MT India Newsletter - http://groups.yahoo.com/group/MTIndia

04 Jan 2003

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Analyzing Quality Control (part III)
~Suresh Gonsalves

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ANNOUNCEMENT
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A happy New Year 2003 to all!

The MTIndia Team
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Dear Friends,

This is a continuation from Suresh's article, published in the last
issue. To read earlier MT India Newsletters, see the archives at:
http://groups.yahoo.com/group/MTIndia

Enjoy !
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Continued from last issue...

The detailed method of evaluation is a comprehensive and objective
line-by-line review of each page in the sample. All the errors are
then marked on printed copies of the documents, and a detailed
evaluation sheet is filled out for each sample batch. The document
copies and evaluation sheet are then subsequently returned to the
medical transcriptionist along with any pertinent comments and
suggestions by the transcription supervisor who conducts the
evaluations. The evaluation sheet lists the number of errors in
each of the six categories, each with a point rating. There could
be several different categories and several different point ratings
of the different errors based on the types and the gravity of the
errors. Blatant errors, careless errors, repetitive errors, and
tiny errors could be further classified into major error, minor
errors, grammar errors, major English word errors, Americanism
errors, and punctuation errors and could all be given a different
scale of weightage. The biggest and most blatant of these errors
where the medical transcriptionist leaves out an entire sentence or
transcribes complete nonsense having no significance whatsoever to
the body of the report or the case history of the patient should be
classified as a weighted comprehension error where a massive chunk
of points should be cut, e.g.: 2, 2.5, 3, 3.5, or even 4, depending
on the gravity of the error committed and the policy of that
quality assurance department. This would certainly help in
curtailing such indescribable or blatantly irresponsible errors in
the future and would act as a deterrent to the medical
transcriptionist as he or she knows that he/she will be severely
penalized on these kind of errors which would ultimately affect
his/her salary package for that month.

To encourage improved performance in both quantity and quality, one
can introduce an exclusive incentive pay program for the medical
transcriptionist's position as part of the compensation package.
To discourage any temptation to sacrifice quality in favor of
quantity, one can introduce a rider or clause of meeting the
minimum standard for quality as an essential prerequisite for
participation. The implementation of applicable performance
standards will enabled the management to be much more objective in
evaluating employee performance and in the medical
transcriptionist's responses to fluctuations in workload.

The ideal characteristics of quality patient care documentation as
they relate to the transcription process include that all
all required, desired, and relevant information be documented.
All information should be consistent within each report and with
the remainder of the patient record. The information should be
such that it is readily understood for patient care, reimbursement,
statistical, research, and legal purposes. The entire
documentation is accurate in content and presentation. The
complete documentation should be dictated, transcribed,
authenticated, and incorporated into the patient record in a timely
manner. The documentation system should provide realistic means
for achieving quality, including appropriate opportunities and
methods of corrections. The patient's rights to confidentiality
and privacy should be protected throughout the documentation
process. The report should be well organized and succinct. The
report should reflect a commitment to professionalism and quality.
The report should demonstrate appropriate use of references and
other resources necessary to prepare a high-quality document. The
report should effectively document patient care. The report should
demonstrate continuing efforts to improve the process and content
of patient care documentation.

When it is recognized that a quality and productivity standard must
be implemented, the medical transcriptionists should be fully and
wholly involved in the process. Medical transcriptionists do have
an integral knowledge of what is going on around them, what exactly
is affecting quality and productivity, and they can give several
valuable inputs in developing the standard. Most medical
transcriptionists would welcome a fair and equitable standard, one
that reflects professionalism, the particular work environment,
characteristics, and expertise. Developing a standard and then
trying to implement it without having the input from the people it
is going to affect most is a grave and serious error. Not only
will morale suffer, but quality and productivity which are the very
goals sought will also suffer.

Medical transcriptionists can help develop a quality program
through suggestions and in-house programs with discussions on
appropriate transcription practices, practical and acceptable
alternatives, and problem areas. Positive communication between
medical transcriptionists and their supervisors/managers is
essential when decisions have to be made that will affect a work
standard. Implementing a new standard or making needed changes in
an established standard takes time. The time required to make
changes will depend on the extent of those changes. If the
transcription department has never had a quality control program,
some medical transcriptionists may have acquired bad habits and
inconsistencies that have never been brought to their attention.
If the supervisor is not a medical transcriptionist, he/she must
become knowledgeable about medical transcription and be fully aware
of the characteristics particular to that department or
institution. The requirement that changes be made overnight in the
quality of transcription is unrealistic and unnecessary. Medical
transcriptionists and their supervisors should work together to set
fair and mutually agreed upon goals. Issues can be addressed in
in-house or group discussions, and reasonable time frames set for
the transcriptionists to make needed changes. Providing
continuing education opportunities on a regular basis will enhance
the quality and productivity of the medical transcriptionists a
great deal and enhance their morale and well-being.

The search for a perfect quality and productivity standard will
probably continue for a long time. There are no easy answers, but
there are suggestions on making the process easier and yet tailored
to the specific transcription department or institution or
organization. Although the process may take some time, the end
result will be a standard for quality and productivity that will be
efficient for both the employer and the medical transcriptionist.

concluded....
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Cheers, and Happy New Year - 2003 !!!

