Transforming Transcription “Confessions of a CEO”

Introduction

We are in the midst of arguably the most significant healthcare reform in our nation’s history.  Although our legislative leaders are still shaping and debating the final changes, it is certain that healthcare executives are going to receive less money to care for a growing number of patients.  This will require us to “transform” operations across every aspect of care delivery to accomplish the cost savings necessary for future success. 

“Confessions of a CEO”

When you are the CEO you are suppose to know everything right?  Here is an honest confession from someone who has been in the C-Suite for many years.  We don’t know everything! This is illustrated clearly if you take the responsibility for approving invoices for your facility.  I noticed during a recent sign off session that my organization had 4 different outsourced transcription companies with 4 different rates per line.  While being asked to approve these invoices I could only verify 3 things. Did I recognize the name of the company? Did the per line charge match our contract? Was the amount similar to previous months? Beyond that, it was impossible for me to verify the number of lines, how those lines were produced, (typed or speech recognition) and if I was being billed only for visible black characters (VBCs) or for template work.  Whether you outsource or continue to employ your own transcriptionists, the following are my recommendations for transforming transcription.

Transforming Transcription

This document is not designed to make a case for in-sourcing or outsourcing transcription services.  There is no universal answer to that business question because of all of the variables such as size of community, volume of work, availability of transcriptionists, physician acceptance and local politics to name a few.  My transformation advice is whatever you do; design a system that is efficient, timely, production based with a data base and reports management process that YOU control.  The essence of such a system is having control of a transcription platform that provides for speech recognition, accurate monitoring of volumes based on VBCs, sophisticated report generation and the ability to establish a production based workforce. 

Employed Transcriptionist Model

If you choose to continue to employ transcriptionists there are a few suggestions to maximize the advantages of such a system. Convert the transcriptionists from hourly employees to production based employees and allow them to work at home.  This will maximize employee productivity and create valuable space in the hospital that can be used for other purposes.  In the event that your facility is part of a system, you can create your own transcriptionist pool that can share work across all facilities. Deploy a system that allows you to track your own volume data by hospital or across a system. 

Outsourced Transcription Model

If you choose to outsource the transcription process, consolidate to one vendor, look to companies with a track record of excellent quality and turnaround times and require them to utilize the hospital based platform that you control.  If you possess the backbone infrastructure that provides accountability, you are in charge of a process that is vendor neutral and lowers your costs.

How are Costs Reduced and by What Percentage

By controlling your own platform, you can lower your costs in several ways. If you have a system that identifies VBCs you can reduce your costs by not paying for template work.  This creates cost saving regardless of whether you employ your own transcriptionist or outsource.  Additional cost savings are realized by allowing the hospital to gain the financial advantages of using a speech recognition system. This places the transcriptionists in an edit mode rather than total document creation on the dictation that qualifies, thus reducing costs. Typical costs savings of 20% or more from current spending levels can be achieved by transforming your transcription system and taking control of the accountability process. Costs saving calculators are available to estimate your specific cost savings based on your current fees and volumes.

Summary

Healthcare executives have not only extracted the “low hanging fruit” cost reduction opportunities in their organizations but have already climbed high into the tree to accomplish more difficult savings.  This process sometimes leaves us scratching our head in regards to how the necessary cost savings to support health care reform will be accomplished. In order to be successful in the future we must think differently than we have before and truly lead transformation initiatives across every aspect of care and service deliver.  Transcription is an area where such transformation can be accomplished. By demonstrating success in this area through the implementation of an accountability platform that hospitals control, healthcare executives can apply that same line of reasoning to other aspects of their care delivery system.

About the Author:

Kevin Shrake is a 35 year veteran of healthcare whose career has spanned from Registered Respiratory Therapist to CEO in some of the largest healthcare organizations in the country.  He has been a trusted advisor to many health care executive colleagues across the country and assists facilities of all sizes and configuration in margin development initiatives. Mr. Shrake holds a Masters Degree in Health Administration from the University of Illinois and is board certified as a Fellow in the American College of Healthcare Executives. He currently serves as the Executive Vice President and Chief Operating Officer of M*D Resources, Inc. based in Fresno, California.

Kevin Shrake is an experienced Health Care CEO .  He is a Fellow in the American College of Healthcare Executives as well as an accomplished author and public speaker.  He currently serves as the Executive Vice President and Chief Operating Officer of M*D Resources, Inc. based in Fresno, California.