OUTSOURCING & CLINICAL DOCUMENTATION: Healthcare’s …The decision to outsource completely brings...
Transcript of OUTSOURCING & CLINICAL DOCUMENTATION: Healthcare’s …The decision to outsource completely brings...
OUTSOURCING & CLINICAL DOCUMENTATION:Healthcare’s New World—a Strategic View
Key Considerations in Outsourcing Transcription 3
Guide to Best Practices in the Transition to Outsourcing 5
M*Modal: The Choice for Outsource Partner 9
Record of Success 11
Take the Next Step 11
TABLE OF CONTENTS
KEY CONSIDERATIONS IN OUTSOURCING TRANSCRIPTION
Cost pressures are relentless. The CFO knows this better than anyone in today’s healthcare organiza-
tions. As the new world of value-based healthcare emerges, pursuing the twin objectives of reducing
cost and delivering higher quality care is imperative. The urgency—for some survival—is forcing
dramatic moves on all fronts.
These moves include strong interest in outsourcing costly internal functions. With the stakes so high,
CFOs continue to distinguish “core” vs. “context” activities. As business strategist Geoffrey Moore
defined the notion, activities which differentiate the organization in its market are “core” and merit
investment. All others are “context” and inhabit “the world of outsourcing.”1
Many CFOs are concluding that in-house transcription is not core. It is a logical candidate for
outsourcing to achieve savings. In-house departments incur not just direct labor costs but also
indirect overheads, volume fluctuations that cause under- or over-utilization of people, and ancillary
expenses. With EHR systems reducing transcription volumes, the cost/personnel equation is already
shifting even without intervention. Approaching this subject in a planned fashion is in order.
Outsourcing options range from overflow to partial to complete. Your organization is likely
outsourcing some work today and may use a sub-optimal set of legacy vendors of different
sizes and capabilities.
1 Geoffrey Moore, Living on the Fault Line, HarperBusiness, 2000, p. 32.
We mentioned the EHR. Transcription outsourcing must be included in the larger EHR strategy
discussion, because gaps in EHRs prevent them from being the universal documentation solution
often claimed.
Every patient has a unique story. Dictated narrative reports have long been the “gold standard”
for documenting complete and variable information. As one doctor put it, “One of the most helpful
lessons I’ve learned about being a physician is that we’re story tellers. We’re trying to capture the
patient’s full story.”
Yet we’ve created a crisis of capture around clinical narrative in the move to EHRs. Pursuing the
legitimate need for structured data, we have pushed a paradigm of template-based data entry at
the expense of rich narrative documentation. This model works for some information, but it can
be cumbersome, demanding behavior shifts and negatively impacting productivity. In addition to
constricting the physician’s ability to capture detail, EHRs frequently encourage such undesirable
behaviors as improper use of cut-and-paste and inclusion of standard text blocks that render the
record unusable.
Clearly an intelligent combination of EHR and speech recognition technology along with outsourced
services is needed to put you in control of savings, while also promoting EHR adoption and truly
meaningful use. This helps you optimize the overall investment.
The decision to outsource completely brings a significant human element into the equation.
Organizations considering this option frequently face concerns about:
• People losing jobs
• Public relations backlash in the community
• Physician perceptions of responsiveness and quality of documentation support
This paper offers guidance on dealing with these issues and implementing a cost-saving outsourcing
strategy successfully.
As the nation’s largest clinical documentation outsourcing company, M*Modal has helped an array of
healthcare organizations. We have distilled this accumulated knowledge into four key considerations
in pursuit of best practices in this area. These considerations establish a structured approach and
promote benefits across the organization.
Best Practice #1: Choose a vendor experienced with successful transitions to the outsourced transcription model
This advice may sound obvious, but many of the firms in this
space are small or have been created through merging disparate
companies. Unlike M*Modal’s tested process they frequently
lack a systematic approach to transitions and cannot adapt to
individual needs. By contrast, M*Modal becomes an extension
of your department.