Maj (Dr.) Amit Chatterjee, SM
Strategist / Founder ~ mailto:amit@...
MT India ~ www.MTIndia.org
"The Community of MT Professionals"

"It takes years to become an overnight success."

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NEWS AND VIEWS :
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1) Apollo to tap $ 250 billion BPO market

Apollo International Health Services of the Apollo Group of
Hospitals is aiming at tapping the huge potential of medical
Business Process Outsourcing (BPO) market. For this purpose, the
Apollo Group has entered into a partnership with two global players
in healthcare, Health Services America, a chain of hospitals, and
Medstaff International, an insurance company, US. According to
sources in Apollo, the two institutions will outsource to Apollo
hospital activities like billing, documentation of clinical and
administrative records and coding the innumerable medical process.
The main objective of outsourcing their activities is to cut cost.

According to the source the BPO market is huge estimated at US $
250 billion. India has an excellent opportunity to have a major
share of this market because of its IT capabilities and economical
costs. Apollo Hospitals expects to tap a significant share of this
business.

The remote IT enabled services division of Apollo Health Services
Ltd is a business process solution and service provider that aims
at helping healthcare providers save time and money by taking over
their non-core activities like billing, coding, etc.

http://www.expresshealthcaremgmt.com/20020930/hyderabad1.shtml

2) World Infotech Launches Three Products For Doctors

World Infotech Private Limited, an IT Enabled Service provider in
the areas of medical transcription and records management, has
launched three new products for the medical fraternity. World
Infotech's managing director Ramakrishna Tummala said, "Having
gained experience in the medical transcription area for the last
three years, the company decided to become a one-stop-shop for the
customers by providing various back-office services."

In order to meet the entire requirements of the doctors in the US,
the company has developed three new products - MTanywhere,
MRanywhere and Imagemate - which would serve the necessary
back-office services to the doctors, he said. MTanywhere is an easy
to use web-based platform for secure exchange of dictation and
transcripts, offering a virtual facility to transcriptionists,
service providers and physicians. It also eliminates hassles such
as running back and forth from physicians offices and transcription
units, monitoring line counts, generating invoices, providing
electronic storage of data and continuous update of file status.

MRanywhere enables doctors to maintain a paperless office and view
patients' records in a digitised format.
The third software product - Imagemate would help in complete image
acquisition from video display and help in making customised
reports.

http://www.financialexpress.com/fe_full_story.php?content_id=24962

3) Temptingly empty?

Sections of the Indian IT industry are viewing healthcare in the US
with interest. A $1.3 to $1.4 trillion industry worldwide,
healthcare is the largest expense sector in the US with around
13-14 per cent of GDP going into it. The market is seen as ripe for
automation with its strong integration into the insurance and the
HIPAA (Health Insurance Accountability and Portability Act) coming
into force.

Indian companies predict that it is a potential boom area, likening
the mandatory HIPAA regulations to the Y2K opportunity two years
ago. In practical terms, however, the sector has not really
outsourced much business to India.

"The healthcare sector does not have the global perspective of
those, say in the finance industry," explains Massachusetts General
Hospital's Dr Sanjay Saini. MGH has just started converting a pilot
project to outsource its radiology reading to Wipro Healthcare in
Bangalore into a confirmed order. If other hospitals see MGH doing
it, maybe they too will look at outsourcing, Dr Saini opines.

The medical transcription industry in the country did nothing to
help the situation. The medical community associates India with the
large number of MT players doing low-quality work, says Dr Salam.
Most of those who damaged the image are not around today, he says.

http://in.biz.yahoo.com/021231/17/1zmql.html

4) Transcend gets delisting notification

Transcend Services Inc. which provides medical transcription
services to the health-care industry, could be delisted from the
Nasdaq SmallCap Market.

The company reported stockholders' equity of $2.26 million its
quarterly report for the period ended September 30, 2002 that was
filed with the Securities and Exchange Commission on Oct. 25, 2002.

On Nov. 11, the company submitted a written plan to achieve and
maintain compliance with the minimum stockholders' equity
requirement. In its letter dated December 23, the Nasdaq staff
"rejected the substance of and the time frame for implementing the
compliance plan."

Transcend's home-based medical transcription professionals document
patient care by converting physicians' voice recordings into
electronic medical record documents.

http://atlanta.bizjournals.com/atlanta/stories/2002/12/23/daily12.h
tml

5) Industry cautious, not worried by New Jersey Bill

In an attempt to create more jobs for native Americans and
discourage outsourcing to foreign countries (India included), the
New Jersey Senate in the US has approved a bill to ban companies
that take government contracts to move their call centres abroad
for cheap labor. However, the bill passed in the state of New
Jersey banning the outsourcing of government projects would not
affect Indian the BPO industry in more than any way. One, the total
government business from the US is about two percent to three
percent and two, the Bill is being passed in one state only. The
Bill has to go the Legislative Assembly to become a law.

Said Kiran Karnik, President, Nasscom, "This Bill in particular is
not going to impact Indian BPO industry in any way. But we also
cannot afford to sit back and relax. We have to act and do it in a
diplomatic manner since there is an emotional issue involved."

http://www.ciol.com/content/news/repts/102122405.asp

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The MTIndia Team
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