Email and FTP sites are poor solutions for a transcription process. Email and FTP were designed as transport and storage mechanisms but  increase administration of the transcription process flow. The headaches occur due to accountability. The dictations (voice files) and documents generally must be manually associated and managed with the finished transcription. Additionally emails and FTP sites require special encryption and decryption software in order to be HIPAA compliant which is very difficult to manage.

Emdat gives a receipt code and assigns a TID (transcription identification number) with every dictation (voice file), which continues to associate throughout the transcription workflow even after completion. This process is automated and creates a verifiable audit trail to track receipts, uploads, downloads, edits, autofaxes (successful/unsuccessful), views, electronic signatures, printing, exports and more. The key is to make this process seamless to all involved in the transcription process and provide accountability for quality, timeliness and security. Since autofaxing is a popular and acceptable feature within Emdat there are sites that are availble to make sure you understand HIPAA's stance on this technology.

• Send To A Friend
• Print This Article
• Comments
• Trackbacks

Recently it was brought to my attention that some facilities like to be charged by the page. Although this sounds very attractive at times I truly believe medical transcription companies open themselves up to potential losses by charging in this manner. I have talked to facilities that get charged anywhere from $2 per page to up words of $10 per page. My feelings are that by being too liberal with the definition of a page (not knowing how many lines are transcribed on that page) you potentially set yourself up for unprofitable business. My conversations with a transcription company owner revealed that they were charging $2 per page and that is what the market would bear. Immediately I went into the Emdat reports menu to see how many reports were produced in the past month for that account and then ran a report on how many lines were generated within that month. By dividing the number of reports by the total of number of lines (65 character line with spaces) I figured this company was charging 5.5 cents per line to the facility. Don't let this happen!! Get paid what is a fair wage and give quality work back to the medical facility. Emdat provides many excellent reports within our system to insure that in fact, transcription companies make money so they can stay in business and service medical facilities. Additionally Emdat also provides reports to the medical facilities so that they can substantiate every line with accuracy. In our opinion everyone wins in this situation.

• Send To A Friend
• Print This Article
• Comments (1)
• Trackbacks

Emdat is going to be airing 800+ TV commercials in the Fort Wayne, IN area from May 7th until July 2nd. This will be our first attempt to use Television as a medium for marketing  Emdat's ASP to medical facilities as well as transcription companies. Spot Runner has made this affordable to at least try TV and see what type of response we get. This commercial will be aired on CNBC, CNN, Discovery, Fox News, The Golf Channel, The History Channel, MSNBC, and the Travel Channel. This could be our first and last TV commercial but at least we can play it on this blog and possibly on You Tube. Tell us what you think? Are we all wet?

• Send To A Friend
• Print This Article
• Comments
• Trackbacks

As a service to the medical facilities, Emdat, with very few exceptions, provides interfacing at no charge.  That is not always the case for EMR companies. At times, the costs charged for the EMR side of the interface can be prohibitive to moving forward. This is frustrating not only to transcription companies trying to win the business by providing better service, but also to the medical facilities which would realize  more value with their EMR. HL7 is the most common interface, but generally requires involvement for either the scheduling/demographic interface or textual/discrete interface back into the EMR.

If costs are prohibitive or cooperation is not forthcoming by the EMR software provider, we do have some options which are pretty straightforward and will save on cost. Don't panic - you can still interface to the scheduler to improve accuracy for the transcriptionist, and Emdat will store all transcriptions on our servers for as long as you are a client. Additionally we can bring past historical transcriptions over to the EMR if/when you so desire and are ready.

We continue to strive to provide additional features such as interfacing at little or no costs because or philosophy has always been to treat clients the way you want to be treated. Generally speaking this feature is of big value.  If you are moving forward with  EMR software in the near future, I would ask them about their ability, willingness and costs to interface with their transcription platform provider.

