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Taming Transcription: A Physician’s Saga
By David Boisoneau, MD

I decided to automate my transcription workflow when I discovered that my trusted transcription service had been, to put it politely, “padding” the bill for more than two years. When I sat down to study the problem, I discovered that the “padding” was just the tip of the iceberg. My transcription process had been devouring exorbitant amounts of time, money, and staff energy.

The process that turns dictation into a transcribed document is seemingly easy, but if it’s not carefully controlled from the beginning, it can go drastically astray. The danger lies in the movement of the files from one stage of the process to the next. In this uncharted space, without a proper tracking mechanism, time slows down and files get lost, rerouted, or, worst of all, misfiled. Additional dangers lie in antiquated recording devices and transcription errors. The result is that this apparently straightforward workflow process becomes chaotic, inaccurate, and costly. Although some of these problems can be temporarily solved, a manual process still leaks valuable resources throughout its entire life cycle. By automating my transcription workflow, I successfully plugged the leaks and implemented a series of checks and balances that track the movement of files from beginning to end.

To start with, I now dictate into an intelligent, handheld device that displays all my patient appointments for the day. The device’s touch screen allows me to touch a name to record a dictation for that patient. It tracks which patients I’ve dictated for, and it represents them visually on screen. It even sends the patient demographic data to the transcriptionists automatically, so I don’t have to spend time dictating patient names, date of birth, and date of service.

Additionally, the device sends the dictations to my transcription service wirelessly as soon as I’m finished. No more docking a digital voice recorder or waiting for a service to pick up tapes. Just 24 hours later, the transcriptions are automatically filed away in the correct patients’ charts in my hybrid electronic medical record system—I even get an alert message notifying me that they’re there.

The icing on the cake? I have a real-time transcription reconciliation report that’s available at the click of a button. I can see, within seconds, exactly where every dictation I’ve made is within the transcription process.

The results have been exciting. My dictation device is easy to use, and having the transcripts filed electronically has eliminated the stacks of documents my staff had to file. The hybrid electronic medical record system has saved us so much time every day that my colleagues and I are now free to direct our energy toward productive patient-focused endeavors. Best of all, I am in total control of my transcription workflow. The peace of mind that offers is wonderful.

David Boisoneau, MD, is a physician/partner at Ear, Nose & Throat Associates of Southeastern Connecticut, PC, www.entofsect.com.