Medical Scribes Role in Transcription Industry

The medical transcription invoice funding specialists recently stumbled upon an “Open Letter Series” written by AHDI’s 2011 Director, Kristen Hagen, discussing the role of medical scribes in the healthcare documentation industry.

Even though, Ms. Hagen wrote the Let’s Talk About…Medical Scribes Open Letter in February, the information within it is still very relevant for our medical transcription factoring blog readers. Here are some tidbits of information we wanted to highlight:

What is the background of a medical scribe?
“Today scribes are commonly referred to as Clinical Information Managers. The primary function of a scribe is the creation and maintenance of the patient’s medical record, which is created under the supervision of the attending physician. The scribe documents the patient’s history and story through direct observation of the physician’s interaction with the patient as well as the procedures performed, the results of the laboratory studies, and the other ancillary information gathered at the point of care…The demand has traditionally been filled with eager pre-medical students, learning first-hand about the workflow patterns and patient care they will deliver in the future.”

What are the skill set requirements and training required to become a medical scribe?
“Medical scribes may be trained on site or through affordable online distance education programs. Skill sets include strong English grammar, a compelling interest in healthcare and  patient improvement, a strong desire to work in a clinical setting, superior analytical and resource skills, understanding and training in enabling technologies…an understanding of information workflow, attention to detail, keen listening skills, and strong multi-tasking abilities…Scribes are also expected to be well-versed in HIPAA and regulatory compliance, and like MTs, scribes have a steep learning curve, with clinical shadowing required in the post training phase.”

Could this be a stepping stone for medical transcriptionists and others in the medical transcription field? Is this an alternate career path for medical transcriptionists?
“There are similarities and distinct differences between medical transcriptionist and medical scribes, as are there in comparing these roles with any other health information management role…Healthcare will need professionals who have flexible resume of contributory skills applicable to an EHR-centric documentation setting. Scribing is a potential alternate documentation setting for medical transcriptionists.”

Ms. Hagen’s two-cents:
“I can tell you that transcribing and scribing are neither competing nor complementary. They are quite unique, with some overlapping fundamental training but with divergent connection to technology and practical application. They are simply two of the many current and evolving roles available for those who seek career in the documentation of healthcare encounters.”

Q: What do you think about the medical scribe industry?

AAPC Launches ICD-10 Resource Site

According to the ADVANCE Perspective HIM Blog, the American Academy of Professional Coders, a trade association dedicated to serving the medical coding industry, recently created an ICD-10 resource site in preparation for the government’s mandated ICD-10 changeover in October 2013.

ICD-10 is expected to affect all heathcare professionals, not just the administrative medical coders and medical billing staff.

Among the key features include:

  • An ICD-10 code conversion tool allowing users to translate an ICD-9 code to ICD-10 instantly;
  • ICD-10 news and articles from industry experts helping prepare for implementation;
  • Two interactive floor plan tools that show how ICD-10 affects all aspects of a practice or health plan; and
  • An online application used to track and graphically measure the ICD-10 implementation progress.

For further information about ICD-10 implementation, please visit the AAPC ICD-10 site.

Recent Study Says Healthcare Employment Showing Significant Growth

Did anyone else see NursingCorp’s February eNewsletter? In it, the Caracci’s discussed the State of Healthcare Employment based on a recent study released by the Altarum Institute’s Center for Studying Health Spending. Here are some of the study’s key findings:

  • In 2007, private sector healthcare employment was 9.5 percent of the total US employment. In 2011, it increased to 10.7 percent.
  • From 2007-2011, non-healthcare jobs have decreased 6.8 percent, while healthcare employment increased 6.3 percent.
  • Currently, 34 percent of all healthcare employment is taking place in the hospital setting, 22 percent in nursing and residential care facilities, 17 percent in physician’s offices and 19 percent in the outpatient setting.

HCA Announced Internal Reorganization

On Friday, February 11, Nashville-based HCA announced an immediate “internal reorganization” to “better align the company’s structure with the future dynamics of the healthcare industry.”

Some of the changes include:

  • Creation of a new subsidiary that will provide business services to other healthcare companies;
  • New structuring of provider operations;
  • Integration of quality performance with physician practice services;
  • R. Milton Johnson has been named president of HCA, while also retaining his title and responsibilities of CFO;
  • Beverly B. Wallace, who was the president of HCA’s Shared Services Group, is president of a wholly-owned subsidiary that will provide revenue cycle, staffing services and supply chain management to other healthcare providers

Click here to read more about HCA’s management changes.