• Send To A Friend
• Print This Article
• Comments
• Trackbacks

For companies that pay attention to progress, every advancement in technology helps streamline an existing process, even if it was once thought it couldn't get any better.  With dictation, cassette tapes were first used to help offload the documentation of patient visits by freeing up some of the provider's time.  As telephone systems became popular, getting these audio files to typists that were off-site became easier, and reduced turnaround time for reports.  The internet had an almost immediate affect on how the dictation and transcription process could be made easier - transcriptions were now able to be transferred back to the physician electronically.  And as digital recorders became popular, physicians were able to use the software that came with these devices to transfer audio to the typists via e-mail or FTP.  But no system was available that really took advantage of every kind of dictation method, while keeping security of the process in mind.

The number of people on the internet has boomed.  Third party research shows high-speed access to the internet increased 40% over the past year, making the internet a viable solution for dictation and transcription.  With typists working at home with a broadband internet connection, instant access to dictation files and completed transcription has become a reality.

But what about all the choices for dictation devices?  Some doctors prefer the freedom that a handheld recorder provides.  Others like the ability to dictate using their telephone, which gets the audio file to the typist even faster, even when away from a computer.  Still others prefer to dictate into a computer, where they can easily reference prior patient records or radiology images while dictating.  The Emdat system takes all of that into account. 

For digital recorders, the Emdat InSync application directly supports many models, from Olympus, Phillips, Grundig, Voice-It and Uher.  Doctors don't even have to touch the computer to upload from these devices - they just dock the recorder and everything works.  Additionally, if a provider has his own preferred recorder, the software that comes with the recorder can still be used to obtain these files and transfer them to Emdat.

For telephone dictation, Emdat has it's own server that can be used, or larger facilities can purchase one to put internally.  Additionally, Emdat has integrated with many other dictation servers, such as DVI, so that we can accept dictations created from these external systems.

In addition to these traditional methods, PDAs have advanced medical documentation and provide a method of integrating a physicians schedule with a dictation device.  Emdat is releasing it's own PDA software this quarter, but also integrates with other vendors that produce audio files via a PDA device.

Finally, the InSync application can be used to directly dictate via the PC, with the audio transferring over the internet to the typist.  Or, if they physician prefers, he can continue to use cassette tapes and send them to the typist - and Emdat will still allow for those typed transcriptions to get back electronically to the medical facility.

In summary, I do not know of any other system which integrates every possible method that a provider may use to dictate, from devices to third-party systems.

• Send To A Friend
• Print This Article
• Comments
• Trackbacks

Although it should be pretty straightforward to estimate your costs for transcription I have found that it has been very difficult to do a direct comparison without validating numbers. To make a complex comparison simple I will only look at billing by the line and not compare that to other methods of billing (page, word etc.). Generally speaking there are three ways to bill by the line. 1) The  standard which is 65 characters per line which will include spaces and punctuation. 2) Basic (Gross) Method which counts each carriage return as a line. 3) Microsoft Word which uses an embedded line word counter similar to the basic method. The differences in costs of these three measures can be as different as an apple to an orange. Let me give you an example....

Emdat, Incorporated

857 Collins Blvd.

Covington, Louisiana 70533

1. AAMT standard calculates this address as 1 line
2. Basic (Gross) calculates this address as 3 lines
3. Word calculates this address as 3 lines

To validate what you are paying per line you first must verify what you are paying for an individual document. Then you should compare the cost of your document to what is being proposed. Only then can you do an apple to apple comparison. "Trust but Verify" was a favorite saying of Ronald Reagan.

I can tell you that I was told by one client that they were paying 12 cents per line. Knowing this was a very competitive price, I wanted to take the conservative route and validate that indeed I could save them money. Once I received copies of 3 transcriptions and analyzed the line counts I was able to compare line counting method with the 65 character standard. According to 65 character standard they were paying 20 cents a line.  Nothing illegal at all in how a line is represented although one method is 60% higher in cost than the other. I know some articles have exposed some fraudulent billing practices but this should not be able to happen if your transcription platform offers excellent reporting tools.