GUIDE TO BEST PRACTICES IN THE TRANSITION TO OUTSOURCING
FOR CFOS
• Lower cost structure
• Free resources such as system maintenance to invest in critical health IT initiatives and additional labor-saving tech-nologies, such as Computer-Assisted Coding
• Optimized revenue cycle from faster and higher quality documentation
• Retain physician documenta-tion choices while fostering EHR
strategy
FOR HDS (HEALTHCARE
DOCUMENTATION
SPECIALISTS)/MTS
• Potentially greater job security than if they remain in-house
• Opportunities for advance-ment that may not be avail-able in-house
• M*Modal HDS (Healthcare Documentation Specialists)/MTs have opportunities to move into management positions and Sr. Healthcare Documentation Analysts can apply their skills in other roles such as a career path to Coding
• Many experience upside
income potential
FOR TRANSCRIPTION
DEPARTMENT
• Methodology to successfully and gracefully migrate department to complete outsourcing
• Cost reductions and/or improvements to quality and TAT measures
• Ability to handle more work, more flexibly
• Contribute proactively to organizational strategy rather than appear resistant to change
BENEFITS OF A STRUCTURED APPROACH
Best Practice #2: Pursue a proven methodology for transitioning
This is not an ad hoc effort. The delicate balance of people, cost and quality demands an organized,
proven process rather than the hasty or cookie-cutter approach often taken. Points to keep in
mind include:
• The status quo can rarely be fully maintained. While there will be pressure to leave intact all
transcriptionists and their work routines, this is rarely possible or even desirable. In fact, in most
cases a prime driver for full outsourcing is that the in-house team is not adhering to consistent
turnaround time or achieving desired quality standards.
• Opportunities abound to satisfy long-run objectives through proper transition planning. Moving
some physicians to self-editing speech recognition and implementing clinical documentation
improvement efforts are two moves that can feed your longer term strategy.
EXAMPLE: THE M*MODAL TRANSITION METHODOLOGY
M*Modal is proactive from both the management and transcriptionist perspectives, engaging with
HR, the CFO, and Department staff from the beginning. In the case of complete outsourcing, we will
frequently “re-badge” the in-house transcription staff, making it our own. This offers a clear path to
savings while preserving employment for most.
MANAGEMENT PROCESS
The M*Modal process is holistic and designed to shepherd customers throughout the phases:
• Pre-Decision. M*Modal Human Resources provides pre-decision consultation with the custom-
er’s leadership to outline the HDS/MT recruitment and transition process. You know what to
expect before you decide, and critical issues, such as unionized employees and benefits, can
be addressed.
• Implementation Planning. M*Modal follows a formal project management approach with dedi-
cated resources and a project plan. Project team calls are held to set a timeline for announce-
ment, job offers, paperwork completion, equipment ordering and training to insure that go-live
targets are met. Details such as HDS/MT experience, skills and more are collected and maintained
by HR to help formulate the right offers.
• Implementation. Most important, M*Modal assigns you a Customer Relationship Manager
(CRM) and Healthcare Documentation Services Manager. Their jobs are to satisfy customers by
leveraging resources across M*Modal as required to address needs. Customers consistently cite
this approach as a significant benefit. A weekly quality audit is performed on all transitioned HDS/
MT for the first four weeks of employment, with the expectation of 99.6 accuracy. All receive the
M*Modal National Quality Program requirements.
• Ongoing Reporting. M*Modal’s Performance Monitor portal (Fig. 1) lets administrators view
meaningful data and metrics to track performance, provide management reports and obtain data
required by The Joint Commission. Turn-around time, work-type and dictator statistics, quality
indicators, and much more are included—often more than currently available.
HEALTHCARE DOCUMENTATION SPECIALIST (HDS)/MEDICAL TRANSCRIPTIONIST (MT)
TRANSITION PROCESS
As a company that manages thousands of transcriptionists daily, M*Modal understands the impact of
the outsource decision on individuals and follows a process designed to handle the transcription staff
migration in a smooth, speedy, fair and sensitive fashion. M*Modal’s transition package includes:
• Employment offers to all facility-employed HDS/MT, waiving the professional
courtesy test; however, a background check is performed
• Benefits effective the first of the month following the date of employment with us
• Honoring the years of service. For those with the facility longer than 2 years, this policy allows
them to accrue PTO at our highest rate; three-year veterans join our 401k fully vested
• Primary assignment of work on the facility’s account when possible
• Flexible work schedules that meet the needs of the employee and the customer
• M*Modal supplies a full equipment package at no charge to the employee,
along with 24x7 technical support assistance
• Opportunity to get additional education to move into a Coding Services career
Fig. 1: Performance Monitor Portal
Best Practice #3: Consider your outsource partner’s enablement team
The transition methodology described here is only as good as the people implementing it.
They are crucial to realization of the projected cost savings as well as the maintenance of high
quality standards. A firm such as M*Modal brings people with deep experience serving hospitals of
all sizes, clinics, radiology departments and many more care settings. The Customer Relationship Manager dedicated to your organization will be carefully selected from our ranks, and these
CRMs are supported by a Customer Care Region Vice President
and a highly effective operations, IT and leadership organization.
