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Changing technology without changing workflow

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By Global Medical Transcription
Published on: 12/16/2009

Future Healthcare: Please give our readers a brief background on Global Medical Transcription.

Gary Lustberg: Global Medical Transcription is a company that has evolved over many years, originally starting as an addition to a vendor's electronic medical record software with whom we had partnered. In working with this vendor, we helped develop a hybrid electronic medical record with an integrated transcription component. As a company, my sales reps and I were educating providers on the values of an EMR and quickly realized back in 2000, most practices were not only not interested, but truly not technologically ready to advance into the Digital Age of electronic charts.

However, we did learn these providers were very interested in our electronic transcription component and what it could do for their practices. Our fact finding exposed many physicians were not quite satisfied with their current transcription service, whether an in-house person not being timely enough or an outsourced company's quality not up to par. So, in 2001, we decided to abandon the EMR portion of the software and design a piece of software that was Fisher-Price easy (simple like a child's toy) just for document management, giving the providers what they are looking for.

GMT has grown, moved forward and developed into what we are today, a technology company assisting in finding solutions to all aspects of transcription as well as seamless integration into current or future electronic medical record software.

FH As you know, the demand for medical transcription has increased over recent years. What makes Global Medical Transcription stand out from the rest in the industry?

GL Since we started the company as a transcription solution provider in 2001, we truly understood what the physicians want and need. We understand how different each provider is, not only in the different medical specialties, but even within the same practice. What has set us apart from the many thousands of cookie cutter-type transcription companies or even in-house transcriptionists, is both our strive for perfection as well as our customized software with its' ability to adapt to a physician and practice workflow, not vice versa.

We provide our software at no additional charge and roll out each version depending on a practice's needs and technical know-how. For example, many practices still print out the transcribed report, whereby the physician corrects them by hand and returns it to an administrative staff member to be corrected on the computer and reprinted on letterhead for a signature. While other practices may be completely paperless and utilizing electronic medical records, they still have a need to get the dictated report into the correct place in the patient's electronic chart. GMT offers a solution to both without altering any part of a physician's workflow.

As for accuracy, what good is quoting a ridiculous accuracy number like most companies tout? If there is an error that can cause a misdiagnosis or treatment plan of a patient, then what good is being 98.5 percent perfect? In this case, what truly sets GMT apart in the industry is our over 90 proofreaders who do nothing but listen at a slower speed than a transcriptionist to each and every word of every report, making sure that the dictated word is transcribed verbatim and the patient record is as accurate as humanly possible. These quality assurance personnel are what I like to call our "last line of defense" and although an unheard of additional step in our industry, it affords GMT the comfort of knowing we will catch almost any mistake before a report is returned to a client. In 10 years, GMT has maintained almost 100 percent of our client base due to this attention to detail and quality.

FH Most healthcare facilities have cut back their spending; so with that in mind, what are the cost benefits of utilizing GMT's product offerings and services and how soon can customers expect ROI?

GL GMT's Scope of Services includes all hardware, software, installation and training costs that go along with our transcription service. For most of our practices, this includes digital recorders as well as our Document Management Software and interfaces. This simple-to-use software provides for a seamless integration into a provider's current workflow. To ask a highvolume orthopedist, cardiologist, urologist or any number of other medical specialists to change their way of doing business by changing transcription companies or moving to new technologies does not work - as proven by so many unsuccessful electronic medical records implementations.

Our software is an advanced, yet simple dictation and transcription process that adapts to the physician and the practice workflow no matter what their technology. GMT's software allows for an immediate return on the investment by utilizing a practice's exact workflow and making it more efficient and cost effective. By converting each step of the workflow into the same digital process, we can save money on printing by embedding letterhead. Placing an electronic image of the physician's signature saves providers time, and e-faxing at no charge directly from the computer eliminates stamps, envelops and staff time.

This, along with automatically sending the record into a client's EMR, will make the practice and the staff much more efficient and allow the referring physicians to receive their patients' information much quicker. A process that currently can take more than week - with a tangible cost of letterhead, stamps and envelopes - can be accomplished in one day and done electronically for almost no cost at all.

FH Can you please give us some brief examples of how customers have utilized your products or services and what they have gained from the experience?

GL GMT has evolved in so many ways and has helped so many different partners by providing as you said, a paperless office, I would like to give you an example of one of our first clients we worked with to interface into an Electronic Medical Record.

In 2002, GMT signed an agreement with the Faculty Practices of Indiana University Hospital and Riley Hospital for Children on the IU campus, and to this day they are still very much our clients and partners in development. Our quality, support and especially the ease of use of our GMT Document Manager has continued to make them extremely satisfied and content in their workflow. IU is an extremely unique institution in that it was one of the first institutions to utilize an EMR. Funded by the Regenstrief Institute, an internationally recognized informatics and healthcare research organization, it has and continues to be at the forefront of new technology.

In the beginning, GMT's transcribed MS Word documents were returned into our Document Management software where they were copied and pasted into a patient record inside the EMR. In 2004, our IU clients asked us: How can we take this manual process and automate the workflow to make it more efficient? With 200-plus providers in the faculty practices, their obvious goal was to have the reports viewable inside the EMR repository as quickly as possible. Working with the Regenstrief Institute, our programmers redesigned our software with that end goal in mind, but with our GMT users needs first and foremost. We needed to complete the task without altering any part of our client's current workflow of dictating a patient visit, sending back a Word document, having it corrected and completed in our document management software and have the physicians signing off electronically.

Using a feed from the hospital ADT system, we acquired the Visit ID, Patient Name, Medical Record Number, Date of Birth and Service Date to be input into the backend properties of our word documents. Once the transcribed report was corrected, our upgraded version of the GMT Document Manager would send an HL7 message to the EMR server confirming the patient information was correct. Once validated, the report would be marked completed and ready for the physician's electronic signature. Multiple reports could then be signed at once by the provider and automatically converted to an HL7 text file and sent directly into the patient's electronic chart. For the physician, the software looked and felt identical to what he/she was currently using and they had no idea all of the rest was happening behind the scenes to accomplish the EMR's goals.

As an example, this is just one of the ways we have adapted and helped our practices adapt to new technology as well as assist in successful EMR implementations. As for other practices using different EMRs, our approach is exactly the same due to our open-ended HL7 generation capabilities allowing for a seamless interface with almost every EMR software without altering any part of the physician's workflow.

FH What is your outlook for the medical transcription industry in the coming years and how do you see technology advancing for medical transcription in the future?

GL That certainly is the million dollar question! We firmly believe medical transcription will continue to play an integral role in documenting the patient health care record. For years, we have been watching and experimenting with voice recognition (VR), waiting for it to live up to its' hype and although the technology is getting better, it is still a long way off. When VR can allow a provider to achieve the same efficiency, then one day GMT might transition from a transcription company to an editing company. However, as I see it, in the coming years the direction of this new technology as well as the advancing electronic medical records requiring pointing and clicking to generate a report, our thought process of physician productivity and patient care will continue to allow for successful utilization of all different types of EMRs. These same advances in point-and-click technology will also allow GMT to continue our strive for newer ways to help our clients create structured data from their dictated words, which has been the missing link for these types of hybrid systems.