• Send To A Friend
• Print This Article
• Comments
• Trackbacks

Last month, Bob Haugen, Emdat's VP of Sales and Marketing, posted on our blog about "Coopetition".  It took me a while to figure that word out, but it's really a great word when describing our system in relation to other systems at a medical facility.  Some facilities have practice management systems, electronic medical records systems, dictation systems, hospital information systems, radiology systems, etc.  Quite a few of these boast a transcription module to go along with their primary function.  But what does each system have in common?  They all can integrate with Emdat.

Ever since Emdat started, we've prided ourselves on our simple integration strategy.  We developed tools to accept data from other vendor's systems, so that patient demographics, appointment information, and referring physician data can be easily accessed by typists and the medical staff.  We also created methods with which we could interact with EMR systems.  The key to our integration was that we provided most of these interfaces for free.  Since many systems adhere (even loosely) to interfacing standards in the industry, we can easily connect and interact with many systems - in fact, we have yet to meet a system to which we cannot talk.

Many of these systems have their own transcription modules, but none are as full-featured as the Emdat system.  With our ability to accept dictation from so many devices and still deliver an end product seamlessly through our web-based InQuiry work flow application, we look at our transcription offering as the best out there.  But with our ability to integrate with practically any system, we don't see ourselves competing with these systems, but rather complementing them.  Our system *is* the transcription module for your system, if you want it to be.  And with some of these vendors, we've worked hard to integrate more deeply than just a transfer of data. 

Recently, our ShadowLink application took interfacing to a whole new level, providing a more robust communications tool.  With ShadowLink, we've seen interfaces become easier to build, much more reliable, and a breeze to maintain.  But that was just the start...

In 2007, Emdat is focusing further on system integration.  Besides a major update to ShadowLink, we're adding interfacing tools to every part of our system.  In InQuiry, chosen users will be able monitor interfaces.  Through InCommand and Client Maintenance, users will be able to adjust ShadowLink's configurations, and even alter and create new data mappings.  Users will be able to start sending us data and receiving standard transcribed results via ShadowLink with just a few clicks of the mouse.  And ShadowLink itself has many new features, from additional notifications to easier setup.

I plan to use this blog to describe more of the functionality that is planned with ShadowLink and our interface system over the course of the next few months (as well as other development efforts in progress).  Of course, if there are any suggestions for features in this system, we are always listening to your feedback.

• Send To A Friend
• Print This Article
• Comments
• Trackbacks

Steve Jobs, founder of Apple computer, once said, "You can't just ask customers what they want and then try to give that to them. By the time you get it built, they'll want something new."  Nothing has made that more visibly true to Emdat then when we implemented our Feedback system.  Emdat *is* asking our customers what they want, and for the most part are trying to deliver.  That can be a long road, and more ideas will come in while on that road, but we believe it is a road worth traveling.

Emdat is a constantly evolving system.  We originally built the system around the ideas of the three founders, who brought in their experience working at various medical institutions.  But their experiences were one-sided - coming mostly from a technical background.  Steve Palmisano, one of the founders, recognized this early on, and has always kept the User Experience in the foreground of our application development.  Almost no piece of any application goes out the door without Steve (and more recently, Rich and his QA staff) designing and analyzing the user experience.

But they can't think of it all.  Because of that, we instituted an e-mail address, feedback@emdat.com.  If there is anything our software doesn't do, which may be a benefit to your organization or to any other organization, we welcome your suggestions at this address.

To date, Emdat has received hundreds of e-mails at this address.  Soon, a major release of InCommand is scheduled to be released, containing many of the suggestions of our user community.  After this release, we expect InScribe, InQuiry, and another InCommand release to follow.

