Fresh thinking means timelier, more accurate medical reports

June 22, 2016

No one likes waiting, especially when it comes to getting important test results or other health information back from a family physician or other clinician. No doubt, the quality of care improves when physicians and other clinicians have the right information about their patients at the right time. The reason is simple: good decisions are made based on timely and accurate information.

That’s why the provincial health system is standardizing how dictation and transcription services are delivered in Saskatchewan. Today, each health region has different technologies and processes in place to support this work, which contributes to backlogs, delays, inefficiencies and uneven service provision from one region to the next. But all that is starting to change for the better.

“The system we’re implementing will allow for much faster turnaround times for reports that have been dictated by a physician or other clinician but have not yet been transcribed,” explains Dr. Joy Dobson, Physician Consultant with 3sHealth.

With better technologies to capture both dictations and do the subsequent editing of reports that have been transcribed, “the patient’s medical record will be updated much faster than it is today,” says Dr. Dobson. “This means that when a patient goes to their family doctor following a hospital stay or after a medical procedure, their doctor will have access to all the information related to that hospital stay or procedure in less time.”

This innovative approach, which involves the deployment of new technologies and processes at a provincial level, has already been rolled out to Sun Country and Prairie North Health Regions. And it’s already producing results.

“Our goal for the entire province is to achieve a turnaround time of 24 hours or less for all non-urgent medical reports,” said Lorne Shiplack, Manager of Provincial Transcription Services. “So far in Sun Country, the percentage of reports that are being turned around in 24 hours or less has gone from 18 per cent in February to more than 56 per cent in April. Over that same period, the average turnaround time for all transcribed medical reports in Sun Country is 41 hours, which includes nights and weekends when no transcription work takes place.”

It’s significant that nothing this comprehensive has ever been attempted in transcription services. As regions transition to new provincial technologies, clinicians can easily dictate accurate medical reports and have those reports show up on a patient’s chart much faster than they do today. As well, through a common pool of transcription work, a transcriptionist in one region can complete a dictated report for another region. The result is that as a province, we will be able to level the workload like never before as more regions come on to the service. Even more significant is the positive effect this has on care, as physicians get timelier access to accurate information about care events of patients.

One way to innovate? Standardize!

In a two-day event last February, a team of physicians, transcriptionists, and health information managers from across Saskatchewan streamlined the number of templates that physicians and other healthcare providers use to dictate medical reports using new voice recognition technology. Those reports are then typed up by a medical transcriptionist and incorporated into a patient’s electronic health record.

The number of templates was dramatically reduced from 171 to just 11 – a 94 per cent improvement.

The project team at 3sHealth is working with the technology vendor to incorporate those templates into the new voice recognition software that was procured provincially to support acute care dictation and transcription work – M*Modal’s Fluency for Transcription. That software, which includes the provincial set of acute care templates, was implemented in Sun Country Health Region and is currently being rolled out on a region-by-region basis.

Less is more

“What we know about healthcare is that standardization improves quality of care,” said Dr. Mark Brown, family physician in Moose Jaw and participant in the standardization event. “The last thing you want is for 13 different regions to be working in 13 different ways. And if [as physicians] we can do our reporting very efficiently, it frees us up to provide more direct patient care.”

Dr. Ayaz Ramji, pediatrician in Prince Albert, said that standardization “will make physicians better at dictating.”

“I really enjoyed the [standardization] session,” said Cathy Makie, Director of Health Information Management Services in Regina Qu’Appelle Health Region. “It was a very good mix of physicians, transcriptionists and managers from all the different regions and I think we got to a good place by working together like we did.”

Leslie Sharp, Director of Health Information Services in Sunrise Health Region, who also took part in the event, added that with standardization, “Saskatchewan is on its way to setting a golden standard for improving communication in the care and experience of our patients.”

Other innovative approaches in transcription services include:

  • Sourcing new dictation and transcription technologies at a provincial level through a competitive procurement process known as a Request for Strategic Partnership (RFSP), as opposed to the traditional Request for Proposals. In the RFSP, the province was able to signal to the marketplace our intention to find a collaborative partner who would work with us on an ongoing basis to help ensure a successful, long-term transformation. In this case, we’re talking about M*Modal. The company is more than a traditional vendor to us – they really are our strategic partner.
  • Collaborating with our system partners (regions and agencies) as well as provider unions to successfully negotiate an agreement that provides for the establishment of a provincial pool of transcription work and enables the distribution of that work across regional boundaries.
  • Hiring a physician consultant to engage with the physician community in the province in regard to transcription, as well as other clinical projects being led by 3sHealth.




pdf  2016-06-22-Fresh-thinking-means-timelier-more-accurate-medical-reports.pdf

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