eScription

Carle Clinic

INCREASE IN TRANSCRIPTION VOLUME, DECREASE IN COSTS

Challenge

Carle Clinic Association based in Urbana, Illinois is one of the largest private physician groups in the country and works in partnership with Carle Foundation Hospital, a 300 bed not-for-profit hospital. Both organizations take pride in the Carle name and its strong tie to the surrounding community.

With a plan to transition to an EMR in 2004, Carle Clinic anticipated a decrease in paper records and a significant increase in medical transcription. When the Clinic analyzed the impact of this increase on an already full workload, the organization realized that its current structure was not sustainable; it needed to find a more streamlined and cost-effective approach. Yet, any new system could not compromise on report quality or turnaround time in support of patient care.

"In discussions to move to an EMR, certain issues we had with our transcription processes were brought to light," said Tricia Truscott, HIM Director of Carle Clinic. "We were spending a lot of money for a system that was not able to handle the influx of dictation we expected from the transition to the EMR. We did not have the resources to increase our staff of 50 medical transcriptionists (MTs), and we wished to reduce the money we were spending on more than seven outsourcing companies."

Solution

To address its rising transcription volume, Carle Clinic selected Computer Aided Medical Transcription (CAMT) software from eScription, Inc. eScription streamlines the clinical documentation process using intelligent background speech recognition that turns clinicians’ dictations into formatted draft documents that are subsequently edited by MTs. The CAMT process requires little to no change to clinicians’ dictation behavior or workflow and often doubles MT productivity.

Carle Clinic’s goal with CAMT was to improve each MT’s productivity and thereby increase the overall transcription capacity of its in-house staff. By taking on more transcription work in-house, Carle Clinic would be able to reduce considerably its outsourcing requirements and associated costs.

Following a successful, enterprise-wide implementation of eScription software in 2005, Carle Clinic’s CAMT system is currently processing more than 47 million lines of transcription per year. The software is used by more than 500 clinicians across the healthcare system, covering work types ranging from clinical notes to correspondence to emergency room reports. The speech recognition yield is at 92% and this number continues to grow.

With CAMT, the Clinic’s in-house transcription department has been able to increase its capacity from 13.3 million lines/year to more than 17 million lines/year and it is handling this work with approximately four fewer FTEs. As part of the transition and with a focus on increasing productivity, the Clinic worked with eScription to develop a style guide for consistent formatting. Further, the organization reevaluated its in-house compensation plan and moved to a production-based system, motivating MTs to take advantage of the product’s efficient editing tools.

In addition, Carle Clinic reduced the number of MTSOs it needed, streamlining management time for the HIM department. Three primary MTSOs, down from seven, regularly handle the overflow work. Across transcription groups, overall MT productivity has doubled.

On average, document turnaround time went from approximately four days to under 23 hours. One reason for this result was the standardization and subsequent reduction of templates used by Carle Clinic clinicians. Under the new system, fewer mistakes can be made by either clinicians or MTs leading to more consistent documents and faster turnaround time.

The eScription system has improved internal processes as well. For example, prior to CAMT, many MTs had difficulty deciphering certain clinicians’ dictations, and back-and-forth revisions delayed completion and signature. According to Truscott, "After eScription, we really noticed a significant improvement with the whole transcription process. As a result of the accurate drafts, blanks going back to the clinician were reduced by 90%."

Results

"eScription offered the most advanced technology. No other software available was as sophisticated to handle our needs across the enterprise."
— Tricia Truscott, HIM Director

"The change to eScription software had a huge cost savings impact. In one year, Carle cut transcription costs by 16% in part because of productivity gains that enable us to handle more volume in-house."   
— Lisa Pellum, Executive Director for Compliance at Stratum Med, Inc.,
     a division of Carle Clinic Association

Today at Carle Clinic:

• The organization is successfully handling an increase in transcription volume from 28 to 47 million lines/year along with significant savings.
• Within one year, the transcription department decreased its costs by over $1 million, a reduction of 16%.
• MT productivity has increased more than 100% and continues to rise.
• In-house transcription volume increased 28%; outsourced services were reduced from seven to three.
• Document turnaround time was reduced from approximately four days to an average of 23 hours.
• There has been a 90% decrease in the number of "blanks" going back to clinicians contributing to a more efficient workflow and faster time to signature.
• Clinicians now work with only a few standard templates rather than with the many different ones previously used, adding to report consistency and efficiency in the EMR.
  

eScription helped Carle Clinic move to an EMR-based system while cutting down on transcriptionist costs without sacrificing the quality and turnaround time of documents. Learn more about the complete EditScript solution that is delivering real results to the Carle Clinic in our Products section

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