Development takes time and effort, and Emdat must, of course, weigh the ideas that are sent to us against current development, the needs of the customer, and the likelihood that a feature will be beneficial to other customers or the system in general.  Because of this, some feedback requests get done rather quickly - rolled into a existing release, or one that is currently in development.  Most others, however, go onto a feature list, which is reviewed regularly by our development committee.  It is not our goal to receive feedback, add them to a list, and have them die there - it is our goal to review the list and choose ideas that should go into a new release. 

It takes time to develop a release of software, it is likely any new idea will come in while others are already in development.  However, all ideas are welcome, and some we are internally surprised that we hadn't come up with ourselves!  Emdat's success depends on the success of it's clients (and it's client's clients).  A better product means better productivity for you, and a better solution for us.  Emdat is constantly in development, but that isn't stopping us.  So despite the words of wisdom above, we're asking you today and everyday:  What do you want?

• Send To A Friend
• Print This Article
• Comments
• Trackbacks

Some systems give transcription companies the option of charging for these lines.  Since Transcription Companies pay for the software that generates these lines, they have every right to charge their client for them.  Traditionally, anything on the final report is considered chargeable lines.  In the Emdat system, the transcription company or medical facility (whomever is contracted to use the software) not only have the choice of charging for headers and footers, but also patient demographic labels, clinician titles and credentials, first and last paragraphs of a transcription (if as a template).

The Print Template was first designed by Emdat and uses the technology built into Internet Explorer to allow for variable information before the transcription body and after the transcription body.  Because these variables are populated through setup screens and the transcriptionist doesn't type them, Transcription Companies can use Emdat without any additional expenses and usually save money by using Emdat. 

Medical Facilities are able to dramatically drop the number of lines that are transcribed and therefore dramatically drop their transcription expense each month.  Using Print Templates is a major improvement and cost savings over traditional transcription.  Contact Emdat for more details.

• Send To A Friend
• Print This Article
• Comments
• Trackbacks

Emdat publishes a monthly newsletter. The newsletter contains helpful information regarding the use of Emdat plus uncoming features and applications.

• Send To A Friend
• Print This Article
• Comments
• Trackbacks

For the past 50 years, transcription has been the most efficient means of documenting a patient encounter.  During this time frame, the transcription industry has grown to be a multi-billion dollar industry annually.  Doctors love the convenience of dictating the encounter and the time savings they realize. Administrators frown each time they receive a transcription bill and are constantly trying to find a solution that will dramatically decrease or eliminate their transcription cost.

One popular solution to eliminate or reduce transcription costs is to implement an EMR type of system. The system allows clinicians or their staff to document the patient encounter on-line, thereby eliminating or drastically reducing the need for transcription. In a recent article titled “Transcription’s Coopetition with EMR’s”  by Bob Haugen, Vice President of Sales and Marketing for Emdat, Inc., he explains the problems associated with such an approach. These problems result in loss of revenue for the health care facility.

An approach that can drastically reduce transcription expenses while at the same time, allowing clinicians to document encounters using dictation is called “Structured Templates”. This approach, similar to an EMR approach, uses templates that clinicians use while dictating. Instead of a clinician or staff person using the templates on-line as they would in an EMR system, the Structured Templates are dictation templates that allow the clinician to spend less time dictating and the transcriptionist less time transcribing. The result is a win-win.

The clinician chooses from a library of specialty specific transcription templates and makes these templates their own by editing or changing them. The template should include as much pre-defined text as possible to reduce the time of dictation. The clinicians simply dictate the blanks or dictates free text that is required to complete the template. The new part of this process is that the health care facility pays a reduced price for template lines (usually 50% of the transcribed price) and pays the full transcription fee for lines that are typed by the transcriptionist..

In the end, the transcriptionist, Transcription Company and medical facility experience a win. This can be done without negatively impacting the productivity of clinicians. In fact, in most cases, it will impact productivity in a positive manner.

