Talking it through: busy physical therapy practice converts from manual transcription to voice recognition - What Works: Speech Recognition

Health Management Technology, Feb, 2002

Fulfilling the requirements for Medicare compliance is a challenge for every healthcare organization. For a paper-based physical therapy practice, the challenge is accentuated by volumes of referral paperwork and documentation on patients' progress. Switching from handwritten reports and outsourced transcription to a voice recognition System helped us meet the challenge and save money in the process.

PROBLEM

Mid-Florida Physical Therapy is a large, 22-year old private practice located in Ocala, FL. We have six satellite offices and 17 providers, including eight physical therapists and assistants, and one occupational therapist and an assistant. On average, we see 545 patients per week and dictate 600 notes within the same timeframe.

Since the practice was established, we have outsourced our dictation to an external transcriptionist. This worked well in the beginning, but as the number of providers increased and our patient volume multiplied, the method proved costly, with monthly fees ranging from $2,500 to $3,000.

An additional ramification of our practice's expansion was that the transcription service slowed. Larger patient volume meant that reports might take from five to seven days to complete, and often up to 10 days total, from the time we initiated them to the time they were returned to our office.

This, of course, produced a subsequent slow down in billing, which only increased the lag time between service delivery and reimbursement. When the transcriptionist announced her retirement, we decided it was time for a change.

SOLUTION

In early 2000, we began our research to identify an alternative transcription solution. Our first idea was to use a telephone system for dictation and to hire a full-time transcriptionist. After evaluating six or seven different systems, we eliminated the idea of a new hire and narrowed the list down to two information technology products. One of those was a template-based point-and-click system, and the other was TalkNotes[R] from ProVox Technologies.

We used the template system on a trial basis for 30 days. One of our original goals was to afford our therapists greater freedom in using a dictation system to capture the detailed, yet free-form, notes they wanted to dictate. During the trial period, we determined that the presets in the template system were too uniform, forcing most of the dictation into "canned" format. Our therapists were unable to free-form dictate as they wished.

Based on our trial with voice recognition software, we unanimously selected TalkNotes for the practice.

RESULTS

Installation of TalkNotes was a smooth process and included troubleshooting the interface with our practice management system to ensure that all patient demographic information was pulling into the system correctly.

Training was painless. The 17 providers and the editors were trained within the three days that a ProVox team was in our home and satellite offices.

Within two weeks, we were completely reliant on the new system--and growing more fluent every day. We already had most of the hardware in place, except for eight PCs which we leased in conjunction with the system. The overall cost of the system, on a monthly basis, is about half of what we paid in transcription fees and we will own it in five years. Even with those expenses, we net about $1,000 a month in savings.

With TalkNotes, we have fully transcribed notes in patients' charts within a day. This streamlines our Medicare compliance efforts and significantly decreases the time between service delivery and billing/reimbursement.

We have cut our dictation time in half by creating 70 macros that allow us to pull commonly used paragraphs of text automatically into patient notes. The system allows patient history information to be automatically included in the dictation. It learns speech patterns, accents and specific voices and can achieve 99 percent accuracy within weeks.

We are currently testing the handheld version of TalkNotes for expanded use, giving us the ability to take the application, including "patient charts," anywhere, using a Compaq iPAQ personal digital assistant.

For More Information from ProVox Technologies, Circle 193

SOURCE

Jim Simmons, M.A., A.T.C./L.
Assistant Administrator
Mid-Florida Physical Therapy
Ocala, FL
mfpt@juno.com

PRODUCT/COMPANY
TalkNotes[R]
ProVox Technologies
Roanoke, VA

www.talknotes.com