Transcription outsourcing: Here’s what to ask

Do you have a standard contract?

Outsourcing medical transcription makes economic sense for many hospitals and health care providers of all sizes. Forunately, medical transcription companies come in all sizes and varieties.George Heymont, managing partner of Alert and Oriented Medical Transcription Services in San Francisco advises asking these questions before you hire an agency to ensure a good fit with your organization:

Does the agency use a digital dictation system?

Digital technology has so far outstripped the sound quality of tapes that a digital dictation system is a must, Heymont says.

"Any agency handling a large account should be" using digital technology, he advises. "Tape sound quality is poor. Tapes get lost." If they are not using digital technology, "It tells you they have not invested in today’s technology."

Tapes can be lost or destroyed

The new technology also offers protection in case of an emergency, he adds. If one transcriptionist has 20 tapes at his house during a fire, they could be lost, whereas digital technology allows the dictation to be routed to someone else, he points out.

In an emergency, can the agency handle dictation from tapes?

Despite the availability of new technology, there may still be some doctors who refuse to use the new technology and prefer to dictate into a hand-held microphone using tapes.

Is someone available at all times for technical support?

Since hospitals don’t keep nine-to-five hours, doctors should be able to dictate their notes 24 hours a day and be able to get help with the system if there are problems, Heymont says.

Does the agency have a standard contract?

A customized contract is best — one that specifies the unique needs of your medical records department and how those requirements will be met by the transcription service. Failing that, a standard contract is the next best thing. Both are better than no contract at all. Many health care providers and transcriptionists don’t even bother to sign contracts, Heymont says. A contract protects both parties in the event of a dispute.

What kind of turnaround time is the agency willing to commit to?

"The standard is 48 hours for things that are not critical," Heymont says. X-rays notes may require a shorter turnaround. The key is to specify the requirement in the contract.

Does the agency count Saturdays, Sundays, and holidays within turnaround time?

How many people will be transcribing the notes?

If only a few people will be working on your hospital’s transcription, they’ll become familiar with particular dictators’ idiosyncrasies, which are less likely to show up as mistakes in the medical record. It is more common at large transcription agencies however, for dozens of transcriptionists to handle large hospital clients.

What is the expertise of the transcriptionists who will be assigned to the work?

For the sake of accuracy, it’s preferable to have transcriptionists trained in certain clinical vocabularies such as OB/GYN or neurology, for example.

Is the agency’s software compatible with yours?

It’s easy to imagine the headaches caused by a transcription agency trying to send documents in the latest version of WordPerfect when your system can’t recognize the upgraded version and is still using an old version of Word for Windows.

How does the agency deliver the finished product?

If you’re still using a paper record system, electronic delivery won’t work for your medical records department. Alternatively, if your system is computer-based, using notes transcribed onto paper is a step backward.

How long does the agency archive its transcribed files?

Six months is fairly standard, Heymont says.

Does the agency have a system for tracking its reports?

If a report is lost, the transcription agency should be able to retrieve it easily. It should use a document naming system that is not difficult to decipher for its documents.

Will the agency work with your organization to improve the quality of dictation?

This can be tricky, but some agencies will offer to work with doctors to better understand accents or speech impediments.

For reports on paper, can the agency reproduce your letterhead as a computer- generated template?

This saves money by avoiding paying for expensive embossed paper, Heymont says.

Will the work be transcribed in the United States?

There are quality concerns about notes transcribed overseas. (See story, p. 33.) When notes are transcribed overseas, your doctors should be aware of the practice, Heymont advises.