovation. Moving forward, MPC will continue monitoring and improving hard and soft-dollar savings in their committment to Total Quality Management.