Electronic Medical Records (EMR) usher in the demand for medical scribes to transcribe and chart patient evaluation data directly in the software of choice

Electronic Medical Records (EMR) usher in the demand for medical scribes to transcribe and chart patient evaluation data directly in the software of choice

There is no question that the field of medical transcription is changing. Already, we have seen a majority of doctors, clinics, and hospitals convert to Electronic Medical Records (EMR), aka Electronic Health Records (EHR). This transition, in essence, effectively streamlines and optimizes data storage, patient tracking, record keeping, and government regulation.

Electronic medical records (EMR) implementation is perhaps the principle clause in the American Recovery and Reinvestment Act (ARRA). It has become known as, simply, the EMR mandate – requiring medical professionals to demonstrate “meaningful use” of the EMR software by 2014. Though the mandate took effect on the 1st of January, enforcement is not set to roll out until 2015. This gap offers another 365 days for the industry to adopt selected software before facing fines or reduced Medicare reimbursements.

This fundamental shift in the medical transcription industry has raised a much-needed discussion: Is this the end for medical transcription services? Quite simply, the answer is no.

An electronic medical record is a convenient, organized, and efficient way to retain patient data. After patient evaluations, medical professionals are expected to continue dictating their notes using an audio recording device. They then have the mundane option of inserting the data and transcribing notes themselves directly into the software. However, this is obviously incredibly inefficient and time-consuming, ultimately decreasing the number of patients one can see and dropping annual revenues. There are also consequences that result from abusing the copy-paste function. Following is the second option of hiring an aide to assist in the documentation. Advocates of this path have realized that an experienced understanding of medical terminology and processes is needed. Doctors and other medical professionals must then spend laborious hours editing, or face the chance of incorrect documentation.

If you think you can transcribe and chart on your own, you may need to think again according to EHR Intelligence: “While EHRs are sold to physicians as a way to increase quality while making documentation more efficient, few providers have seen as much return on that promise as they could like. EHRs can be time consuming to use on a daily basis, and patient interaction can suffer when being forced to peer at a computer screen during consult after consult. The solution, according to one cardiology practice, is to let a professional typist do the typing, and allow the physician to use his skills where they do the most good.”

The move to personally prepping and actively charting looses time and money. Also, it takes the individual attention and personable eye-contact out of the equation. Not only does this leave the patient with greater dissatisfaction, but it also reduces the physician’s efficiency.

If you’re following…this is where the medical transcription service is heading. There is a third option that is the chief recommendation on how to proceed with EMR charting, transcribing, and documentation.

Employing a medical transcription service company, or medical scribe, to transcribe and chart directly into the EMR / EHR saves an incredible amount of time and money. It also guarantees the accuracy of documentation. Doctors will do as they always have: utilize audio recording devices and software to dictate patient evaluation notes. After uploading the audio file, medical scribes and transcriptionists efficiently and effectively work directly in the EMR to chart and, if desired, embed a medical transcript.

One reason the federal government is pushing a mandated electronic data system for healthcare is for regulatory purposes. To avoid punishing fines, documentation must be complete and undeniably accurate. The only certain way to ensure compliance is to partner with a professional medical transcription service.

KMTS offers full EMR Medical Transcription Integration with all partnerships. Contact us today to discuss your specific needs.

Healthcare IT News also published a great article detailing the medical transcription shift to chart and transcribe directly in the EMR software.