NHS Budget Cuts- How we can help

The transcription of letters and patient notes is a significant budgetary issue for all Trusts. It is an essential service (you have no choice but to generate a letter or note for each clinical interaction) but one that is responsible for a significant part of the departmental budget.

The departmental medical secretaries are often working at full capacity and it is rarely possible to reduce headcount and achieve targeted turnaround times for clinical correspondence: indeed most Trusts have to use expensive temporary staff in order to hit those targets.

However use of DICT8’s UK based medical transcription service can solve these issues. Outsourcing transcription enables movement away from large numbers of band-4 medical secretaries being used inefficiently as well as completely cutting out expensive bank and temporary staff.

On average DICT8 provides a 60% reduction in the cost of medical transcription over existing costs as well as transforming fixed into variable costs.

There is no initial set-up cost (although you will need to have digital dictation machines), monthly minimums or standing fees- you only pay for the transcription that you put through; and you can put through as little or as much work as you require- you keep control.

Why should you outsource your medical transcription?

Financial Benefits

It is becoming increasingly important for Trusts to reduce their clerical budgets- DICT8 have helped over 50 NHS Trusts to do so over the past few years- please contact us to find out how we can help you to do so.

Reduction in cost of medical transcription

• In house medical transcription is financially inefficient – Reduction in overall cost of over 60% is often achievable.
• We can also help you to cut your reliance on expensive temporary agency staff.

Medical Transcription becomes a variable as opposed to fixed cost

• Due to the fact that you would be paying for transcription as it is needed as opposed to paying staff full-time the budgeted fixed cost becomes a variable one.
• Improved cost-efficiency on administrative functions.
• Enables the use of other budgets within the department.

Functional Benefits

Reduce Turnaround times on letters

• We can reduce turnaround times from days/weeks to hours (our average is 2 hours 34 minutes). This has a significant impact on clinical care.
• Improvements in clinical care help to achieve targets. Indeed medical transcription outsourcing is often one of the cheapest, quickest and most straight-forward things that can be done to help achieve the 18 week target.
• Less time is spent by secretaries in dealing with GPs/ patients who are waiting for letters.
• This enables the Trust to achieve targets that are critical for star ratings.

Reduce need for cover staff

• When internal secretaries are on annual leave or sick, there is a need to get temps or bank staff in for cover.
• Cutting out inefficient temp/bank staff provides an instant cost saving. We believe that our costs work out approximately 70% lower than temp staff.

Reduce management pressure to recruit staff

• This occurs for both cover and full-time staff. This has become increasingly important due to the reduction in medical secretaries that are available in the employment market as fewer enter the profession.
• Management resources can be allocated to other areas.

Allows internal staff to change roles to more of a PA role

• Due to the reduction in specialty specific knowledge needed due to typing being outsourced, staff become not only more mobile within the trust (improving efficiency) but it also allows for recruitment of lower pay grade staff in many roles.
• Reduction in the average pay level for administrative staff. NB. this is in addition to the reduction  in overall administrative staff numbers.

Maintain critical functions of staff

• Experienced medical secretaries provide a clinical safety net that cannot be replicated by voice recognition.
• Experienced medical secretaries will always be better than voice recognition, or poorly qualified temps, as they will understand the medical context of the dictation and will spot clinical dication errors and ensure that the letter makes sense- reducing clinical risk.

Benefits over voice recognition

In theory voice recognition is a great idea: it should enable quick and easy transcription of medical dictation. However we believe that there are a number of important benefits that may only be realised by outsourcing work to experienced medical transcriptionists:

 

• Medical secretaries often act as safety nets for their clinicians. Doctors may make mistakes in their dictation (e.g. dosage and other clinical errors), a human secretary will notice, bring them to the attention of the clinician and correct those, whilst a voice recognition computer lacks the common sense and contextual understanding to do so.

• The grammar and general English used in many medical dictations is poor: whilst human transcribers will endeavor to re-order the letter so that it is clear and easy to understand for the recipient, voice recognition will not be able to do so.

• As in all other fields the great advantage that human involvement has over computer automated systems (e.g. voice recognition) is that of common sense! A letter transcribed by a computer program may contain patently absurd phrases whilst a human has the common sense to ensure that the content and context of the transcript make sense.

• In order to use voice recognition effectively it is often necessary to train both the system into the dictating clinician’s voice and also the clinician themselves to dictate in a particular way so that the system understands them. This is not only antagonistic to the clinicians but also causes problems where new or locum staff come into a department.

Benefits for Trusts

The utilisation of DICT8′s transcription outsourcing solution can bring significant benefits to NHS Trusts.

Hospital benefits

• A significant reduction in the turnaround time of dictation tasks from several weeks to just a few hours: increasing administrative efficiency within departments and aiding the attainment of star ratings.
• A significant reduction in the cost of dictation – approximately 50% – will often be achievable.
• Little to no start-up costs.
• Management can audit workflows and usage through their own administrative interface that allows them to see what is happening at any time and control cost.
• DICT8 utilises the skills of experienced UK based transcribers – this can lead to a reduction in the error rates suffered by many Trusts.
• Reduction of managerial pressure to find adequate secretarial coverage, as older secretaries retire and to cover sick days.
• Reduce temporary staff costs.
• Transfer fixed administrative overheads to a variable cost.
• Allow secretarial resources to be diverted to more of an organisational/PA role.
• Established system already in use by other Trusts.
• A secure system that complies with Caldicot, NHS guidelines, e-GIF and the Data Protection Act.
• Extremely low impact on Trust IT systems due to the system being browser based – you can start using the system quickly without IT problems.
• Straightforward integration with existing PAS systems (if required) to enable automatic saving of letters and notes to the patient record and population of letters with addresses etc.

