eScription

July 11, 2005 (Boston, MA) — It was the shortage of transcriptionists that led John Avedian to look to technology, instead of offshore, to ease the strain at Maine Medical Center six years ago. At the time, the hospital was doing 60% of its transcription work in-house and outsourcing 40%. Eclipsys Corp., which provides other information technology products to the hospital, co-markets a system called KBT, or knowledge-based transcription, a computerized dictation and transcription service developed by eScription of Needham, Mass. KBT employs a speech recognition engine used by transcriptionists "on the back end." The alternative is a so-called "front-end" system in which the clinician reviews and edits the text transcribed by the software as he or she speaks.

Avedian says Maine Medical piloted the system in 2001 and began seeing results in 2002. "We started working with eScription, hoping for about a 20% productivity gain," he says. "We're now at about 100%. It was around 170 lines an hour; now we're up into the 340s, 350s or 360s.

"The way the system works, it gets more and more productive as the transcriptionists make changes and they flow back to the model, so the next time, that edit is learned," Avedian says. "Physicians that have been on for years, they barely have to edit them. It's punctuation and formatting, very little changes. That's why we continue to see productivity gains."

Maine Medical moved back to handling 80% of its transcription work in-house by hospital employees at a savings of $1 million since implementing the system, Avedian says. "I've been in the business for over 20 years and this technology is just the biggest no-brainer. There isn't a reason why you shouldn't be using speech recognition in your transcription."

But as high as he is on the technology, Avedian doesn't foresee a day when the transcription service will be eliminated by front-end speech recognition systems.

"I believe this institution would not support having the physician do their own self-editing," he says. "Our physicians are so busy they want and need the service. The analogy I use with physicians is they certainly can iron their own shirts but their time is too valuable, so they send them out to be done. Most physicians need and want the service. There is a value to electronic documentation and there is a point where they need a transcription service for them. They don't want a system to add more time to the documentation process, because if you add more time, they're going to revolt."

Conn, Paul. “Not Dead Yet.” Modern Healthcare 11 July 2005: web

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