Speaking of Union Hospital …

April 25, 2014

Union Hospital’s investments in digital dictation and transcription over the years have not only improved its documentation productivity and reduced costs, but have also helped prepare our hospital for the upcoming ICD-10 transition well in advance of the deadline.

Union Hospital is a 155-bed community hospital with 185 physicians and more than 1,000 employees in Dover, Ohio. Until 2006, Union Hospital had used separate digital dictation systems in its radiology, pathology and medical records departments. Physicians would dictate their notes, and then the recordings would be transcribed by in-house staff or third-party companies.

While digital was an improvement over analog tape, the separate dictation systems in each department started to fall behind the demands of the growing hospital. As patient volume and complexity increased, the number of recordings and length of dictations also expanded. This led to frequent transcription backlogs, increased overtime among the hospital’s transcriptionists and slower turnaround times from outsourced transcription companies.

With transcription costs rising and a decrease in documentation productivity, hospital leaders determined that a systems change was necessary. The hospital could have phased out dictation and required clinicians to learn and adjust to new workflows, further impacting productivity and costs. Instead, Union invested in more efficient digital dictation and speech recognition solutions that would accommodate clinicians’ current workflows, while also preparing the hospital for the future.

Consolidating systems

After deciding to eliminate its separate dictation machines, a natural step for the organization was to adopt a centralized system throughout its hospital and Healthplex, which includes facilities for physical, occupational and speech therapy.

Consolidating these systems allowed the hospital to eliminate its outsourced transcription, which until that point had been assigned to as many as four companies. The hospital also transferred four internal transcriptionists from its radiology unit to its health information management department and trained them on the new speech recognition and transcription technologies.

The speech technology system, Dolbey’s Fusion Voice, was selected based on the hospital’s previous positive experience with components of the suite of solutions. The centralized system is accessible at any of the 40 physician workstations around Union’s facilities, each equipped with a Philips SpeechMike for dictation. The devices all integrate with front-end speech recognition software, Dolbey’s Fusion Expert.

Union Hospital’s technology vendor, Roach-Reid Office Systems in Akron, Ohio, recommended this combination of technology because it was designed for speech recognition. The hospital had to have a technology set that could filter out busy background noise and would also stand up to the dynamic environment of the hospital. Physicians also appreciated that they could continue to operate with the same workflow they were used to with their old dictation microphones.

The speech recognition functionality is especially crucial as Union Hospital, as well as every other United States healthcare organization, transitions from the ICD-9 code set to the updated ICD-10 codes. ICD-10 includes tens of thousands of additional and more specific codes, requiring physicians to document, and to dictate, in greater detail. Even with the recently announced delay, it’s still important to make sure our clinical documentation is as detailed and accurate as possible. Recently, Union initiated computer-assisted coding, computer-assisted physician documentation and clinical documentation improvement programs using technologies from Dolbey and ChartWise to help physicians build experience dictating for coding purposes in anticipation of the new ICD-10 deadline.

Cost reduction with improved productivity

Due to the physicians’ familiarity with dictation, the consolidated systems did not disrupt workflow or productivity. The transition was also smooth for physicians who adopted the speech recognition transcription software, which analyzes voice files to learn from each dictation and improve accuracy.

The streamlined, consolidated system has helped Union Hospital greatly reduce its transcription costs. The organization has eliminated $280,000 in outsourced transcription services over two years and saved thousands of dollars more by reducing staff transcriptionist overtime hours.

Furthermore, while the hospital used to have 300 to 400 radiology reports backlogged for transcription, that number is down now to almost zero. The hospital’s medical records department was experiencing a similar report backlog but is now down to less than 100 reports.

Like hospitals all over the United States, Union Hospital is continuously exploring health information technology tools to keep pace with the expanding data demands of the healthcare industry. Years ago, instead of adopting a radical technological and workflow change, we upgraded and consolidated our current systems that were best suited for the hospital’s anticipated needs. The early results are encouraging, but the long-term perspective looks even more promising.

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