Changing EHR Market is Wreaking Havoc on Vendors’ Cash Flow

Advance Perspective’s HIM Blog recently re-posted a blog post by Don Fornes of EHR Software Advice, in which he discussed the ever-changing eletronic health record (EHR) market and how it’s impacting vendors’ cash flow. The medical transcription factoring specialists and medical billing and coding invoice funding specialists at PRN Funding took the liberty of summarizing the bulk of the post below:

In a nutshell, Fornes’ article talked about how most people would think that the Federal subsidies for EHR implementation would create a massive boom for EHR software industry, however, this concept couldn’t be further from the truth. Based on the data points that Fornes has observed over the past few months, he thinks that most EHR software vendors are actually experiencing a cash flow crunch.

According to Fornes, these EHR software vendors have been pouring cash into marketing and brand awareness initiatives to remain top-of-mind for physicians’ practices and medical facilities, however, most providers have taken a “wait-and-see” approach to EHR adoption.

Couple these two scenarios with the increasing shift for the software industry as a whole to shift to cloud computing because of low monthly pricing.

As a result of EHR vendors investing a lot of money into their business expansion, providers writing fewer checks than anticipated and the checks that are written are much smaller and more spread out, a difficult cash flow scenario has been playing out for a number of vendors. Fornes commented how he’s seen “some EHR vendors stretching their payables out 90 or even 120 days.”

Overall, it was a very informative article, however, what Fornes left out what that EHR vendors have the ability to drastically improve their cash flow by factoring their invoices. For example, an EHR vendor could sell its invoices to PRN Funding and receive cash the same day.

Click here to read Fornes’ original blog post.

Hospitals See Specialty Nurse Shortages

It’s no secret that the United States is on the cusp of a nationwide nurse shortage as baby boomers continue to age and need more medical care. In fact, the Journal of the American Medical Association projects the RN shortage to hit 400,000 by 2020.

The nurse staffing factoring specialists at PRN Funding have blogged about how nurse staffing agency owners can and should take advantage of this shortage by filling open positions before, however, we found a recent article stating that facilities don’t just need RNs. They need specialty nurses too.

The article, Nationwide Shortage of Nurses Hits Local Hospital in Specialty Health Care Departments, talks about nurse shortages specifically in cardiology and pediatrics. Specifically, the medical facility has been trying for two years to fill the catheter lab nurse position.

For nurse staffing business owners, this would be a great opportunity to get your foot in the door at a facility.

PRN Funding helps provide reliable nurse staffing funding solutions for your agency. Learn more about our nurse staffing factoring solutions today.

Health.com’s Top 10 Careers with High Rates of Depression

Health.com recently released the results of a study that ranked personal care providers as having the number one career that’s linked to bouts of depression. Nearly 11 percent of the people working in this field reported a major bout of depression.

Specifically, Health.com posted this about the caregiver career:

A typical day can include feeding, bathing, and caring for others who are “often incapable of expressing gratitude or appreciation…because they are too ill or too young or they just aren’t in the habit of it,” says Christopher Willard, clinical psychologist at Tufts University and author of Child’s Mind.

“It is stressful, seeing people sick and not getting a lot of positive reinforcement.”

Here is the Top 10 list of careers with high rates of depression:

  1. Personal care providers
  2. Food service staff
  3. Social workers
  4. Healthcare workers
  5. Artists, entertainers, and writers
  6. Teachers
  7. Administrative support staff
  8. Maintenance workers and groundskeepers
  9. Financial advisors and accountants
  10. Salespeople

Click here to read the entire article: 10 Careers with High Rates of Depression

How Medical Facilities Can Establish Reality-Based Turnaround Times

“When it comes to establishing realistic turnaround-time (TATs), clearly defined expectations are crucial.” That’s the mantra of Elizabeth S. Roop’s article in the November 22 edition of For the Record Magazine. Her article discusses the importance for medical transcription service organizations (MTSOs) to achieve an appropriate balance between speed, quality and consistency with their TAT service-level agreements.

Ms. Roop points out a number of things for medical providers to consider when contracting with an outsourced medical transcription vendor, namely:

  1. High quality, ability to meet TATs and affordability are all pieces of the same triangle. Skimping on any of the three will affect the triangle’s properties. For example, if a hospital demands an MTSO have produce high quality and high speed records, then it must be willing to pay a high premium for those services.
  2. Be sure to take into account any unique medical facility characteristics (i.e. type of records, frequency, required skill levels,  etc.).
  3. Prepare and negotiate ahead of time to handle staffing fluctuations and possible overflow situations. Two scenarios where volume fluctuations are hard for MTSOs absorb are: (1) When a hospital chooses to outsource all of its medical transcription, leaving no in-house staff to pick up the slack; and (2) When a hospital uses an MTSO to supplement in-house overflow. (NOTE: Keep in mind, in either of these situations, an MTSOs cash flow can dramatically change. Receivables can take longer to come in even though the work levels are increasing. One way to counter this situation is to use a medical transcription factoring firm.)
  4. Busy clinicians can also alter turnaround times. It’s important for medical facilities to establish proactive relationships with their clinicians to help avoid nasty surprises and ensure that clinicians are aware of how the quality and timeliness of their dictation impacts the speed with which they receive reports.