• Send To A Friend
• Print This Article
• Comments
• Trackbacks

EMRs have been around for some 20 plus years and in that time frame, have slowly been adopted by more and more medical facilities.  Many go into the implementation phase of an EMR based upon the  information received from their EMR vendor during the sales process.  Eliminating transcription is the number one cost justification for purchasing an EMR.  EMR vendors know this is a thorn in the side of medical facilities and any system that can reduce or eliminate transcription would be widely received.  The theory is a sound one.  Take a clinician who dictates and utilizes a transcription service and eliminate that monthly transcription expense by having the doctor use a template on-line within the EMR.  Immediately, the savings are realized in the elimination of transcription expenses.  Administrators rejoice because this was one of the major reasons they elected to implement an EMR.

Within one to two weeks after implementing the EMR and its template features, clinicians are upset because they have increased their time in the office by 15-20%.  At this point, either 1 or 2 things happen:

1. The clinician begins to rely on support staff to document a patient encounter by having them enter template information into the EMR system. (this assumes the support staff has the time to take on a new responsibility)
2. The clinician instructs the scheduling personnel to adjust his or her schedule either by reducing the number of patients seen or by increasing the visit time allocated for particular appointment types.  Either way, the result is less patients seen.

Above, in the first scenario, the cost of transcription is simply shifted internally to a staff person who is probably paid more that a transcriptionist and eventually, either new staff is budgeted or the original duties maintained by the staff person begin to suffer.  In the end, the result becomes a shift of work from a lower paid transcriptionist to a higher paid internal staff person.  The first scenario can be successful if your medical facility is over staffed and staff personnel have the time to take on additional responsibilities.  The bottom line is additional monthly expenses since over staffing is simply an administrative problem in itself that can be dealt with to eliminate expenses.

In the second scenario, the doctor, after a few weeks of putting in the extra time to make the system workable, adjusts his or her schedule so that they can see patients and have time to document their encounter.  The end result is obvious; lower production thus leading to lower revenue numbers.

One to two months later, the same administrator who championed the EMR system is looking at revenue reports and realizes the numbers are down.  This usually happens over the course of the first 3 months after clinician templates are utilized on an EMR system instead of dictation and transcription.  After some research and speaking with the clinicians, the administrators learn that the clinicians are seeing less patients. 

The bottom line is that a transcriptionist expenses, although a necessary evil in most administrators eyes, are in fact the least expensive way to document patient encounters.  A doctor seeing 25 patients may pay on average $100 per day for transcription ($4 per transcript).   If a clinician sees 2 less patients per day, the production revenue will drop by $300 per day.  The result is a $200 revenue loss per day.

Having all patient information in one system is important especially when an EMR is being used.  Administrators can rest easily knowing the systems are out there that integrate with EMR systems so that all transcribed notes are entered into the EMR system and readily available.  In some systems including the Emdat solution, a doctor dictates in the traditional sense, but the transcription actually populates the EMR as if the doctor were doing on-line templates themselves.  This solution is one whereby discrete data for each major heading in a transcription (HPI, Medications, etc) transfer to the EMR system and populate the discrete fields within an EMR.  This type of transfer allows clinicians and administrators alike the ability to search and data mine within the EMR on information contained within the transcribed document.

I believe that EMRs are the future but I believe they are the future because of what they bring to health care, not the savings they bring in the form of transcription elimination.  The EMR is a one stop system whereby all patient information is available, regardless of the source.  Justifying an EMR should not be done at the expense of transcription.  Doing so usually correlates to a decrease in production by your clinicians.  An EMR is a capital expense and the Return On Investment (ROI) should be based upon improvements in the patient care process, not the reduction of the easiest and most cost effective documentation process, transcription.

