[X4U] Transcription, document management

[Jim Robertson]

I hope I can make this not too long-winded.

My medical practice has for years used a local nice lady who does
transcription out of her home. Once a day she'd come to our office, pick up
our little analog cassettes, and return 1-2 days later with printed
documents on our letterhead.

We're nephrologists, so our practice is primarily consultative; i.e., each
of the notes we generate in our office likely is sent to one or more other
docs involved in the patient's care (other consultants and the primary care
physician). Our workflow involved photocopying each of the transcriptions,
stuffing envelopes, and mailing the copies.

Seven or eight months ago we were seduced by an internet-based transcription
service that promised a better workflow - we'd dictate into the phone, the
transcription would be done within a few hours, and the transcriptions would
automatically be faxed to our referring physicians. Even better, the
documents would be available to each of us on the web via their secure
server - a HUGE plus if I'm seeing one of my partner's patients in the ER at
2 am and the patient doesn't remember his meds, his lab data, etc.

All looked great during our first few weeks with the service (they gave us a
limited free trial). Turns out they used transcriptionists in the US during
the free trial, and people in India for whom English was at best a third
language once we started paying them. The reports would pass spell checker
muster but often would be nonsensical in terms of basic sentence structure.
(Anyone wanting a heads-up on a transcription service to avoid can write me
off-list and I'll be happy to provide you their name).

Since we had to edit every single document they created, the workload for
our staff wasn't reduced - it increased!

Since the documents were not accurate, we couldn't permit them to be faxed
to our referring docs from their servers.

AND, to add insult to injury, they redefined the meaning of a "line" of
characters, so that they were actually just as expensive as our local
transcriptionist!

(I know I must be butting against message size limits, so part two will
contain my questions)

Jim Robertson
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