Doctor benefits

• Reduction in turnaround time will enable the doctor to actually remember the consultation when signing the letter.
• Easy to use interface that works with MS Internet Explorer
• Very little change in working practices for staff – hence no retraining required.If you are interested in discovering more about DICT8′s Medical Transcription Outsourcing solution then please contact Dr. Michael Urdang on murdang@dict8.com or contact our sales department.

Why we only use UK Transcribers

At the core of the DICT8 offering is the fact that we only use UK based experienced transcribers.

All of our transcribers have significant experience of working as full time medical secretaries in either NHS Trusts or PCTs. All work done by them is specialty matched: only neurology transcribers do neurology work etc.

On average our transcribers will have 11 years of full time experience within a Trust as medical typists, and it is for this reason that we believe that the quality of typing provided by the DICT8 service is higher than that of any other.

The principle benefits of UK based typing include:

• Higher quality work, especially where medical terms are concerned. This is due primarily to the fact that experienced medical secretaries will understand the context of text within the dictation.
• Less checking required at the Trust end: checking through poor quality work is the hidden cost of medical transcription. If Trust staff have to check through and correct poor quality offshore transcription then it will result in a significant addition to the overall cost to the Trust.
• Reduction in clinical risk: medical secretaries will often act as a safety net for their clinician checking their letters for clinical errors in dictation, hence reducing clinical risk. This can only be replicated by transcribers that understand the context of the letter through extensive experience within that specialty.
• Data security:  CfH has  gone on record to declare that medical data should not go outside of the EU until such time as the regulatory framework has been improved. No medical data leaves the UK in the DICT8 system and is therefore subject to UK data regulations and safeguards- these would be hard to enforce in, say, Asia. There have been many newspaper reports regarding offshore data security such as this expose reported by the Mail on Sunday, this article in the Sunday Times and this one in the Telegraph.
• Lower real costs: whilst the headline rate for offshore transcription may be lower than that of having it done by proper UK medical secretaries, the actual cost is higher. This is due to the fact that if work is being done offshore by inexperienced ‘call centre’ type staff then there will be a significant cost involved in your staff having to check through the work and correct the mistakes made.
• Political issues: outsourcing is always a politically contentious issue. We have found, however, that the greatest fear is that of secretaries jobs going offshore. Due to the fact that DICT8 utilises the skills of transcribers very similar to that of existing staff (and does so within the UK) use of the DICT8 system is often far more acceptable to existing staff. Unison condemns offshoring…

“The extent to which you can move data around will constrain the outsourcing/offshoring. At the NHS we have not crossed the line in terms of data being processed offshore; data will not go outside the European Union until there is a regulatory framework in place.” Richard Granger (whilst DG of IT for NHS)

Medical Transcription implementation process

Implementation of the DICT8 service is surprisingly easy. This is predominantly due to the fact that we use a web-based system so there is no requirement for code to be installed on your organisation’s IT system. As long as you have access to the web, you should be able to use the system.

One of the concerns that people have regarding use of a web-based system is that of security. Our system is secure meeting NPfIT and eGIF standards (we would not have been able to implement in the large number of Trusts that use our service otherwise). Please click here for more information regarding security.

The implementation process is as follows:

1. We discuss your requirements with you. Due to the fact that we only provide UK based Medical Transcription services and have supplied to a large number of Trusts, PCTs, Clinics and Private Practitioners around the country, our experience of various organisational structures and working practices can be of real benefit during this process. The DICT8 system has been built with flexibility in mind- we endeavour to work around you and not get you to work around us.
2. You are assigned a dedicated account manager.
3. We supply you with dictation machines. If required we can supply digital dictation machines, they can be procured elsewhere if required. DICT8 will work with most modern digital dictation machines.
4. We set up your user accounts. This is a straightforward process and can often be done within 24 hours. There is no charge for setting up accounts (and indeed no start up costs other than the purchase of digital dictation machines- if required). Further accounts can be added at any time.
5. We supply manuals and training as required. Your users will also have access to freephone and web support.
6. You start using the system. In most cases implementation will take 48 hours.

The 18-week-wait

Waiting for correspondence to travel between different parts of the healthcare system can add up to six and half weeks to the referral-to-treatment process and can be one of the reasons for missing the 18-week target.

DICT8 can significantly reduce the time taken to type up clinical letters, notes and reports from days or weeks to just hours: this will have a significant impact on the achievement of the 18-week wait.

All transcription work is done by highly experienced UK based medical transcribers, with an average of 11-years NHS experience. Using these skills to clear backlogs and speed up correspondence can achieve a positive effect without hiring extra staff or buying equipment. It’s an easier way of sorting out the target problem than many other systems.

The DICT8 solution has minimal impact on existing systems and working practices: users dictate their letters in the usual fashion and send them to us using our web browser interface (no software installation is required on Trust computers). We then return transcribed letters through the web in a few hours.