TRANSCRIPTION CENTRALIZATION BENEFITS:

A CUSTOMER PROFILE OF SOUTHERN ILLINOIS HEALTHCARE

Southern Illinois Healthcare, a 400 bed system of 6 hospitals, headquartered in Carbondale, IL, was given the go-ahead to select a new transcription and document management product for HIM, Cardiopulmonary, Pathology, Radiology, and ER reports in the fall of 1999.  An HIM committee, comprised of Marcia Matthias, RHIT, Corporate Director Health Information Management, Mona Stevens, RHIT, Senior Clinical Systems Analyst, and Cheryl Hammel, RN, CMT, Supervisor of Central Transcription, identified goals and requirements for the much-needed, enterprise-wide transcription solution.  Since facilities had been acquired by Southern Illinois, (SIH) at different times, there were multiple transcription systems in place.  Also, clerical support expenses were higher than desired since there was little automation of document management.  Physician electronic signature had not been introduced, although some physicians were requesting to sign on-line.  Marcia Matthias describes the ‘before’ scenario as follows: “The disparity of systems and geographical location of the hospitals made it difficult to share transcription staff across facilities and manage transcription volume fluctuations at the facilities resulting in increased turnaround times and transcription outsourcing costs.” 

Mona Stevens, the Information Systems representative on the committee, outlined these major goals in her initial contact with AAI:

From a systems standpoint Marcia explains: “Southern Illinois Healthcare was in a good position with our base systems to proceed with our centralization plan; all hospitals had the same HIS system (Siemens MedSeries4) and only one hospital had to convert dictation equipment to have standardization of dictation systems.”  Arrendale delivered competitive pricing and hosted two site visits during the selection phase so that Marcia, Mona and Cheryl could see TAŽ in a multi-campus environment and witness the program level integration of TAŽ with the Siemens MedSeries4, AS/400-based platform.  After a March 2000 decision, installation and training of Transcript Advantage were scheduled to begin July 2000.  SIH committee members were delighted to find that the TAŽ system works well with enterprises that have transcription centralization in place for multiple departments and facilities.

Marcia explains some of the intricacies of the technical install by saying, “Although the hospitals had the same HIS system, the MPI was specific to each hospital and we also had more than one physician listing database.  TAŽ allowed us to manage this setup again in an enterprise installation.”  AAI and SIH programmers worked out an interface to an existing Sunquest system to bring in order related information (such as order numbers and ordering physician) for Pathology reports.  Having both patient demographics and order information downloaded into template headers and footers was a new feature for most of the 18 transcriptionists at SIH and has proven to be a real timesaver.  An AAI HL7 interface to ClinicalXpress (an SIH developed document flow system) allows SIH to continue the previously arranged electronic transfer and faxing of patient documents to physicians’ offices.  Mona of the Info Systems department continues, “ClinicalXpress allows us to send electronic copies of the reports via our Intranet and the physicians can cut and paste the transcribed report into their electronic office record.  We have successfully implemented this feature in a multi-physician office practice group.  The routing is triggered by physician numbers provided in the TAŽ document and the reports go out via the outbound HL7 interface.”

Over a period of two months, six weeks of transcriptionist training took place within the newly centralized transcription area of Memorial Hospital of Carbondale, the largest of the Southern IL facilities.  After Memorial went live, the other hospitals were successively brought up, approximately one facility per week.   Initiating at-home transcription, currently with 8 MTs, allowed a single transcription area (Memorial) to serve all facilities and to gain the physical transcription space for other uses in five SIH hospitals.  Marcia tells us, “We wanted to implement home based transcription options to retain and recruit transcriptionists.  With the new system, almost half of our transcription staff are now in the home based setting and plans are to increase this number.  With the installation of TAŽ, our productivity has increased, and our turn around times have improved.  We have the ability to support all 5 hospitals with 24 hour, 7 days a week transcription support.”  Cheryl reports that favorite TAŽ features from the transcriptionist point of view include T.A. Speed, AAI’s abbreviation expander, automatic carboning and the multiple, easy report retrieval methods. 

Other results of TAŽ benefit the entire enterprise, not just the HIM department, of Southern Illinois.  These include immediate viewing of completed transcriptions on both PCs and terminals located throughout the enterprise.  Since the at-home MTs are on-line, the reports that they transcribe are available on-line just as quickly as those completed by the in-house staff.  Reports (no matter if the transcriptionist is in-house or at-home) now print remotely on nursing floors, are charted by the nursing staff, and are available sooner to physicians.  TAŽ Batch Printing allows each hospital to set the times of their daily batch print jobs for those reports directed to the HIM department of each SIH hospital.  Marcia has achieved the desired reduction in clerical support duties that were once devoted to managing courtesy copy distribution, thanks to this TAŽ automation while physicians and clinicians have quicker access to needed reports.

 

Transcript Advantage improvements continue into 2001.  Arrendale support staffs will be working with Cheryl on TAŽ Productivity, Turnaround and Incentive reporting capabilities in the transcription area.  These flexible reports are individually tuned to each customer’s needs and presented in a graphical format via Crystal Reports.   In the near future, SIH will expand TAŽ Electronic Signature, now being used by some Cardiologists and Radiologists, to more physicians.  The installation of TAŽ Archiving within Southern IL Healthcare is another part of the TAŽ project slated for 2001.  With this TAŽ module, SIH will be able to keep transcriptions on-line indefinitely, while conserving hard disk space.  Hospital staff will have instant access to all transcriptions from TAŽ Viewing, both recent transcriptions stored on the AS/400 and those much older reports moved to optical storage.  TAŽ viewing is a menu option within the familiar Siemens HIS system, simplifying the training needed by SIH personnel to access transcriptions.  

The chart above summarizes the improvements within Southern Illinois due to TAŽ installation.  In addition to financial savings due to automation of both transcriptionist and clerical activities, patient care is improved with wider and immediate access to patient transcriptions.  Coders appreciate this improved access as well, allowing them to perform their jobs more efficiently.  Marcia reviews by saying, “With a recent snow storm in our area, the home based transcriptionists were a valuable resource, with the ability to access all 5 hospitals’ dictation and databases to meet our transcription needs when the on-site MTs could not make it into work.” 

Feb 2001 TAŽ News