In addition to the author’s suggestions, medical transcription industry experts suggest the following tips on how to manage TAT:

  1. Establish whether medical transcription work can be outsourced offshore and make any necessary accommodations to ensure TAT can be met if it will not be.
  2. Clearly define penalties for nonperformance  as well as any “cure” period during which service can be brought back up to par. Also consider specific rewards for outstanding performance.
  3. Conduct due diligence, including checking MTSO references with case mix and TATs similar to what will be expected.
  4. Select an MTSO appropriately sized for the expected demand and ensure it has the resources to handle fluctuations.

Mobile Dictation Tools Gaining Ground in Healthcare

Robert N. Mitchell wrote an interesting article in the November 8th edition of For the Record Magazine in which he discussed the rise of mobile dictation in the healthcare industry.

With the government urging HIT adoption, there’s been a gradual change in physician documentation habits. Moreover, physicians are being asked more frequently to use electronic health records (EHR) instead of narrative dictation to dictate. However, using an EHR takes twice as long to accomplish because physicians have to “leave the exam room, find a computer, log in to it, load an application, search for the patient, find a template, fill out the template–all the while hoping that the template covers all the information that has to be documented.”

Some physicians combat the lag time by taking notes and entering all of the day’s the information into EHRs at the end of the day. However, when this is done from memory, it increases the risk of incomplete or inaccurate EHRs. Enter mobile dictation apps.

Good Shepherd Medical Center (Longview, TX) recently developed an iPhone app for its physicians to view patients’ clinical and demographic information. Using the app allows doctors to “see which patients need attention and to view lab values, medication lists and radiology reports” all from their smart phone.

3M Health Information Systems developed a mobile app that interfaces with scheduling systems and patient admissions, discharge and transfer systems. Doctors can use their app to “dictate notes, view patient lists…and access current patient information.” In addition, 3M’s app allows physicians to dictate directly into a smartphone during a patient encounter. The completed dictation is then automatically sent for speech recognition and then into the medical transcription system.

Emdat has also developed an app that allow doctors to download their patient schedule and record their dictation directly into an iPhone and/or Windows Mobile platforms. In addition, physicians can review the completed dictation and use electronic signatures from their mobile devices.

Finally, BayScribe has developed mobile dictation apps for the iPhone (both 3 and 4), iPad, Windows Mobile devices, and Blackberry, and Android is on its way.

BayScribe’s IT manager Dean Ganskop,  said: “This takes an entire narrative from a doctor and the engine parses out discrete reportable transcription [DRT] information such as allergies or diagnosis list.”

As exciting as these new mobile dictation technologies are, Claudia Tessier (RHIA, MEd, president of mHealth Initiative and former CEO of the American Association for Medical Transcription) insists that the need to review a dictated report will never go away.

Q: What do you think about mobile dictation devices?

CDC Report Finds 59 Million Americans without Health Insurance

CDC analyzed data from the National Health Interview Survey (NHIS) for 2006, 2007, 2008, 2009 and early release NHIS data from the first quarter 2010 to help determine the number of uninsured Americans or who had gaps in coverage. Then CDC used their findings to determine whether lack of health insurance coverage was associated with increased levels of forgone health care. Here are some of it’s key findings:

  1. In Q1 of 2010, approximately 59.1 million people had no health insurance for at least part of the year before the interview, which is up from 58.7 million in 2009 and 56.4 million uninsured in 2008.
  2. Of the 58.7 million who were uninsured in 2009, 82.8% were between the ages of 18-64, and 16.2% were under the age of 18.
  3. From 2008-2009, the number of uninsured children decreased 5%, however the number of adults (aged 18-64) who went without insurance increased 5.7%.

CDC also concluded that Americans aged 18-64 with chronic medical conditions and without consistent health insurance coverage are much more likely to forgo needed medical care than those with the same conditions and continuous coverage. In addition, CDC said: “Increasing the number of persons with continuous health insurance coverage can reduce the number of occasions that persons forgo needed health care, which can reduce complications from illness and avoidable long-term expenditures.”

Click here to read more from CDC’s report on Health Insurance Coverage and Health Care Utilization.

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