• Send To A Friend
• Print This Article
• Comments
• Trackbacks

For Immediate Release

January XX, 2007

EMDAT Selects M*Modal to Provide

Speech Recognition to It’s Customers

Integrated Speech Understanding Improves Productivity and Operational Efficiencies in Medical Dictation & Transcription Processes

PITTSBURGH, PA, January XX, 2007 – Emdat, Inc. a leading national provider of transcription work flow and management solution M*Modal, a leader in on-demand, speech understanding services, have entered into an agreement that is expected to elevate Emdat’s competitiveness in the marketplace. This partnership leads to an integration of M*Modal’s proprietary speech understanding technology into Emdat’s hosted medical transcription platform and will enable Emdat to provide its clients with the leading edge transcription technology that covers the entire cycle of health care documentation – from capture of physician dictation to publishing of final medical reports.

Emdat is pleased to offer the AnyModal CDS product to their ever expanding dictation and transcription business. Steve Palmisano, CEO of Emdat says, “M*Modal’s AnyModal CDS complements the Emdat process because physicians can be added at anytime and do not need to be aware that speech understanding technology is being used in the transcription process. Due to the fact that over 32,000 clinicians and over 1,300 medical facilities currently use Emdat we had to be very careful in our choice for the best available speech understanding technology.”

Emdat’s platform used for dictation and transcription will integrate M*Modal’s back end speech technology that will be incorporated into the transcription work flow process. The new process requires no physician participation or training. The new tool empowers physicians to capture medical facts and orders from dictation, without requiring any change to their normal documentation routine. Our feeling is that a significant percentage of the 7,000 transcriptionists using our system will transition into an editor’s role when speech understanding is deployed. Palmisano says, “We choose M*Modal because everything we do needs to have a positive effect in productivity, quality or cost - and this appears to be a home run.”

Michael Finke, Chairman, CEO and founder of M*Modal comments, “Our relationship with Emdat expands the reach of AnyModal CDS, making it available to hundreds of transcription service providers and health care organization who use Emdat’s hosted transcription platform. Our objective is to provide these organizations with the best available speech recognition based technology that is fully integrated into their work flow, transparent to the speaker and that transforms the clinical documentation process. The result is a combined solution from Emdat which without requiring any change to the physician’s work flow or dictation routine and makes the process of medical transcription significantly more efficient - while also delivering documents which capture the narrative along with the clinical facts contained therein in structured and encoded form.”

About Emdat

Emdat’s dictation and transcription platform, based on an ASP model, is being used by over 130 transcription companies. Emdat was architected to improve the process flow of dictation and transcription by using a suite of web based applications. These applications are used by physicians, transcription companies, transcriptionists and medical facilities to better manage work flow. Emdat helps facilities reduce costs, meet HIPAA requirements and improve productivity by providing electronic access 24/7 from anywhere. Emdat is based out of Chicago, IL.

For more information, please contact bh@emdat.com or 1-866-GO EMDAT. www.emdat.com.

About M*Modal

M*Modal offers on-demand conversational documentation services (CDS) that help health care providers to capture discrete clinical information from dictation to generate complete and timely electronic medical records. The company’s unique speech recognition and understanding technology platform, AnyModal CDS, is a vital tool that empowers physicians to capture clinical facts and orders from dictation without requiring any change to their normal dictation routine. M*Modal's focus is on providing hospitals, MTSO’s and HIM companies with the industry's most comprehensive yet most adaptable solution for creating highly accurate, structured, encoded and shareable medical documents to increase patient safety, promote continuity of patient care, and reduce cost. For more information, please visit www.mmodal.com.

• Send To A Friend
• Print This Article
• Comments
• Trackbacks

Emdat is proud to announce that development on our new PDA dictation application, "Emdat Mobile", is nearing completion and will be in beta in March.  Physicians with a PDA will be able to:

• Use their PDA to access their daily schedule
• Dictate against any patient
• Review prior transcription for patients on their schedule

In a recent artcle titled  "Affordable technology solutions for today’s busy practices", Shelly K. Schwartz of Cunningham Group identifies PDA devides as the wave of the future for the medical industry.

For more information on our PDA product, see the new Emdat Mobile link on our software page.  To participate in the beta, please drop us an e-mail at: beta@emdat.com.

• Send To A Friend
• Print This Article
• Comments
• Trackbacks