Customers frequently reference the value of the M*Modal
people as the difference in an effective transition.
Fig. 2: M*Modal Care Team
REGION VICE
PRESIDENT
HEALTHCARE DOCUMENTATION
SERVICES MANAGER & PERFORMANCE
COACH
HEALTHCARE DOCUMENTATION SPECIALISTS AND SR. HEALTHCARE
DOCUMENTATION ANALYSTS
HUMAN RESOURCE EXECUTIVE
CUSTOMER RELATIONSHIP
MANAGER
Best Practice #4: Communicate the right message clearly.
Outsourcing can be an uncomfortable step to communicate. Organizations may face complaints to
local media, online posts and pressure from other affected constituencies. In response, experience
shows it is best to explain outsourcing not just as a necessary cost-cutting exercise, but rather as
part of the need to address the major demands facing all healthcare organizations today to improve
and coordinate care efficiently. It is also advantageous to be proactive post-implementation.
Communicating success metrics from the outsourcing can go a long way to setting the context and
countering general complaints and allegations.
M*MODAL: THE CHOICE FOR OUTSOURCE PARTNER
M*Modal knows clinical documentation.
As one of the largest and most experienced transcription services providers, we have been delivering
transcription services for over 40 years. M*Modal offers an experienced workforce of over 5,500 U.S.-
based and global transcriptionists and speech editors who turn 200 million minutes of dictation (more
than 2 billion lines) into quality documents each year. Such scalability addresses the needs and growth
of a wide range of organizations.
“Our quality first philosophy within transcription services produces clinical documentation accuracy
with speed, quality and performance monitoring. M*Modal’s robust cloud-based technologies range
from transcription and speech recognition-based platforms to CDI applications and dedicated
imaging reporting solutions.”
Unlike other systems, M*Modal has a single architecture with one speech recognition and one
Natural Language Understanding technology. This enables a seamless experience and more
complete documentation by providing dynamic feedback and closed-loop workflows all throughout
the documentation process—instead of after the fact.
The M*Modal Fluency platform and clinical documentation services capture the patient story and
transform unstructured data into encoded clinical documentation, regardless of the source—whether
it’s front-end speech/EMR, transcription services or self-edits. Our cloud-based platform is always
connected, compatible with virtualized systems, and accessible anywhere. This integrated approach
enables you to preserve the richness of each patient encounter and enhance care delivery, while
promoting higher efficiency and accuracy.
In addition to transcription services we provide expert coding staffing, education and consulting
services. M*Modal Coding Services credentialed coding staff has been serving healthcare organiza-
tions for nearly 20 years.
M*Modal has over 3,850 hospitals, clinics and practices and more than 200,000 physicians as
customers. M*Modal’s mix of technology and service offerings is designed for healthcare today and
tomorrow—helping you to improve physician adoption, deliver higher quality documentation, and
promote better, more meaningful patient care.
Fig. 3: M*Modal Clinical Documentation Solutions
A UNIFIED PORTFOLIO
M*Modal Fluency workflow solutions promote collaboration and proactive CDI through integrated real-time insights
M*Modal Coding Services provides one stop for all of your coding needs—staffing, auditing, and education
M*Modal Transcription Services deliver world-class transcription service quality, data security and confidentiality
RECORD OF SUCCESSM*Modal’s success in transitioning to outsourcing shows up in the numbers:
TAKE THE NEXT STEPThe outsourcing decision is difficult and it is important to consider some key
factors when investigating this option:
• Choose a vendor who has experience managing through this transition
• Define a clear methodology for transitioning
• Take the long view—consider your outsource partner’s people
• Communicate, Communicate, Communicate
If you are considering a move to outsourced transcription, M*Modal can help.
We invite you to consult with M*Modal as you assess and analyze your options,
the implications for your own organization and the benefits of a structured
transition approach.
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0519© 2019 MModal IP LLC. All rights reserved.
To find out more, visit our website at mmodal.com
or contact us at 866-542-7253.
About M*Modal
Now a part of 3M, M*Modal is a leading healthcare technology provider of advanced clinical documentation
solutions, enabling hospitals and physicians to enrich the content of patient electronic health records (EHR) for
improved healthcare and comprehensive billing integrity. M*Modal also provides advanced cloud-based Speech
Understanding™ technology and data analytics that enable physicians and clinicians to include the context of their
patient narratives into electronic health records in a single step, further enhancing their productivity and the
cost-saving efficiency and quality of patient care at the point of care.