The experts and professionals consulted for these tips include Dr. Joseph E. Glaser, nuclear medicine physician at Radiologic Associates PC; Eric Slimp, purchased services director at TractManager; and Dr. Kathleen A. Bishop, professor of health science at Purdue University Global.
1. Consider your workflow.
No solution is right for every practice. Your workflow, the preferences of your staff, your specialty and your practice's needs all influence which service or product will be most effective. For some practices, outsourcing transcription services might be an immense benefit; for others, it could be a waste of valuable resources when in-house voice recognition software would have sufficed. It's all about how you work, the volume of your documentation, and what your practice best adapts to. Look at transcription from all angles before deciding which direction to go.
"If you're looking to retrofit an existing practice, or a transcriptionist is retiring, you could consider getting a service that's used infrequently," Glaser said. "If you're going from room to room seeing patients all day … [then you might] prefer to have a transcriptionist look at the dictation later."
2. Spell out absolutely everything in the contractual terms.
When negotiating with any third-party service, it's important to know exactly what you can expect from it and at what cost. This means taking the time to sit down and negotiate the contract that you need line by line. It can be an arduous task to make sure before signing that the contract includes every last detail, even the seemingly understood ones, but it's well worth it for your practice. You can also use the terms of the contract to hold the company accountable for its performance.
"Build quality metrics into the contract," Slimp said. "The way we see it typically is that it will be a tiered scale, where it will have certain percentages … You want to shoot for 98% accuracy in general, that being for major errors. There will be just typos and things like that. Minor errors are OK, but you want to strive for 98% of charts without major errors."
Slimp said you can enforce the target metrics by negotiating some incentives for when the company delivers exceptional service and penalties for when it demonstrates poor service. Make those quality-control metrics measurable and grounded in statistics that you can easily demonstrate with the transcribed reports you have on record.
3. Make sure you only pay for what you need.
Many vendors pride themselves on flashy features and a lot of optional components. While some of these might be useful for you and your staff, it's worth considering whether you really need all the latest features and frills. If all you need is effective, accurate transcription, then you should only pay for the basic package. Scrutinize the pricing models: Find out if it's a one-time fee or a monthly subscription, and also ask about the frequency and cost of software updates. As always, inquire about the level of support you can expect from the vendor if something goes wrong.
"Some companies can be very expensive and want to give you all the bells and whistles when you only need the basic package," Bishop said. "Find out how much it will cost – is it a one-time price, or do you pay for the software/hardware and then a monthly or yearly fee? Are there upgrades of the software, and if so, are they free, and how often do they upgrade? And if there is a bug or glitch in it, how quickly do they get it fixed?"
4. Make sure the software interfaces with your existing systems.
Any software that you might use, either on your own or in conjunction with a medical transcription service, has to be compatible with your electronic health records (EHR) system and practice management system. In today's increasingly digitized healthcare industry, the ability to generate and share records across platforms – both in your office and other providers' offices – is invaluable. Any software necessary for the transcription process needs to be able to properly communicate with all the electronic aspects of your practice.
"Everything has got to work together," Glaser said. "It's a question you must pose to the vendor when you're buying these things. I've seen some practice management systems with transcription built in … but you have to make sure it can interface with your records system as well."
5. Always check references.
As with any other major purchasing decision, it is important to perform thorough research before buying. Ask for a complete list of the company's references within your specialty, not just a predetermined list of positive reviewers. Find out from other physicians in your field how they use transcription services, what it costs them, and what the quality of their service is. You can also find ample reviews online and look up information on the company with the Better Business Bureau. If there is a dearth of information on a given vendor, that should be a signal that something isn't quite right. There's usually at least some useful information out there on any reputable vendor.
"When outsourcing, make sure you have looked at all the services that the company or transcriptionist is prepared to offer and if they actually do what they say they can," Bishop said. "Get a couple of references, look them up online, and check out the Better Business Bureau … to see how reputable they are."
6. Use your practice's small size as leverage.
If you are a small or even midsize practice, just about any transcription service will be equipped to handle the volume of reports you generate. Unlike large hospital systems, which produce so much dictation that only a large company could handle the workload, smaller practices have the option of using smaller transcription services. You can use this as leverage when considering a transcription service or negotiating a contract. You could go virtually anywhere, so make the company truly win your business.
"[A small practice] will want to use to their advantage that their volume is low enough that almost any service provider could offer them what they need," Slimp said. "Small practices have the option of going anywhere because almost anyone can handle their volume. It's important to know the playing field is really open and to use that competitive advantage as leverage."
7. Focus on getting as short a term as possible.
Finally, do your best to negotiate a short contract, or find a company that offers monthly subscriptions. That way, if the service you partner with ends up being something other than what you expected, you can always go elsewhere at the end of the contracted period. Some companies will try to lock you into a longer contract, but it's best to talk them down to one year or less. Remember, they don't have your business until you sign the contract, and simply refusing to sign on to a multiyear agreement might persuade them to reduce the timeframe. Of course, if you're satisfied with the service, you can always extend the contract in the future.
"There are companies – and we still see this – that will want to lock you into a three-, four-, five- or even six-year contract," Slimp said. "But you'll really want to focus on getting as short a term as possible."
